Background: Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas. Aims: To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice. Design: An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general (...) hospital in England were interviewed, using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification. Participants and context: Participants were interviewed about their contribution to the resolution of ethical dilemmas within the context of working in an acute hospital ward. Participants were recruited from all settings working with patients of any age and any diagnosis. Ethical considerations: Ethical approval was obtained from the local National Research Ethics Committee. Findings: Four major themes emerged: ‘best for the patient’, ‘accountability’, ‘collaboration and conflict’ and ‘concern for others’. Moral distress was also evident in the literature and findings, with moral dissonance recognised and articulated by more experienced nurses. The relatively small, single-site sample may not account for the effects of organisational culture on the results; the findings suggested that professional relationships were key to resolving ethical dilemmas. Discussion: Nurses use their moral reasoning based on their beliefs and values when faced with ethical dilemmas. Subsequent actions are mediated though ethical decision-making frames of reference including deontology, consequentialism, the ethics of care and virtue ethics. Nurses use these in contributing to the resolution of these dilemmas. Nurses require the skills to develop and maintain professional relationships for addressing ethical dilemmas and to engage with political and organisational macro- and micro-decision-making. Conclusion: Nurses’ professional relationships are central to nurses’ contributions to the resolution of ethical dilemmas. (shrink)

This article describes the unauthorized uses of a coauthored work and a copyrighted U.S. dissertation by European scientists. The case involves alleged infringements of copyright and plagiarism in 6 works that were published up to 19 years after completion of the dissertation and up to 11 years after publication of the coauthored work. Relevant copyright laws, international copyright agreements, and professional psychology ethics and definitions of scientific misconduct are presented. Graduate students and professionals are advised to protect themselves from copyright (...) infringement and recognize that the responsibility for detecting and correcting misappropriated work usually lies with them, not journal editors. (shrink)

Western stereotypes often characterize gender relations in Muslim-majority societies as uniformly traditional and patriarchal. Underlying this imagery is a unidimensional understanding of gender ideology as moving along a single traditional-to-egalitarian continuum. In this study, we interrogate these assumptions by exploring variability across and within Middle Eastern, North African, and South Asian (MENASA) societies in beliefs related to two regionally salient gender principles: women’s chastity and marital patriarchy. Data from a new online survey of Muslim Facebook users show substantial heterogeneity across (...) and within six MENASA societies in support for these principles. These data also reveal a multidimensional structure, in that societies show different configurations of chastity and marital patriarchy beliefs, and each of these gender principles is influenced by respondents’ religious beliefs and gender status in different ways. Although religious absolutism predicts agreement with both gender principles, piety is associated with support for chastity but not for marital patriarchy. Results also show a clear gender divide in attitudes toward hierarchy in marriage but not with respect to chastity. Findings complicate broad-brush depictions of patriarchy in the region and corroborate previous research on the multidimensionality of gender beliefs and the multifaceted attitudinal influences of gender and religious beliefs. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This longitudinal study was in the main concerned with the relationship between developmental maturity (in the physiological sense) and attitude to school science, among a group of secondry school children. The sample consisted of 269 boys and girls in a midland secondary school. They were administered a non?verbal intelligence test, a Piagetian conceptual development test, and an attitude to school science scale, in the first and second years. In the fifth year they were again administered the attitude to school science (...) scale. On the basis of the onset of menstruation, the girls were divided into early, normal and late developers. The results showed that between the second and fifth years, attitudes to school science became more negative??this applied to both boys and girls, but it was more marked in the case of the girls. It was also found that in the first and second years of the study, early maturing girls showed significantly more negative attitudes to school science, but that by the fifth year, early and late maturing girls were showing equally negative attitudes to this subject. Although the normal developers shared in the general decline in attitudes between the second and fifth years, their reactions to school science were less unfavourable throughout. The implications of these findings are discussed at length within the framework of current reserch and theory in this area. (shrink)

This article delineates two dimensions along which computational models of face processing may vary, and briefly review three such models, the Dailey and Cottrell model; the O'Reilly and Munakata model; and the Riesenhuber and Poggio. It focuses primarily on one of the models and shows how this model is used to reveal potential mechanisms underlying the neural processing of faces and objects—the development of a specialized face processor, how it could be recruited for other domains, hemispheric lateralization of face processing, (...) facial expression processing, and the development of face discrimination. It turns to the Riesenhuber and Poggio model to describe the elegant way it has been used to predict functional magnetic resonance imaging data on face processing. The overall strategy of these modeling efforts is to sample problems that are constrained by neurophysiological and behavioral data, and to stress the ways in which models can generate novel hypotheses about the way humans process faces. (shrink)

In this paper, we examine the practicalities of nurse managers’ work. We expose how managers’ commitments to transformational leadership are undermined by the rationing practices and informatics of hospital reform underpinned by the ideas of new public management. Using institutional ethnography, we gathered data in a Canadian hospital. We began by interviewing and observing frontline leaders, nurse managers, and expanded our inquiry to include interviews with other nurses, staffing clerks, and administrators whose work intersected with that of nurse managers. We (...) learned how nurse managers’ responsibility for staffing is accomplished within tightening budgets and a burgeoning suite of technologies that direct decisions about whether or not there are enough nurses. Our inquiry explicates how technologies organize nurse managers to put aside their professional knowledge. We describe professionally committed nurse leaders attempting to activate transformational leadership and show how their intentions are subsumed within information systems. Seen in light of our analysis, transformational leadership is an idealized concept within which managers’ responsibilities are shaped to conform to institutional purposes. (shrink)

This paper proceeds from examining the debate regarding the question of whether a systematic literature review should be undertaken within a qualitative research study to focusing specifically on the role of a literature review in a phenomenological study. Along with pointing to the pertinence of orienting to, articulating and delineating the phenomenon within a review of the literature, the paper presents an appropriate approach for this purpose. How a review of the existing literature should locate the focal phenomenon within a (...) given context is illustrated by excerpts from the first author’s literature review within a descriptive phenomenological study. Also discussed is the important issue of when the researcher should fully enter the attitude of the phenomenological reduction and how this may influence the study. (shrink)

Student cheating and reporting of that cheating represents one form of organizational wrong-doing and subsequent whistle-blowing, in the context of an academic organization. Previous research has been hampered by a lack of information concerning the validity of survey responses estimating the incidence of organizational wrongdoing and whistle-blowing. An innovative method, the Randomized Response Technique (RRT), was used here to assess the validity of reported incidences of wrongdoing and whistle-blowing. Surprisingly, our findings show that estimates of these incidences did not vary (...) significantly when RRT questionnaire results were compared to those obtained from standard surveys. In fact, a large number of business undergraduates admitted cheating while only a small percentage reported peers'' cheating when they observed it. These results should be sobering for managers and their implications are considered in some detail. (shrink)

Crisis demands -- Crisis narratives -- Crisis: refrain!

This is an excellent article, probably the best there is in defence of prohibiting the sale of organs, and it deserves a much fuller discussion of detail than there is space for here.1 My concerns, however, are with generalities rather than detail. Although some such argument might justify prohibition of organ selling in particular places and at particular times, it is difficult to see how it could support the kind of general, universal policy currently accepted by most advocates of prohibition.Whenever (...) the subject of organ selling is discussed, it is useful to keep in mind the natural history of the debate. Prohibition was instituted by most governments and professional bodies just about as quickly as possible after it was discovered that payment for kidneys was going on, and was a direct response to feelings of moral outrage. It all happened without time for debate. It was only later, as challenges appeared, that justifications began to be produced; and when they did they followed a pattern long familiar to philosophers, and more recently recognised by moral psychologists, of determined efforts to find a justification for the initial intuition that organ selling must be wrong. New arguments kept appearing in the cause as earlier attempts were shown to fail, and many were so weak that they could not have seemed plausible unless their advocates had already been committed to their conclusion. This does not mean, of course, that a good justification could never be produced. It does, however, suggest a widespread feeling that organ selling must be intrinsically …. (shrink)

Efforts to professionalize the field of bioethics have led to the development of the Healthcare Ethics Consultant-Certified (HEC-C) Program intended to credential practicing healthcare ethics consultants (HCECs). Our team of professional ethicists participated in the inaugural process to support the professionalization efforts and inform our views on the value of this credential from the perspective of ethics consultants. In this paper, we explore the history that has led to this certification process, and evaluate the ability of the HEC-C Program to (...) meet the goals it has set forth for HCECs. We describe the benefits and weaknesses of the program and offer constructive feedback on how the process might be strengthened, as well as share our team’s experience in preparing for the exam. (shrink)

Background: Improved techniques and life sustaining technology in the neonatal intensive care unit have resulted in an increased probability of survival for extremely premature babies. The by-product of the aggressive treatment is iatrogenic pain, and this infliction of pain can be a cause of suffering and distress for both baby and nurse. Research question: The research sought to explore the caregiving dilemmas of neonatal nurses when caring for extremely premature babies. This article aims to explore the issues arising for neonatal (...) nurses when they inflict iatrogenic pain on the most vulnerable of human beings – babies ≤24 weeks gestation. Participants: Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia. Ethical consideration: Ethical processes and procedures set out by the ethics committee have been adhered to by the researchers. Findings: A qualitative approach was used to analyse the data. The theme ‘inflicting pain’ comprised three sub-themes: ‘when caring and torture are the same thing’, ‘why are we doing this!’ and ‘comfort for baby and nurse’. The results show that the neonatal nurses were passionate about the need for appropriate pain relief for extremely premature babies. Conclusion: The neonatal nurses experienced a profound sense of distress manifested as existential suffering when they inflicted pain on extremely premature babies. Inflicting pain rather than relieving it can leave the nurses questioning their role as compassionate healthcare professionals. (shrink)

Background: The ability to save the life of an extremely premature baby has increased substantially over the last decade. This survival, however, can be associated with unfavourable outcomes for both baby and family. Questions are now being asked about quality of life for survivors of extreme prematurity. Quality of life is rightly deemed to be an important consideration in high technology neonatal care; yet, it is notoriously difficult to determine or predict. How does one define and operationalise what is considered (...) to be in the best interest of a surviving extremely premature baby, especially when the full extent of the outcomes might not be known for several years? Research question: The research investigates the caregiving dilemmas often faced by neonatal nurses when caring for extremely premature babies. This article explores the issues arising for neonatal nurses when they considered the philosophical and ethical questions about quality of life in babies ≤24 weeks gestation. Participants: Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia. Ethical considerations: Ethical processes and procedures have been adhered to by the researchers. Findings: A qualitative approach was used to analyse the data. The theme ‘difficult choices’ was generated which comprised three sub-themes: ‘damaged through survival’, ‘the importance of the brain’ and ‘families are important’. The results show that neonatal nurses believed that quality of life was an important consideration; yet they experienced significant inner conflict and uncertainty when asked to define or suggest specific elements of quality of life, or to suggest how it might be determined. It was even more difficult for the nurses to say when an extremely premature baby’s life possessed quality. Their previous clinical and personal experiences led the nurses to believe that the quality of the family’s life was important, and possibly more so than the quality of life of the surviving baby. This finding contrasts markedly with much of the existing literature in this field. Conclusion: Quality of life for extremely premature babies was an important consideration for neonatal nurses; however, they experienced difficulty deciding how to operationalise such considerations in their everyday clinical practice. (shrink)