In this paper, we put forward the view that emotions have a legitimate and important role in health professional ethics education. This paper draws upon our experience of running a narrative ethics education programme for ethics educators from a range of healthcare disciplines. It describes the way in which emotions may be elicited in narrative ethics teaching and considers the appropriate role of emotions in ethics education for health professionals. We argue there is a need for a pedagogical framework to (...) productively incorporate the role of emotions in health professional ethics teaching. We suggest a theoretical basis for an ethics pedagogy that integrates health professional emotions in both the experience and the analysis of ethical practice, and identify a range of strategies to support the educator to incorporate emotion within their ethics teaching. (shrink)

Background: Visual technologies are central to youth culture and are often the preferred communication means of adolescents. Although these tools can be beneficial in fostering relations, adolescents’ use of visual technologies and social media also raises ethical concerns. Aims: We explored how school public health nurses identify and resolve the ethical challenges involved in the use of visual technologies in health dialogues with adolescents. Research design: This is a qualitative study utilizing data from focus group discussions. Participants and research context: (...) We conducted focus group discussions using two semi-structured discussion guides with seven groups of public health nurses (n = 40) working in Norwegian school health services. The data were collected during January and October 2016. Discussions were audio recorded, transcribed, and coded into themes and subthemes using systematic text condensation. Ethical considerations: The leader of the public health nursing service who agreed to provide access for the study and the Norwegian Center for Research Data that reviewed and approved the study. All participants gave informed consent. Findings: In adolescents’ use of visual materials with public health nurses, ethical concerns were raised regarding suicide ideations, socially unacceptable content, violation of privacy, and presentations of possible child neglect. The nurses utilized their professional knowledge and experience when identifying and navigating these ethical dilemmas; they resolved ethical uncertainties through peer discussion and collaboration with fellow nurses and other professionals. Discussion: We discussed the findings in light of Annemarie Mol’s interpretation of the ethics of care. Mol expands the notion of ethical care to include the action of technologies. Conclusion: Although the increasing use of visual technologies offered benefits, school nurses faced ethical challenges in health dialogues with adolescents. To address and navigate these ethical issues, they relied on their experience and caring practices based on their professional ethics. Uncertainties were resolved through peer dialogue and guidance. (shrink)

In theory, HREC members should use the ethical guidelines in the National Statement on the Ethical Conduct of Research Involving Humans as the basis for their decisions, and researchers should design their research in accordance with these guidelines However, very little is known about what researchers and HREC members actually do in practice. In this paper, we report some of the key findings of the study “Human Research Ethics in Practice”, a qualitative interview-based study of health researchers and HREC members (...) in Victoria. The findings shed light on how researchers and HREC members conceptualise ethics, how they use the National Statement, and what deliberative strategies they employ to assess the ethical appropriateness of research studies. The findings also reveal differences and similarities between health researchers’ and HREC members’ perceptions of the roles of HRECs, and point to some sources of misunderstanding and tension. We examine the implications of some of these findings for the ways in which HRECs carry out their task, and research institutions support and promote ethical conduct in research amongst their staff and students. The focus of this study is on health research, but we suggest that the findings are highly relevant to all other research areas where human participants are involved. (shrink)

The proliferation of digital data and internet-based research technologies is transforming the research landscape, and researchers and research ethics communities are struggling to respond to the ethical issues being raised. This paper discusses the findings from a collaborative project that explored emerging ethical issues associated with the expanding use of digital data for research. The project involved consulting with researchers from a broad range of disciplinary fields. These discussions identified five key sets of issues and informed the development of guidelines (...) orientated to meet the needs of researchers and ethics committee members. We argue that establishing common approaches to assessing ethical risks of research involving digital data will promote consistency in the ethical standards for research, enable the smooth functioning of ethics committees, and sustain public confidence in research. We conclude with recommendations for the development of educational resources for ethics committees, data management guidelines and further public education. (shrink)

Ethical concerns about therapeutic misconception have been raised since the early 1980s. This concept was originally described as research participants' assumptions that decisions relating to research interventions are made on the basis of their individual therapeutic needs. The term has since been used to refer to a range of ‘misunderstandings’ that research participants may have. In this paper, we describe a new concept—therapeutic appropriation. Therapeutic appropriation occurs when patients, or clinicians, actively reframe research participation as an opportunity to enhance patients' (...) clinical care, while simultaneously acknowledging the generalised research aims. To illustrate the concept of therapeutic appropriation, we draw on data from an interview study which we conducted to investigate the experiences of patients and general practitioners involved in clinical trials in primary care. We argue that therapeutic appropriation has two key elements: comprehension that the research project is not necessarily aiming to benefit participants and the deliberate use of incidental features of the research for personal therapeutic benefit of various kinds. We conclude that therapeutic appropriation is a useful concept that refines understanding of potential ethical problems in clinical research, and points to strategies to address them. (shrink)

Visual research is a fast-growing interdisciplinary field. The flexibility and diversity of visual research methods are seen as strengths by their adherents, yet adoption of such approaches often requires researchers to negotiate complex ethical terrain. The digital technological explosion has also provided visual researchers with access to an increasingly diverse array of visual methodologies and tools that, far from being ethically neutral, require careful deliberation and planning for use. To explore these issues, the Symposium on Exploring Ethical Frontiers of Visual (...) Methods was held at the University of Melbourne, Australia, on 4 March 2014. The symposium was hosted by the Visual Research Collaboratory, a consortium of Australian and Canadian visual researchers, with support from Melbourne Social Equity Institute, University of Melbourne. The symposium represented the culmination of a process to develop a resource outlining principles of ethical practice for visual researchers and ethics committee members, the Guidelines for Ethical Visual Research Methods, which were launched at the event. The Guidelines present a framework for considering ethical matters in visual research, distinguishing six groups of issues united by an overarching theme: confidentiality; minimizing harm; consent; fuzzy boundaries; authorship and ownership; and representation and audiences. (shrink)

Clinical work in Alcohol and Other Drugs has not generally been an area of focus for ethicists. Likewise, ethics is not usually part of Alcohol and Other Drugs training or practice. This means that resources available to Alcohol and Other Drugs clinicians navigating ethical challenges are not widely available. This paper describes a systematic review of literature at the intersection of ethics and clinical practice in Alcohol and Other Drugs. The review will potentially benefit Alcohol and Other Drug practitioners by (...) outlining what resources currently available and will also highlight potential directions for future research. The review searched for all published work in ethics at the intersection with Alcohol and Other Drugs. Searches within academic databases, the World Wide Web, and within journal Tables of Contents identified 18 relevant papers from 1985 onwards. An inductive process of categorisation produced two categories of this literature. The first was codes of ethics, further divided into rule-based codes (n = 4) and principle-based codes (n = 10). The second category was of empirical ethics (n = 4). Rule-based codes are not considered useful to practitioners. They can discourage reflection and potential irrelevance of rules. Principle-based codes are more useful, and principles specific to Alcohol and Other Drugs were identified in some literature. Empirical ethics enable the identification of ethics in everyday clinical work, rather than categorising ethics as a special case in particularly challenging circumstances. The four empirical ethics papers describe highly specific situations, guiding practitioners in these areas. This small body of work demonstrates that future research in empirical ethics is of potential benefit to research in ethics and to clinical practice in Alcohol and Other Drugs. (shrink)

ObjectivesTo investigate the views of Human Research Ethics Committee (HREC) members and of researchers concerning the human research ethics review process in Australia.To examine whether there are differences between views of researchers and HREC members.Design and settingRegistrants at the NHMRC Ethics in Human Research Conference held in Canberra in May 2005 were surveyed by anonymous questionnaire comprising 14 questionnaire items and background demographic questions.ResultsOf the 407 registrants, 252 completed the questionnaire (62% response rate). Respondents comprised 219 (87%) HREC members or (...) administrators, and 33 (13%) researchers who were not HREC members. Researchers generally had a less positive attitude to the HREC process than did HREC members. Researchers were less likely to believe that HRECs: make clear and reasonable decisions in an acceptable timeframe; provide informal guidance to researchers; and have the necessary expertise to make appropriate decisions. The largest difference related to relations between researchers and HRECs: 82.5% of HREC members thought relations were good, but only 59.3% of researchers held this view. Despite these differences, both HREC members and researchers held the view that the ethics review process in Australia is working well.ConclusionAlthough our study suggests that both HREC members and researchers are satisfied with the process of human research ethics review in Australia, there are areas of concern that merit further investigation. These include the timeliness and clarity of HREC decisions, the methodological expertise available to HRECs and the basis for HREC decisions. (shrink)

Although there are many possible ways of understanding menopause, it is the notion of menopause as hormone deficiency that currently dominates. How is it that this account remains prevalent rather than some alternative understanding of menopause? This question is explored through the employment of a framework informed by both actor network theory and symbolic interactionist studies. The author exploits the common ground shared by these two conceptual approaches to analyze how practices generate and reify particular kinds of knowledge about menopause. (...) The analysis is situated within Australian menopause clinics and explores several key contemporary practices of these clinics to show how the particular understanding of menopause as hormone deficiency is generated and stabilized. The study stresses the knowledge/practice nexus and emphasizes that meanings are not given in advance but are generated through practices. In particular, the focus is on the interactions of the social and the material entities of menopause clinics and how through these interactions the understanding of menopause as hormone deficiency is produced. (shrink)

Qualitative research is largely dependent on building good interpersonal relations between researcher and participant. This is necessary for generating rich data, while at the same time ensuring respect is maintained between researcher and participant. We argue for a better understanding of researcher–participant relations in research practice. Codes of ethics, although important, do not address these kinds of ethical challenges. Negotiating the ethical relations between researcher and participant is paramount in maintaining ethical rigour in qualitative research. In this paper we propose (...) concepts that can assist in understanding how the ethics of research relations are negotiated in practice; the ‘zone of the untouchable’ from the Danish philosopher, Løgstrup, is combined with the notion of ‘ethical mindfulness’. We argue how and why these concepts in tandem can heighten awareness and offer ways to address the ethically important moments in research. (shrink)