Management consultants and their moral standards and behaviour have been questioned and caricatured, but it is not sufficiently appreciated that they frequently have to operate in situations which are characterized by ambiguity, ignorance, uncertainty and sensitivity and they cannot always simply apply ethical rules in cooperating with their clients. In addition, more attention should be given to the ethics of the client, and “dual ethics” should be a joint concern. Research among consultants and clients has identified several ethical dilemmas (...) frequently experienced by consultants which are explained and explored. Dr Poulfelt is Associate Professor of Management at the Department of Management, Politics and Philosophy at Copenhagen Business School, Blaagaardsgade 23 B, DK‐2200 Copenhagen N, Denmark. (shrink)

The academic literature on management consulting raises many questions about the ethics of management consulting. The uncertain, emergent, and often socially constructed nature of management consultancy knowledge limits the scope both for regulating the industry in the manner of the established professions, and for evaluating management consultants’ work objectively. The character of management consultants is therefore a central issue in how far clients and other stakeholders can trust them. This paper considers three questions, (...) using Aristotle’sNicomachean Ethicsas a guide. These are, first, ‘What is the function of a management consultant?’, second, ‘How should a management consultant act in order to be a good management consultant?’, and third, ‘Where does the boundary lie between the ethical responsibilities of the management consultant and those of the client and other stakeholders?’ Aristotelian virtue ethics are valuable in answering these questions. Their focus on character is well suited to the distinct ethical problems of management consulting. Aristotle’s overarching concern with human flourishing, and an ethically balanced approach towards benefiting from the good things to which a virtuous person may aspire, has more promise as an influence on consultants’ behaviour than the lists of prohibitions that typify codes of ethical practice in the industry. Aristotle’s call for leaders to habituate their people to ethical behaviour should be heard by the leaders of management consultancy firms. In accordance with Aristotle’s philosophy, this paper proposes a positive target at which management consultants can aim in shooting for ethical practice. (shrink)

What happens when management consultants enter the academic arena and offer their services to universities? In the following article, we examine this question by drawing on findings from a qualitative study based on a series of 30 interviews with senior management consultants and academic managers in Germany. The aim of this explorative study is, first of all, to provide theoretically informed observations about the working mechanisms of management consulting in academia. A second, and related objective, is (...) to contribute to the ongoing debate on the changing nature, role, and implications of managerial expertise and authority in higher education institutions. We begin our study by providing an overview of the literature on the changing nature of university management. Although these studies show a shift in the power constellation of universities from professional to managerial authority, we argue that they remain suspiciously vague as concerns the way academics and managers actually deal with this conflicting situation. By drawing on the insights of consulting studies, we then explore the stakes of consultancy in academic change projects and determine the analytical factors that will guide our qualitative analysis. Finally, we present and discuss the findings before concluding with more general remarks on the nature of academic management in German universities. (shrink)

This article is a transcript of an interview with David Shaw, the author of the book, “An Ancient Greek Philosophy of Management Consulting: Thinking Differently about its Assumptions, Principles and Practice”, published with Springer in 2022. It discusses his reasons for looking to the ancient Greek philosophers for new ideas about management consulting, and how his papers for this journal have contributed to the development of the book.

Plato decided that the poets, that is, all creative writers, should be banned from his ideal state. He objected to the claim that they imparted knowledge to their audiences. The poets gave no explanation of the basis for the stories that they told or the conclusions to which those stories led. Plato denied the validity of any claim to knowledge that was not accompanied by an account that justified the claim. Management scholars make comparable objections to management consultants. (...) They argue that consultants use rhetoric and story-telling to persuade clients of their knowledge, when their services often have no foundation in real knowledge. Consultancy knowledge is to a large extent socially constructed, dependent for its status as knowledge on clients’ acceptance of it as such. Consultants often sell their services and persuade clients of their value by appealing to their relevance to passing management fashions and fads. The poets necessarily are susceptible to Plato’s objections, because they are creative artists whose proper business is primarily to entertain rather than to impart knowledge. By contrast, consultants have a clear role in imparting and applying management knowledge. They should respond to management scholars’ objections by shifting their focus ever more sharply towards the technoeconomic contributions that consultants can make to their clients, and away from the use of rhetoric and story-telling to promote their services. (shrink)

This article analyses the relationship between the Belgian government and the national Nuclear Research Centre (SCK CEN) in the renegotiation of the mission and organization of Big Science in Belgium. While the founding decades of nuclear laboratories are often characterized by ever-increasing budgets and the establishment of large infrastructure, I show that downsizing or transforming Big Science demanded a new form of politics on the organization of science. Drawing on archival material, this article will demonstrate how the mission and (...) class='Hi'>management of SCK CEN were critically followed by a variety of stakeholders. Furthermore, the Belgian government explicitly aimed to allow corporate principles to guide the reorganization of the research centre by hiring consultants from Arthur Andersen. This episode in the history of nuclear research invites historians of science to reflect upon both the politics of Big Science in an era in which its original principles were fundamentally questioned and the historical development of new norms and expectations attached to this phenomenon. (shrink)

This paper discusses the diversity of specializations, applications, practices and practitioners of management consulting ; ways in which consultants do, can or should relate to or contribute to the effectiveness of executives and/or specialized staff personnel ; optimization of contribution; advancing the profession as a whole, etc.In situations of great complexity, the creative contributions derived from judgment — when the factual foundations are sound and adequate — can often be especially valuable to clients. The necessary and appropriate foundations (...) for these are also considered; all in connection with the concept of excellence, as inseparable from ethics. (shrink)

A businessperson acts,quabusinessperson, in two institutional contexts which in principle are completely distinct, and normally entail two different ways of relating to other people; on the one hand as an actor in the market, and on the other as the employees’ manager. We shall assume that different sets of norms govern how to relate to trading partners in the market and how to relate to subordinates in the company. The moral problems which arise in the two different institutions for conducting (...) human relations consequently also differ. The main problem relating to market operations originates in the fact that one achieves the most desirable consequences when the objective as such is difficult to justify on moral grounds. Profit is the target, if necessary at the expense of the person one is dealing with. In this context—i.e. in the market—altruistic considerations, or acting out of consideration for the other party, can produce socially undesirable results. The problems confronting the businessperson as manager are of a different nature. We shall not be considering all aspects of management or consultancy ethics, only what we regard as in principle the fundamental problem, one which in fact applies to all management in modern society. (shrink)

Curbside ethics consultations occur when an ethics consultant provides guidance to a party who seeks assistance over ethical concerns in a case, without the consultant involving other stakeholders, conducting his or her own comprehensive review of the case, or writing a chart note. Some have argued that curbside consultation is problematic because the consultant, in focusing on a single narrative offered by the party seeking advice, necessarily fails to account for the full range of moral perspectives. Their concern is that (...) any guidance offered by the ethics consultant will privilege and empower one party’s viewpoint over—and to the exclusion of—other stakeholders. This could lead to serious harms, such as the ethicist being reduced to a means to an end for a clinician seeking to achieve his or her own preferred outcome, the ethicist denying the broader array of stakeholders input in the process, or the ethicist providing wrongheaded or biased advice, posing dangers to the ethical quality of decision-making. Although these concerns are important and must be addressed, we suggest that they are manageable. This paper proposes using conflict coaching, a practice developed within the discipline of conflict management, to mitigate the risks posed by curbside consultation, and thereby create new spaces for moral discourse in the care of patients. Thinking of curbside consultations as an opportunity for clinical ethics conflict coaching can more fully integrate ethics committee members into the daily ethics of patient care and reduce the frequency of ethically harmful outcomes. (shrink)

In order to maximize human performance, defence forces continue to explore, develop, and apply human performance enhancement (HPE) methods, ranging from pharmaceuticals to (bio)technological enhancement. This raises ethical, legal, and societal concerns and requires organizing a careful reflection and deliberation process, with relevant stakeholders. We discuss a range of ethical, legal, and societal aspects (ELSA), which people involved in the development and deployment of HPE can use for such reflection and deliberation. A realistic military scenario with proposed HPE application can (...) serve as a starting point for such an iterative and participatory process. Stakeholders can discuss this application, modify its features, and design appropriate processes around it – for instance, procedures for informed consent. We propose that organizing aspects into these three categories – ethical, legal, and societal – can help involve appropriate interlocutors at different moments: legal aspects with people in strategy or management roles, from the start of a project; ethical aspects with people in operations and medical roles, during development; and societal aspects with people in communication and personnel roles, during deployment. Notably, we developed and discussed this framework and the three aspects in close collaboration with personnel from the military. (shrink)

The increase of scandals in the business sector is forcing many companies to examine their corporate ethical behavior with a view toward rebuilding their corporate value system. This article describes how value-system reconstruction must proceed in a company and demonstrates that corporate ethics can only become plausible if based on a corporate ethical ethos. It outlines a five-step development plan of management strategies toward rebuilding a company's value system on this corporate ethos through: corporate policy and strategy reformulation; corporate (...) ethical code promulgation and value-statement formulation; management ethical training and corporate ethical education; and corporate ethical performance evaluation. The role of the corporate ethical consultant is also outlined to illustrate how corporate ethical consulting can provide the specialized services designed to insure an enduring management ethical upgrading and to improve a company's corporate ethical performance record. The discussion indicates how corporate ethical consulting promotes good business through its capacity to deliver industry credibility and company security. (shrink)

Conflict resolution is a core component of healthcare ethics consultation (HEC) and proficiency in this skill set is recognized by the national bioethics organization and its HEC certification process. Difficult interpersonal interactions between the clinical team and patients or their families are often inexorably connected to the normative disputes that are the catalyst for the consult. Ethics consultants are often required to navigate challenging dynamics that have become entrenched and work with patient-provider or family-provider relationships that have already broken down. (...) The first step in conflict resolution is diagnosing the source of the conflict. Because so many interpersonal and normative conflicts rest on misunderstanding and mischaracterization, the diagnosis of the problem requires untangling the actual positions and perspectives of the conflicting parties from the fallacious assumptions made about the parties’ respective positions and views. Developed in management science, the Ladder of Inference (LOI) is a diagnostic tool for assisting stakeholders in re-examining the process they used to form beliefs about others involved in the conflict. The LOI is a device that detects errors in reasoning, including implicit racial bias, that lead to false judgments and counterproductive responses to those judgments. The LOI is an instrument that can be used by ethics consultants to help resolve contentious bedside conflicts, but the LOI can also be employed as a teaching tool used by healthcare ethics consultants in training the clinical staff in how to avoid such conflicts in the first place. (shrink)

In The Philosophic Consultant, acclaimed business consultant, philosopher, and author Peter Koestenbaum links deep insights of philosophy with practical business issues. Throughout this one-of-a-kind resource, Koestenbaum shows consultants and human resource practitioners how they can foster philosophical leadership within their organizations to positively affect the business environment. The book promises tangible results-- credibility, trust, and thoughtful attention-- and demonstrates how to apply philosophy, share knowledge with others, and use this newfound thoughtfulness to achieve bottom-line results.

This open access book offers four ways to enrich traditional research methods in business ethics. By looking at critical jokes and cartoons on management consultants, their business practice and their clients’ demands, many ethical transgressions in business get addressed. By illustrating and criticizing such transgression, jokes can serve as an example in a theoretical argument, as a prompt to reflect on in an open interview, as a statement to assess in an enquiry or as basis for qualitative content analysis. (...) By adding jokes to the conversation on ethical transgressions in business much depth and honesty can be added, resulting in better research data. Jokes can help to surpass social desirability bias included in answers given in traditional interview settings or enquiries. This book is of interest to consultants, researchers, educators and students in business ethics and management. The book showcases what kind of practical and ethical wisdom is embedded in business jokes and how this knowledge can be made productive in the context of business ethics. (shrink)

Critical evaluations of the current movement of corporate social responsibility commodification have neglected an important question: How do CSR professionals manage the tensions resulting from the search for both profit and social responsibility? This article addresses this question by analyzing the discourse of CSR consultants with the aim of understanding how they deal with such tensions through identity work. Our findings suggest that people who claim, or who are ascribed, paradoxical professional identities may engage in ‘paradoxical identity mitigation’ – a (...) process whereby the concomitant and paradoxical use of linguistic strategies is aimed at simultaneously embracing and distancing oneself from contradictory identity demands. In uncovering how CSR professionals discursively manage the tensions engendered by CSR commodification, our results also advance current knowledge of CSR by shedding light on the underlying processes whereby new ‘hybrid’ identities are constituted and mobilized by actors to make sense of their professional activities. (shrink)

While there is no denying the relevance of ethical knowledge and analytical and cognitive skills in ethics consultation, such knowledge and skills can be overemphasized. They can be effectively put into practice only by an ethics consultant, who has a broad range of other skills, including interpretive and communicative capacities as well as the capacity effectively to address the psychosocial needs of patients, family members, and healthcare professionals in the context of an ethics consultation case. In this paper, I discuss (...) how emotion can play an important interpretive role in clinical ethics consultation and why attention to the role of defense mechanisms can be helpful. I concentrate on defense mechanisms, arguing first, that the presence of these mechanisms is understandable given the emotional stresses and communicative occlusions that occur between the families of patients and critical care professionals in the circumstances of critical care; second, that identifying these mechanisms is essential for interpreting and managing how these factors influence the way that the “facts” of the case are understood by family members; and, third, that effectively addressing these mechanisms is an important component for effectively doing ethics consultation. Recognizing defense mechanisms, understanding how and why they operate, and knowing how to deal with these defense mechanisms when they pose problems for communication or decision making are thus essential prerequisites for effective ethics consultation, especially in critical care. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bioethics ConsultationPat Milmoe McCarrick (bio)(John La Puma, M.D., from the Department of Medicine at Lutheran General Hospital in Chicago, contacted the National Reference Center for Bioethics Literature and suggested bioethics consultation as a topic for the Scope Note Series. He provided an extensive list of citations about ethics consultations collected by him and by David Schiedermayer, M.D., for their new book Ethics Consultation: A Practical Guide.)In Ethics Consultation in (...) Health Care, editors John Fletcher, Norman Quist, and Albert R. Jonsen (I, 1989) define ethics consultation as "the provision of specialized help in identifying, analyzing, and resolving ethical problems that arise in clinical care. In medical ethics the area of consultation has grown rapidly since 1978 when Edmund D. Pellegrino (II, 1978) noted, "we cannot separate technical-moral decisions from the philosophic principles we use to justify them. Medicine and ethics must be engaged with each other at every level."In 1980 Albert Jonsen raised the question of whether an ethicist could be a consultant and said that the ethicist as consultant is a casuist, one whose moral reasoning is based on a system of reasoning that is applied to particular cases. He describes historical casuistry in Western culture, comparing it to modern moral philosophy, and suggests that a "new casuistry seems timely" for ethics consultation (II, Jonsen 1980). By 1984 ethicist Ruth Purtilo recorded her thoughts following an ethics consultation. She raised questions about the ethicist's place on a hospital staff and how to make that role appropriate and beneficial to all concerned, saying that "the ethicist retreats after the consultation; under no circumstances would the outcome of an ethics consultation be that the ethicist became the primary care giver or assumed ongoing responsibility for the clinical management of a case" (II, Purtilo 1984). Nevertheless, in 1992 two physician-ethicists who had been called as ethics consultants for a patient who had requested that he be removed from his ventilator reported that they became the persons who turned off the ventilator and administered the drugs that eased his dying (II, Edwards and Tolle 1992).In recognition of the growing number of persons identifying themselves as [End Page 433] consultants, the Society for Bioethics Consultation was founded in October 1985 as a professional society of persons engaged in bioethics consultation. It encourages and supports consultation, assists in establishing clinical education programs, and raises funds for consultation education. Although the Society has no permanent office, the president (currently, George Kanoti in the Cleveland Clinic Foundation's Bioethics Department) conducts its work and plans an annual meeting.The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) established new criteria concerning ethics in its 1992 Manual (III, JCAHO 1992) and in a special issue of QRB devoted to ethics consultation (I, Defining Quality 1992). These publications undoubtedly have contributed to the increased use of experts in medical ethics. The Manual notes that all organizations seeking accreditation should have some sort of "mechanism for the consideration of ethical issues arising in the care of patients and to provide education to care givers and patients on ethical issues in health care." A health care institution's eligibility for JCAHO accreditation, which is required for federal reimbursement, requires adherence to this specification (III, JCAHO 1992).The new International Directory of Bioethics Organizations provides an index of 129 different groups that indicated to the authors that they offer bioethics consultations. Of these, 83 are in the United States and 46 are in other countries. The ethics consultants included in the directory encompass a broad group of professionals who will assist patients, families, and primary care medical staff in finding solutions to ethical dilemmas resulting from use of new technologies or new treatments in health care. Consultants often come from the health fields: physicians, nurses, and other health personnel, but other professionals are also active as ethics consultants. Lawyers, pastoral counselors, philosophers, and social workers also offer bioethics consultation services (III, Nolen and Coutts 1993).Drs. Siegler, Pellegrino, and Singer wrote in 1990 that "Physician-ethicists and professional ethicists will continue to work side by side in the future. One is not likely to replace the other, nor is this desirable, because... (shrink)

Objective We sought to understand ethics and education needs of emergency nurses and physicians in paediatric and adult emergency departments in order to build ethics capacity and provide a foundation for the development of an ethics education programme. Methods This was a prospective cross-sectional survey of all staff nurses and physicians in three tertiary care EDs. The survey tool, called Clinical Ethics Needs Assessment Survey, was pilot tested on a similar target audience for question content and clarity. Results Of the (...) 123 participants surveyed, 72% and 84% of nurses and physicians fully/somewhat agreed with an overall positive ethical climate, respectively. 69% of participants reported encountering daily or weekly ethical challenges. Participants expressed the greatest need for additional support to address moral distress, conflict management with patients or families and resource issues. Of the 23 reported occurrences of moral distress, 61% were associated with paediatric mental health cases. When asked how the ethics consultation service could be used in the ED, providing education to teams was the most desired method. Conclusions Nurses report a greater need for ethics education and resources compared with their physician colleagues. Ethical challenges in paediatric EDs are more prevalent than adult EDs and nurses voice specific moral distress that are different than adult EDs. These results highlight the need for a suitable educational strategy, which can be developed in collaboration with the leadership of each ED and team of hospital ethicists. (shrink)

The latest research in Spain indicates that the most advanced neuromarketing consulting companies in the sector are those that have been able to innovate in the development of their own technologies and methodologies. Despite their reduced volume of business compared to total investment in Marketing and market research in our country, there are signs that suggest these companies have great potential to improve this sector, which is still to be explored. For this reason, this research straddling the ethnographic method (...) and the theoretical-descriptive method, aims to help us better understand the characteristic features of this sector by actively listening to the professional voices that lead it. Its epistemological value lies in its contribution to understanding the business culture related to the professional development of neuromarketing in our country today. The study shows that the main human resources strategy of neuromarketing consulting companies is based on the creation of multidisciplinary work teams. In addition, most of them develop data analysis software, which they can safeguard under various types of copy right, and on other occasions they manage to patent them, to later apply them to the objectives and purposes of their company. This would also explain the widespread use of certain procedures and resources by the vast majority of the consulting companies investigated. Thus, the trend in the market is the implementation of different synchronization software to the available technological and methodological resources. Others have even gone so far as to create a new technological support to incorporate methodologies already in use. Therefore, this gives them exclusivity in their services and the necessary competitive advantage over their competitors. Among other factors, these inferences about how this sector really works are very likely to be very useful in the academic field, which will constitute a further step in generating critical thinking and in expanding the frontiers of knowledge around this disciplin. (shrink)

How can organisations ‘manage for integrity’?1 Two differing approaches have been called the compliance strategy and the integrity strategy. While the first seeks to instil compliance with externally imposed standards, the integrity strategy seeks to teach ethical decision-making and values as well, so that ‘ethical thinking and awareness…[are]…part of every manager’s mental equipment’. In this paper the Dutch consultant philosopher Hans Bolten reports on how Socratic dialogue has helped managers develop ethical capacities and responsibility. Drawing on research with dialogue members (...) he concludes that organisations that care about ethics cannot rely on abstract moral codes and rules. He argues that they need Socratic dialogue as an instrument if their managers are to shape moral guidelines they both agree upon and can apply in practice. And he shows how dialogue can foster in managers the readiness to give an account of their actions, a readiness implicit in the idea of moral action itself. Thus Socratic dialogue can help create a culture in which morally accountable action is the rule, not the exception, and in which the responsibility to give an account of one’s actions has its rightful place.2. (shrink)

The increasing age of the patient population around the globe and in the United States has resulted in a growing number of patients with dementia. In this manuscript, we examined the role of the ethics consultation service in patients who have dementia and associated cognitive and neuropsychiatric sequelae. We addressed a particularly challenging case presenting with behavioral and psychological symptoms of dementia. We discussed the ethical questions and challenges considered by the ethics consultation service and compared these with current suggestions (...) and expectations from the research literature regarding the role of ethics consultation service in dementia management. We demonstrated two potentially useful approaches of clinical ethical analysis, the principalist theorem and Jonsen's four quadrants approach. While the number of consults in patients with behavioral and psychological symptoms of dementia is likely to increase in clinical ethics, the role of the ethics consultation service in this cohort of patients still remains to be determined. There are significant gaps in understanding of the ethics consultation service role in dementia management, and much work remains to be undertaken on the part of regulatory and healthcare systems in clarifying their roles, expectations, and competencies. (shrink)

Clinical ethical consultants are subject to an unavoidable conflict of interest. Their work requires that they be independent, but incentives attached to their role chip relentlessly at independence. This that they be independent, is a problem without any solution, but it can at least be ameliorated through careful management.

Purpose: The purpose of this article is to examine the unique challenges faced by choir directors in Ghana and provide recommendations for managing and thriving in this context. It aims to highlight the importance of resilience, resourcefulness, and cultural sensitivity in navigating the funding constraints, limited resources, intense competition, and cultural expectations that characterize the Ghanaian choir environment. Methodology: The methodology used in this article is not explicitly stated. However, the recommendations and insights provided are based on a combination of (...) scholarly research, professional experiences, and observations related to choir management in Ghana. The authors gathered data through a literature review, interviews, and observations to understand the challenges faced by choir directors and identify effective strategies for managing them. Findings: The findings of this study suggest that choir directors in Ghana can overcome challenges and contribute to the country's musical heritage by implementing specific strategies. These include seeking diverse funding sources, engaging with local businesses, cultural organizations, and government agencies for financial support, promoting the unique qualities of their choirs, and emphasizing cultural authenticity, repertoire diversity, and innovative performances to attract audiences and sponsors. Recommendations: The theoretical ideas that informed this article's recommendations and the actual experiences that took place in the Ghanaian choir context validated them. The authors likely drew upon their expertise, scholarly research, and consultation with practitioners to develop and validate these recommendations. They should seek diverse funding sources, engage with local businesses and organizations, and promote the unique qualities of their choirs to attract audiences and sponsors. Policymakers are encouraged to support the development and sustainability of choirs in Ghana by recognizing their cultural significance and providing financial and logistical support. Policies that promote the arts, cultural preservation, and community engagement can contribute to the growth and success of choirs. Additionally, policies addressing funding constraints and resource limitations can alleviate some of the challenges faced by choir directors, enabling them to thrive and contribute to Ghana's musical landscape. The article aims to inspire and guide directors in managing choirs in Ghana, highlighting the potential for cultural enrichment and artistic excellence within this unique context. (shrink)

This paper investigates the key drivers behind the origins of value-for-money (VFM) audit in Canada and the aims, intents, and logics ascribed by the original proponents. Drawing on insights from governmentality and New Public Management, the paper utilizes analysis methods adapted from case study research to review a wide range of primary documentation (e.g., Hansards from the Public Accounts Committee, House of Commons debates, the so-called Wilson report and the FMCS study) and secondary documentation (newspaper articles, Office of the (...) Auditor General internal publications, journal articles). Major findings indicate a rise of a management consulting culture within the Auditor General’s office following the appointment of James Johnson Macdonell. VFM legislation effectively operationalized practices drawn from management consulting expertise by invitation of the consultant. It was offered as an answer to the growing scope and size of government, which had become problematized by the Auditor General in terms of parliament losing control over the public purse. The Auditor General’s invocation of financial crisis led to a substantial broadening of mandate and increase in resources for that office. (shrink)

BackgroundTo help inform the development of more accessible, acceptable, and effective ethics consultation (EC) training programs, we conducted an EC training needs assessment, exploring ethics practitioners’ opinions on: the relative importance of various EC practitioner competencies; the potential market for EC training (that is, how many individuals would benefit and how much individuals and hospitals would be willing to pay); and the preferred content, format, and characteristics of EC training.MethodsAs part of a multipart study, we surveyed “best informants” who self-identified (...) as the person most actively involved in EC or healthcare ethics in a random sample of 600 U.S. general hospitals, stratified for bed size.ResultsThe competency that was ranked most important for a lead or solo ethics consultant was knowledge of ethics, while common sense was ranked least important. The median estimated number of individuals at each hospital who would benefit from EC training was six at the basic level, three at the advanced level, and two for EC management training. In 19.1 percent of hospitals, respondents thought their hospital would not be willing to pay anything for EC training within the next two years. Respondents thought potential trainees would be likely to participate in EC training on multiple different topics. Opinions varied widely on preferred formats. Most respondents thought it very important to be able to interact with instructors and with other trainees, practice EC skills, receive a certificate for completing EC training, and complete EC training during work hours.ConclusionsThese findings provide U.S. population data that may be useful to healthcare educators and bioethics leaders in their efforts to develop EC training programs and products that match trainees’ preferences and needs. (shrink)

International health research in malaria-endemic settings may include screening for sickle cell disease, given the relationship between this important genetic condition and resistance to malaria, generating questions about whether and how findings should be disclosed. The literature on disclosing genetic findings in the context of research highlights the role of community consultation in understanding and balancing ethically important issues from participants’ perspectives, including social forms of benefit and harm, and the influence of access to care. To inform research practice locally, (...) and contribute to policy more widely, this study aimed to explore the views of local residents in Kilifi County in coastal Kenya on how researchers should manage study-generated information on sickle cell disease and carrier status. (shrink)

Growing evidence suggests that nurses and other clinicians often feel insufficiently equipped to manage ethical issues that arise in their practice (Truog et al. 2015; Woods 2005; Darmon et al. 201...

This book proposes a review of important Western philosophies and their significance for managers, management academics, and management consultants. It argues that management is an applied philosophical endeavor.

This paper analyzes the relationship between public and private domains in contemporary Danish organizations by examining their increasing focus on the personal health situation of employees, and, more specifically, their body weight. This paper combines literature on identity and management with governmentality-inspired research on risk, morality and the body. The aim of this paper is to show that overweight people are perceived as “risk identities”, i.e. problem people who automatically call for personal management. The author demonstrates that besides (...) the unintended effect of categorizing overweight employees as problem people, this management goal also run counter to the declared value regarding respect for diversity in contemporary organizations. Based on in-depth interviews with managers and recorded talks between health consultants and overweight employees, this paper emphasizes processes that subordinate employees and restrict their autonomy. (shrink)

This research examines the current status of clinical ethics consultation (CEC) in Japan through a nationwide study conducted with chairs of ethics committees and clinical ethics committees among 1028 post-graduate clinical teaching hospitals. We also qualitatively analyzed their viewpoints of the CEC’s benefits and problems related to hospital consultation services to identify the critical points for CEC and inform the development of a correctly functioning system. The questionnaire included structured questions about hospital CEC organization and service purpose and operation and (...) open-ended questions about the benefits and problems of initiating CEC. The questionnaire comprised the presence/absence of an ethics committee, CEC services and membership when services were implemented, users, and the number of cases handled since inception. In addition, the respondents also provided their impressions of the CEC system’s impact on their hospital by describing (a) the benefits of CEC services and (b) the ineffectual or harmful aspects of the CEC system. Qualitative data were examined using qualitative content analysis to determine the impact of establishing a CEC and the difficulties of practice. One hundred twenty-five questionnaires were returned from either the chair of the ethics committee or clinical ethics committee in teaching hospitals. Of these, 90 (72%) reported they provided CEC services. Additionally, 36 respondents (34.6%) reported that their existing research and clinical ethics committees had conducted CEC services, and 35 (33.7%) reported having a newly established clinical ethics committee conducting CEC services. Three positive effects of establishing and four challenges in managing CEC were also identified. (shrink)

PurposeThis paper aims to explore poverty issues in South Africa, to investigate some of the key contributions that knowledge management can make in the eradication of poverty and to suggest a strategy of knowledge management for poverty eradication in South Africa.Design/methodology/approachThis is a conceptual paper. Secondary data sources, in the form of journal articles, policy documents, newspaper articles and the internet, were consulted.FindingsThis paper contributes to the debates on moving towards an integrated poverty strategy that goes beyond reducing (...) poverty by simply raising national income. The paper advocates for a contextualised knowledge management strategy tailored to specific poverty intervention projects and communities. It also suggests that a knowledge management strategy will result in permanent investment in knowledge and the human development of people.Research limitations/implicationsGiven that this is a conceptual paper, the paper recommends empirical future studies that will implement this strategy within specific poverty-stricken communities in the country.Practical/implicationsThe paper raises awareness among policy and decision-makers of the importance of knowledge management as a tool for poverty eradication. In the knowledge economy, knowledge assets – other than the tangible assets of financial capital and local infrastructure – are the prime creator of wealth. It adds to the body of knowledge on knowledge management for poverty eradication by the World Bank and other international organisations.Social implicationsA knowledge management strategy will create an environment in which human development is attained and the minds of the poor are transformed. It will enhance policy formulation and implementation, empower the poor and create a learning organisation.Originality/valueThe paper presents a proposed strategy for knowledge management for poverty eradication in South Africa. (shrink)

Hospitals in many countries have had clinical ethics committees for over 20 years. Despite this, there has been little research to evaluate these committees and growing evidence that they are underutilized. To address this gap, we investigated the question ‘What are the barriers and facilitators nurses and physicians perceive in consulting their hospital ethics committee?’ Thirty-four nurses, 10 nurse managers and 31 physicians working at four Canadian hospitals were interviewed using a semi-structured interview guide as part of a larger (...) investigation. We used content analysis of the interview data related to barriers and facilitators to use of hospital ethics committees to identify nine categories of barriers and nine categories of facilitators. These categories as well as their subcategories are discussed and those specific to nurses or physicians are identified. The need to increase health professionals' use of clinical ethics committees through reducing barriers and maximizing facilitators is discussed. (shrink)

Clinical bioethics is big business. There are now hundreds of people who bioethics in community and university hospitals, nursing homes, rehabilitation and home care settings, and some who play the role of clinical ethics consultant to transplant teams, managed care companies, and genetic testing firms. Still, there is as much speculation about what clinically active bioethicists actually do as there was ten years ago. Various commentators have pondered the need for training standards, credentials, exams, and malpractice insurance for ethicists engaged (...) in clinical consultation. Much of the discussion seems to accept an implicit presumption that all clinical ethics consultation practices look pretty much alike. But is this accurate? What do clinical ethicists do, how and where do they do it, and what kind of clinical ethics is useful in the hospital and in other settings? (shrink)

Managers often ask why their firm should have an ethics program, especially if no one has complained about unethical behavior. The pursuit of business ethics can cost money, they say. It can lose sales to less scrupulous competitors and can drain management time and energy. But as Harvard business professor Francis Aguilar points out, ethics scandals (such as over Beech-Nut's erzatz "apple juice" or Sears's padded car repair bills) can severely damage a firm, with punishing legal penalties, bad publicity, (...) and irreparably injured customer relations. Equally important if less obvious, unethical behavior can undermine a firm's organizational spirit. On the other hand, Aguilar argues, in a well run firm, ethical programs can actually enhance corporate performance, strengthening the company at every level and supercharging employee risk taking and innovation. In Managing Corporate Ethics, Aguilar shows managers how to create ethical programs within their organizations that not only discourage large-scale wrongdoing, but can contribute substantially to the achievement of corporate excellence. Aguilar's program is down-to-earth and comprehensive, and based on his extensive research on highly successful, ethical companies, both large and small. He recommends action on three fronts: first, get senior management to provide effective ethical leadership; second, set up an ethics program that promotes concern for the interests of people affected by the firm's operations and that provides safeguards against corrupting business pressures; and third, staff the company with ethical people and surround the organization with ethical advisors (including legal, financial, accounting, tax, and marketing consultants). To illuminate this three-step program, Aguilar incorporates the lessons learned in his in-depth study of ten prominent firms with proven successful ethics programs--among them Hewlett-Packard, Johnson & Johnson, Nucor Steel, Cray Research, ServiceMaster, and Texas Instruments. He examines Lincoln Electric's attention to compensation and job security to ensure quality products and to reduce the pressure or temptation to act unethically. He shows how General Mills, while pushing product line managers to compete aggressively, uses corporate staff units to guard against illegal or unacceptable claims (testing cake recipes, for example, to see if a product's quality fails under the less-than-perfect conditions of a normal kitchen). And he details how Armstrong World Industries uses pep talks, inspirational stories, role models, and ready access to management to promote ethical standards among employees. Throughout, Aguilar demonstrates convincingly that an ethical program pays dividends: that employees, suppliers, customers, and the community at large know when they are being treated in a positive and constructive manner, and are likely to respond in kind. Packed with real life examples of successful (and failed) ethical programs, Managing Corporate Ethics is a valuable roadmap to an often overlooked source of business success. (shrink)

Organisations face an increasingly competitive and uncertain global environment, after recent experience of unparalleled technological advances and political shifts. Increased dependence on Information Technology (IT) will require appropriate human resource strategies, to develop individuals who will be capable of operating successfully within new organisational structures, with reduced management layers and a requirement for teamworking.This paper presents a university-industry based partnership, revolving around a final year Group Consultancy project, in which undergraduate students work with an external client on a live (...) problem. The project involves the use ofaction research methodology, where academic ideas are applied in the ‘real’ world of business. This is described in the context of group projects, which examine thelegacy system problems faced by three multi-national organisations. (shrink)

In November 2018 the American Society for Bioethics and Humanities (ASBH) administered the first Healthcare Ethics Consultant Certification examination to 138 candidates, 136 of whom (98.5 percent) passed and were “certified” as “healthcare ethics consultants.” I believe this certification process is both premature and inadequate.Certification for ethics consultants is premature because, as Kornfeld and Prager state repeatedly in their article in this issue of The Journal of Clinical Ethics, “The Clinician as Clinical Ethics Consultant: An Empirical Method of Study,” there (...) is a lack of “empirical data on the nature of the problems that prompt ethics consultation requests and on the functions required to address them.” These authors proceed to provide a model for the kind of empirical data collection that is needed.Even more relevant, the ASBH model that certifies clinical ethics consultants is inadequate. First, it is inappropriate for a nonclinical organization such as the ASBH to claim the right to certify a clinical process, ethics consultation, involving patients and health professionals. Second, the current certification process requires only a written examination in contrast to the two-step quality attestation process proposed in 2013 by Eric Kodish, MD, and 11 other senior members of the ASBH, including its then president.Third and most importantly, the eligibility criteria for being certified to work on hospital units and to make clinical recommendations for patients and families are minimal and insufficient. The only stated requirements are a bachelor’s degree and 400 hours of healthcare ethics consulting experience. By contrast, practicing physicians and nurses train for many years to gain clinical experience that enables them to apply clinical ethical standards in the care and management of all inpatients and outpatients, not just the small percent for whom an ethics consultation is requested. (shrink)

In this paper we report a study of the approach of six U.K. water and electricity companies towards managing the relationship with their ''green'' stakeholders. Stakeholders are accorded increasing importance in political discourse and stakeholder theory is emerging as a promising framework for the analysis of corporate social performance.We studied the companies'' general approach towards green stakeholders, their dealings with specific stakeholder groups and whether they emphasised the consultation or the information aspect of stakeholder management. We found that none (...) of the six companies had a systematic stakeholder approach that extended to all potential green stakeholders. Rather, the importance of specific stakeholder groups seemed to be determined by managers'' intuition and by the stance that the stakeholders themselves displayed towards the company. (shrink)

Organizations are increasingly embedded with consultants and other non-employees who have the opportunity to engage in wrongdoing. However, research exploring the reporting intentions of employees regarding the discovery of wrongdoing by consultants is scant. It is important to examine reporting intentions in this setting given the enhanced presence of consultants in organizations and the fact that wrongdoing by consultants changes a key characteristic of the wrongdoing. Using an experimental approach, the current paper reports the results of a study examining employees' (...) reporting intentions subsequent to their discovery of wrongdoing by a consultant. The results of the study indicate that perceptions about the seriousness of a wrongdoing, personal costs and personal responsibility related to reporting a wrongdoing, and moral-equity judgments are significantly associated with reporting intentions for a normal reporting channel. Only perceptions of seriousness and personal costs are significantly associated for an anonymous reporting channel. Lastly, while personal costs for the anonymous reporting channel were lower than the normal reporting channel, reporting intentions were similar across the two channels. (shrink)

In this paper we discuss expected and reported effects on care provider-patient relations of the introduction of electronic patient records (EPRs) in consultation settings by reviewing exemplary studies and literature on the subject from the past decade. We argue that in order for such assessments to be meaningful, talk of effects of “the” EPR needs to be replaced by an “unpacking” of EPR systems into their constituent parts and functionalities, the effects of which need to be assessed individually. Following from (...) this principle, the paper discusses EPR systems ranging from simple data entry and retrieval systems to more sophisticated multi-user and multifunctional on-line systems. On a second level, our analysis of the literature is informed by the question which model of ideal patienthood underlies the assessment of effects of EPRs. To this end, we identify three “models of patienthood” implicit in writing about benefits and drawbacks of EPRs for patients: the autonomy, the consumer, and the holistic models, and argue that assumptions concerning these models need to be reflected upon more critically to improve understanding of what exactly EPR use does to the doctor-patient relationship. (shrink)

Mutual funds are common investments because they provide a cost-effective and effective means to vary your investments (or possess an assortment of securities -- stocks, bonds, etc.) without having to make a huge starting investment.

The purpose of this article is to illustrate the role of sociology in the field of corporate social responsibility (CSR). It presents a case study conducted by a research group consisting of two University partners in association with a Swiss SME. This project attempted to draw conclusions from a specific sociological consultancy research project on the general possibilities and opportunities of sociology in applied research and operational sustainability consulting. On the basis of the project findings, the article reflects on (...) the extent to which sociology could profitably intervene, on the limitations for sociological research and consultations in this field and on the conclusions that can be drawn for future analyses. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Managing the Transition from Patient-Centered Care to ProtocolDavid SlakterI learned that I would need a kidney transplant in the summer of 2015. This was not a complete surprise to me, as I had been subjected to a number of tests and invasive procedures to investigate nephritis since I was a child. I had heard similar stories of clinicians performing repeated tests on my father for similar reasons without any (...) conclusions. Following my recommendation for transplant and consultation with genomics specialists, the cause of my kidney failure was determined to be Alport syndrome. What made Alport syndrome so difficult to diagnose in my case was that the associated mutation is a rare, autosomal-dominant one that has only recently been associated with the condition.After reviewing the data on survival rates for transitioning to dialysis versus a transplant, my family and I then considered the success rates for living versus cadaver donors, and the success rates at various transplant centers. The current data favor the long-term outcomes of transplant over dialysis and living over cadaver donors. Since we had decided to focus on searching for a live donor, my nephrologist recommended contacting Renewal, an organization that specializes in connecting those in need of a kidney transplant with live donors and providing support for donors to make the donation process less burdensome.On Renewal’s recommendation, my family and friends reached out across their social networks to search for potential donors. Many of those tested for compatibility were eliminated on basic matching criteria, others due to previously undiagnosed medical problems. Finally, the wife of a childhood friend came forward as an eligible donor and was also an incredibly close match on the antigens tested for kidney transplants.Having a living donor who was also a friend made the transplant experience somewhat less intimidating than it might have been. It meant the transformation of an existing relationship with someone already close to me, with fewer open questions about what may have motivated them to be so generous than if the donor had been someone I did not know. It also meant our families could be together in the waiting room, and that we shared in each other’s recoveries.Life post-transplant has been a significant improvement from what it was like immediately beforehand. Before my transplant, I regularly weighed food and consulted nutrition charts to gauge how much potassium I was consuming. To prevent too much potassium from building up in my bloodstream, I had to take sodium polystyrene [End Page 111] regularly. As one might guess from the name, it tastes much like burnt Styrofoam, and I could only ingest it with copious amounts of fruit-flavored syrup (strawberry covered up the awful flavor the best). There are other potassium binders on the market now, so fewer people with kidney failure will likely need to engage in such gustatory experimentation.I was also able to engage in more activities than what was possible even years before my transplant. I had long experienced difficulty with aerobic exercises, but assumed the reason was merely being out of shape. Though I have always walked regularly, even the one-mile walk from my office to my apartment had become a chore by the end. Within a few months after my transplant, I was riding a bicycle all over NYC, from Harlem to Brooklyn and back regularly, and hiking trails in nearby state parks. I began sessions with a personal trainer and attained a level of fitness I had not reached since I played soccer as a child.The transition from personalized care to one more driven by protocol has been a surprising and challenging aspect of the transplant process. While my previous experience with medical treatment has been individual meetings with physicians, my post-transplant care is managed by a team of nephrologists and other specialists in transplant care. My initial transplant nephrologist was automatically assigned to me. Because the standard of care for transplant patients is often driven by protocol, my assigned nephrologist recommended a biopsy on my transplanted kidney due to results in my recent lab tests. When pressed on the necessity of a biopsy in my case versus... (shrink)

Background Nurses experience moral distress when they cannot do what they believe is right or when they must do what they believe is wrong. Given the limited mechanisms for managing ethical issues for nurses in Japan, an Online Ethics Consultation on mental health (OEC) was established open to anyone seeking anonymous consultation on mental health practice. Research objective To report the establishment of the Online Ethics Consultation and describe and evaluate its effectiveness. Ethical considerations The research was conducted in accordance (...) with the Declaration of Helsinki. Research design This evaluation describes the outcomes of 5 years of operation of the Online Ethics Consultation on mental health in Japan Participants The Online Ethics Consultation received 12 emails requesting consultation. Consultees included mental health nurses, psychiatrists, and service users. Findings The most common questions directed to the service were about seclusion and physical restraint. Response time from receipt of email to sending a reply was between 1 and 14 days. Despite the disappointing number of consultations, feedback has been positive. Discussion The Online Ethics Consultation was established to assist morally sensitive nurses in resolving their ethical problems through provision of unbiased and encouraging advice. Mental health care in Japan has been less than ideal: long-term social hospitalization, seclusion, and restraint are common practices that often lead to moral distress in nurses and the questions received reflected this. The head of the Online Ethics Consultation sent a supportive, facilitative response summarizing the opinions of several consultants. Conclusion This study provides key information for the establishment of an online ethics resource the adoption of which has the potential to improve the experience of nurses, allied health and clients of mental health services. This paper has implications for services concerned with improving patient care, managing nurses’ moral distress, building ethics into decision-making. (shrink)