The study aimed to explore the subjective need of healthcare professionals for ethics consultation, their experience with ethical conflicts, and expectations and objections toward a Clinical Ethics Committee. Staff at a university hospital took part in a survey (January to June 2010) using a questionnaire with open and closed questions. Descriptive data for physicians and nurses (response rate = 13.5%, n = 101) are presented. Physicians and nurses reported similar high frequencies of ethical conflicts but rated the relevance of ethical (...) issues differently. Nurses stated ethical issues as less important to physicians than to themselves. Ethical conflicts were mostly discussed with staff from one’s own profession. Respondents predominantly expected the Clinical Ethics Committee to provide competent support. Mostly, nurses feared it might have no influence on clinical practice. Findings suggest that experiences of ethical conflicts might reflect interprofessional communication patterns. Expectations and objections against Clinical Ethics Committees were multifaceted, and should be overcome by providing sufficient information. The Clinical Ethics Committee needs to take different perspectives of professions into account. (shrink)

Background: Clinical ethics committees have been broadly implemented in university hospitals, general hospitals and nursing homes. To ensure the quality of ethics consultations, evaluation should be mandatory. Research question/aim: The aim of this article is to evaluate the perspectives of all people involved and the process of implementation on the wards. Research design and participants: The data were collected in two steps: by means of non-participating observation of four ethics case consultations and by open-guided interviews with 28 participants. Data analysis (...) was performed according to grounded theory. Ethical considerations: The study received approval from the local Ethics Commission (registration no.: 32/11/10). Findings: ‘Communication problems’ and ‘hierarchical team conflicts’ proved to be the main aspects that led to ethics consultation, involving two factors: unresolvable differences arise in the context of team conflicts on the ward and unresolvable differences prevent a solution being found. Hierarchical asymmetries, which are common in the medical field, support this vicious circle. Based on this, minor or major disagreements regarding clinical decisions might be seen as ethical conflicts. The expectation on the clinical ethics committee is to solve this (communication) problem, but the participants experienced that hierarchy is maintained by the clinical ethics committee members. Discussion: The asymmetrical structures of the clinical ethics committee reflect the institutional hierarchical nature. They endure, despite the fact that the clinical ethics committee should be able to detect and overcome them. Disagreements among care givers are described as one of the most difficult ethically relevant situations and should be recognised by the clinical ethics committee. On the contrary, discussion of team conflicts and clinical ethical issues should not be combined, since the first is a mandate for team supervision. Conclusion: To avoid dominance by physicians and an excessively factual character of the presentation, the case or conflict could be presented by both physicians and nurses, a strategy that strengthens the interpersonal and emotional aspects and also integrates both professional perspectives. (shrink)

The Principles of Fair Information Practice are almost three decades old and need to be broadened to take account of new technologies for collecting personal information such as drug testing, video cameras, electronic location monitoring and the internet. I argue that the ethics of surveillance activity must be judged according to the means, the context and conditions of data collection and the uses/goals and suggest 29 questions related to this. The more one can answer these questions in a way that (...) affirms the underlying principle the more ethical the use of a tactic is likely to be. Four conditions are identified which, when breached, are likely to violate an individual's reasonable expectation of privacy. Respect for the dignity of the person is a central factor and emphasis is put on the avoidance of harm, validity, trust, notice and permission when crossing personal borders. (shrink)

The study aimed to explore the subjective need of healthcare professionals for ethics consultation, their experience with ethical conflicts, and expectations and objections toward a Clinical Ethics Committee. Staff at a university hospital took part in a survey (January to June 2010) using a questionnaire with open and closed questions. Descriptive data for physicians and nurses (response rate = 13.5%, n = 101) are presented. Physicians and nurses reported similar high frequencies of ethical conflicts but rated the relevance of ethical (...) issues differently. Nurses stated ethical issues as less important to physicians than to themselves. Ethical conflicts were mostly discussed with staff from one’s own profession. Respondents predominantly expected the Clinical Ethics Committee to provide competent support. Mostly, nurses feared it might have no influence on clinical practice. Findings suggest that experiences of ethical conflicts might reflect interprofessional communication patterns. Expectations and objections against Clinical Ethics Committees were multifaceted, and should be overcome by providing sufficient information. The Clinical Ethics Committee needs to take different perspectives of professions into account. (shrink)

. Under‐the‐covers undercover investigations: Some reflections on the state's use of sex and deception in law enforcement. Criminal Justice Ethics: Vol. 11, No. 1, pp. 13-24.

In discussions on the ethics of surveillanceand consequently surveillance policy, thepublic/private distinction is often implicitlyor explicitly invoked as a way to structure thediscussion and the arguments. In thesediscussions, the distinction public and private is often treated as a uni-dimensional,rigidly dichotomous and absolute, fixed anduniversal concept, whose meaning could bedetermined by the objective content of thebehavior. Nevertheless, if we take a closerlook at the distinction in diverse empiricalcontexts we find them to be more subtle,diffused and ambiguous than suggested. Thus,the paper argues (...) for the treatment of thesedistinctions as multi-dimensional, continuousand relative, fluid and situational orcontextual, whose meaning lies in how they areinterpreted and framed. However, the aim ofthis paper is not to finally sort things out. The objective is rather to demonstrate thecomplexities of the distinction in variouscontexts and to suggest that those using thedistinction, when considering the ethics andpolitics of surveillance technologies, wouldbenefit from more clearly specifying whichdimensions they have in mind and how theyrelate. (shrink)