The paper questions the effectiveness of the United Kingdom Central Council's (UKCC's) Code of Professional Conduct upon the moral climate of nursing. It challenges the claim that the empowerment of nurses is significantly enhanced by the Code or that it necessarily makes them more accountable for their practice. The position is taken that the Code, in the absence of an effective support network for whistle-blowers, places an unreasonable burden upon nurses in its exhortations to report unprofessional conduct. The paper (...) acknowledges the need to retain the Code, but with more modest claims being made concerning its empowering qualities. It is argued that unless more attention is focused on ways to support potential whistle-blowers, the Code will come to be seen as an irrelevance. Cet article met en question l'effet du Code du UKCC sur le climat moral des soins infirmiers. Il conteste l'affirmation que les infirmiers/ères sont considérablement plus fort à cause du Code ou qu'il les rend plus responsables dans leur pratique. La position est prise que le Code, en l'absence d'un réseau efficace de soutien pour les 'Whistleblowers' (personnes qui dévoilent un système), met un fardeau excessif sur les infirmiers/ères dans ses exhortations de signaler une conduite contraire au Code professionnel. Cet article reconnâit la nécessité de retenir le Code, mais avec des demandes plus modestes concernant ses pouvoirs de rendre fort. Il est soutenu que si non plus d'attention est concentré sur les moyens de soutenir les 'Whistlebowers', le Code va devenir hors de propos. Dieser Artikel bezweifelt die Wirksamkeit des Kodex des UKCC über das moralische Klima der Krankenpflege. Er stellt die Behauptung in Frage, dass der Kodex das Pflegepersonal bedeutend ermächtigt, oder dass er es mehr verantwortlich macht für seine Praxis. Die Position ist hier, dass der Kodex, in der Abwesenheit von effektiver Unterstützung für 'Whistleblowers' (d.h. Leute, die ein System verpfeifen), zu viel vom Pflegepersonal verlangt, in seiner Ermahnung, berufswidrige Praxis zu melden. Dieser Artikel anerkennt die Notwendigkeit, den Kodex zu behalten, aber mit kleineren Ansprüchen für seine ermächtigenden Qualitäten. Wenn nicht mehr Aufmerksamkeit gelegt wird, auf welche Weise die 'Whistleblowers' unterstützt werden können, dann wird der Kodex als eine Nebensächlichkeit verurteilt. (shrink)

(2004). From an Exercise in Professional Etiquette to Society's Wish List? Review of American Medical Association, Code of Medical Ethics: Current Opinions with Annotations. The American Journal of Bioethics: Vol. 4, No. 2, pp. 69-70. doi: 10.1162/152651604323097907.

There is a belief that exercise has a major role to play in the current health and wellbeing agendas. Consequently, health interventions are implemented based upon the recommendations of the ACSM and similar exercise research organizations. However this development has been challenged through both social and political perspectives. Specifically accusations of medicalization have been raised against the increasing relationship between the exercise and medical domains. The purpose of this article is to present a similar critique of the (...) growing emergence of a medical paradigm within the exercise domain. In this instance the focus will examine the relationship between exercise professional, exercise science and the proposed medical paradigm. Through the use of philosophical essay and systematic review of literature, it is argued that a continuing shift by exercise science to mirror the medical paradigm will cause a number of issues and potential hazards in the working practices of its professionals. (shrink)

The paper describes two practical exercises (and their learning outcomes) requiring students to consider certain concrete decisions made by managers in business and professional life. The first exercise requires students to consider that competitive economic exchange inevitably puts managers in situations where they cannot accurately predict the outcomes of their decisions, and often results in harm to innocent people. In this practical exercise, seven discussion situations are described and students are asked to make decisions that take into (...) account the individuals affected by these managerial decisions. Students are asked to consider various ethical theories and devise creative solutions so as to avoid unnecessary harm. The second exercise places students in roles that represent shareholders and stakeholders and asks them to consider the relocation of a manufacturing company to their community. (shrink)

Nursing professionalization is both ongoing and global, being significant not only for the nursing workforce but also for patients and healthcare systems. For this reason, it is important to have an in‐depth understanding of this process and the factors that could affect it. This literature review utilizes a welfare state approach to examine macrolevel structural determinants of nursing professionalization, addressing a previously identified gap in this literature, and synthesizes research on the relevance of studying nursing professionalization. The use of a (...) welfare state framework facilitates the understanding that the wider social, economic, and political system exercises significant power over the distribution of resources in a society, providing a glimpse into the complex politics of health and health care. The findings shed light on structural factors outside of nursing, such as country‐level education, health, labor market, and gender policies that could impact the process of professionalization and thus could be utilized to strengthen nursing through facilitating increased professionalization levels. Addressing gender inequalities and other structural determinants of nursing professionalization could contribute to achieving health equity and could benefit health systems through enhanced availability, skill‐level, and sustainability of nursing human resources, improved and efficient access to care, improved patient outcomes, and cost savings. (shrink)

The World Medical Association (WMA), the global representation of the medical profession, first adopted the International Code of Medical Ethics (ICoME) in 1949 to outline the professional duties of physicians to patients, other physicians and health professionals, themselves and society as a whole. The ICoME recently underwent a major 4-year revision process, culminating in its unanimous adoption by the WMA General Assembly in October 2022 in Berlin. This article describes and discusses the ICoME, its revision process, the controversial and (...) uncontroversial issues, and the broad consensus achieved among WMA constituent members, representing over 10 million physicians worldwide. The authors analyse the ICoME, including its response to contemporary changes and challenges like ethical plurality and globalisation, in light of ethical theories and approaches, reaching the conclusion that the document is a good example of international ethical professional self-regulation. (shrink)

Professionalization of farmers and rural entrepreneurs is identified as a potential resource to advance transition to multifunctional landscapes and territorial development. Drawing on interactive conceptions of knowledge creation and technical change, I argue that collective structures that support pooling of experiential knowledge can complement public and private sector engagement in innovation systems. Through exercise of leadership in advancing integration of farming into regional development and in integrating ecological and social concerns into agriculture, farmers can forge a professional identity (...) and broker a new social contract entitling them to renewal of their political and economic status. (shrink)

Manuscript based on address delivered February, 1998 at the Annual Meeting of the Association of Practical and Professional Ethics, Dallas, Texas.

Exercise psychology encompasses the disciplines of psychiatry, clinical and counseling psychology, health promotion, and the movement sciences. This emerging field involves diverse mental health issues, theories, and general information related to physical activity and exercise. Numerous research investigations across the past 20 years have shown both physical and psychological benefits from physical activity and exercise. Exercise psychology offers many opportunities for growth while positively influencing the mental and physical health of individuals, communities, and society. However, the (...) exercise psychology literature has not addressed ethical issues or dilemmas faced by mental health professionals providing exercise psychology services. This initial discussion of ethical issues in exercise psychology is an important step in continuing to move the field forward. Specifically, this article will address the emergence of exercise psychology and current health behaviors and offer an overview of ethics and ethical issues, education/training and professional competency, cultural and ethnic diversity, multiple-role relationships and conflicts of interest, dependency issues, confidentiality and recording keeping, and advertisement and self-promotion. (shrink)

Through a witty and engaging style, this book is for anyone who has a job (employees, managers, and leaders), and who wants to do the right thing, but aren't always sure what that means, how to go about it, or how to withstand the forces that push all of us away from being ethical. By poking fun at the ironies and hypocrisies of human behavior, Exercising Your Ethics prompts readers to leverage techniques that can help us become more deliberate about (...) choosing value-driven actions. In a world that seems to reward winning, regardless of how it is achieved, we need a clearer reason for wanting to be and become our best selves. This approach to business ethics is innovative, fresh, and evocative in that the serious subject is treated in an informal and adventurous manner, poking fun at the ironies and hypocrisies of human behavior. Readers will see how our race to achieve quarterly profits, combined with a self-indulgent consumption-based economy, has shaped our entire lives. Readers will delight in the book's humor, as the ironies of human interaction prompt introspection to consider how to better equip oneself with the knowledge, tools, and techniques to engage in and support others in the path to moral action at work. Bringing Ethics to Work explains business ethics in a way that is engaging, understandable and enables the reader to recognise behaviors in themselves and others. It is ideal for adult education (students in undergraduate, Masters, or professional degree programs) and training within organizational settings (employees, management, and future leaders). HR professionals, team leaders, professional coaches, and organizational ethics trainers will find the book particularly insightful and useful. (shrink)

This paper proposes that billing gamesmanship occurs when physicians free-ride on the billing practices of other physicians. Gamesmanship is non-universalizable and does not exercise a competitive advantage; consequently, it distorts prices and allocates resources inefficiently. This explains why gamesmanship is wrong. This explanation differs from the recent proposal of Heath (2020. Ethical issues in physician billing under fee-for-service plans. J. Med. Philos. 45(1):86–104) that gamesmanship is wrong because of specific features of health care and of health insurance. These features (...) are aggravating factors but do not explain gamesmanship’s primary wrong-making feature, which is to cause diffuse harm not traceable to any particular patient or insurer. This conclusion has important consequences for how medical schools and professional organizations encourage integrity in billing. To avoid free-riding, physicians should ask themselves, “could all physicians bill this way?” and if not, “does the patient benefit from the distinctive service I am providing under this code?” If both answers are “no,” physicians should refrain from the billing practice in question. (shrink)

The book offers an accessible account of EDs and closely examines the concept of addiction, Drawing on a wide range of medical, psychological, physiological, sociological and philosophical sources, the book examines the benefits and risks of exercise for the ED population, explores the links between EDs and other abuses of the body in the sports environment and addresses the issue of athletes with disordered eating behaviour. Importantly, the book also surveys current legislation and professional codes of conduct that (...) guide the work of fitness professionals and clinicians in this area and I presents a clear and thorough set of case histories and action points to help professionals better understand, and care for, their clients with EDs. --. (shrink)

The paper takes into consideration the different degrees of power and control that can be exercised by the mediator/arbitrator. This issue is investigated with particular regard to such aspects as the nature of the ADR procedure adopted, the cultural context in which the procedure takes place, and the formulation of specific legal norms. The analysis both of a few arbitration rules and some data from real arbitral proceedings shows great reliance on the arbitrator’s discretion and use of common sense, which (...) is in line with the idea itself of arbitration. Moreover, the high degree of power autonomy enjoyed by the arbitrator during the whole procedure derives from the presupposition that the parties accept the arbitrator’s personal opinion and final judgment and from the fact that the majority of the disputes in international commercial arbitration are of a technical and complicated nature. The analysis also shows that the legal background of most arbitrators tends to surface even when they are involved in alternative dispute resolution proceedings and is clearly visible in the orderly allocation of turns and the strict control over the procedures to be followed. Especially when arbitrators are lawyers or judges, they tend to promote a feeling of belonging to the same professional community, which induces a greater spirit of cooperation and a lowering of the control level. (shrink)

This paper examines the concept of 'professional trust' and argues that trust is an essential component of what it means to be a 'professional'. The first part of the paper discusses the nature of trust in general and attempts to establish two main points: that we are all involved in relationships of trust and that all trust involves risk. The second section examines the idea of professional trust and draws on an analysis of knowledge provided by Michael (...) Oakeshott that divides knowledge into two components, 'information' and 'judgment'. The central argument is that the exercise of judgement through the possession of 'discretionary powers' is central to being a professional, but that judgement itself resists reduction to propositional formulation because it is essentially tacit and individual. The paper's focus is fairly narrow and does not examine, for example, the role of trust in teacher--pupil relationships, how trust may be related to learning or the role of trust in the pursuit of collaborative educational research. (shrink)

Despite substantial controversy, the use of futility judgments in medicine is quite common, and has been backed by the implementation of hospital policies and professional guidelines on medical futility. The controversy arises when health care professionals (HCPs) consider a treatment futile which patients or families believe to be worthwhile: should HCPs be free to refuse treatments in such a case, or be required to provide them? Most physicians seem convinced that professional autonomy protects them from being forced to (...) provide treatments they judge medically futile, given the lack of patient benefit as well as the waste of medical resources involved. The argument from professional autonomy has been presented in a number of articles, but it has not been subjected to much critical scrutiny. In this paper I distinguish three versions of the argument: 1) that each physician should be free to exercise his or her own medical judgment; 2) that the medical profession as a whole may provide futility standards to govern the practice of its members; and 3) that the moral integrity of each physician serves as a limit to treatment demands. I maintain that none of these versions succeeds in overcoming the standard objection that futility determinations involve value judgments best left to the patients, their designated surrogates, or their families. Nor do resource considerations change this fact, since they should not influence the properly patient-centered judgment about futility. (shrink)

Every instructor who teaches media ethics faces the challenge of balancing theory and practice i n the classroom. A typical approach involves training students i n theories of ethical deliberation applied to moral dilemmas presented i n case studies and decision-making exercises. This article callsfor more philosophical inquiry into the basic assumptions of media ethics. Based on a writing assignment that asked students to ponder a philosophical paradox, this article not only tackles the paradox involving ethical competence, but discusses how (...) such speculations can lead tofundamental understanding of what it means to be a professional journalist. (shrink)

This research characterizes and compares the job satisfaction of fitness professionals in Portugal between genders, ages, professional experience, professional title, and educational qualifications. A total of 401 fitness professionals answered the online questionnaire Job Satisfaction Scale, which has 16 factors rated on a Likert scale with seven levels. The statistical analysis comprises descriptive and statistical tests to compare the results of two (t-test) or more (ANOVA) groups. Overall, the results demonstrated that fitness professionals were moderately satisfied with their (...) work. The lower degrees of job satisfaction were concerning salary, opportunities for promotion, and stability at work. The highest levels of job satisfaction were related to the freedom to choose their work method, their work colleagues, the physical conditions of their workplace, and the opportunity to use their competencies. There were no differences in job satisfaction in terms of gender and a few differences between professional title and between educational levels. Regarding age and professional experience, the results showed significant differences in almost all factors, suggesting that, as fitness professionals get older and more experienced, their job satisfaction is greater. The results of this study suggest that even though fitness professionals are, in general, moderately satisfied with their work, some aspects can be improved by employers to increase their satisfaction levels. Such findings would assist employers in guiding the job satisfaction of their employees with consequent enhancements in the services provided by fitness professionals, which can increase participants’ retention in exercise fitness activities. (shrink)

Spaulding vs. Zimmerman is a lawsuit that raised the issue of the extent of how much information a negotiator can withhold from the other side and still remain within the bounds of ethical propriety. The author took the case and fashioned it into an exercise an organization can use as a vehicle for members to analyze their personal ethical choices under difficult, real world circumstances. The exercise is powerful and may be administered at any level of management training. (...) It is disguised as a negotiation, so the ethical issues are obscured by the parties’ negotiation goals and tactics. The debriefing will lead to productive discussions about personal ethics/values decisions. The exercise can be as simple or complex as the moderator chooses. The general fact sheet, the employee’s facts, and the employer’s facts are attached in the Appendix. The user is encouraged to copy them (or modify them) for their specific needs. (shrink)

This paper presents an experiential exercise introducing the concept of the personal ethical threshold (PET) to help explain why moral behavior does not always follow moral intention. An individual’s PET represents the individual’s vulnerability to situational factors, i.e., how little or much it takes for members of organizations to cross their proverbial line to act in a way they deem unethical. The PET reflects the interplay among the situation, the particular ethical issue, and the individual. Exploring the PET can (...) help account for why some people are sometimes able to withstand substantial organizational pressures to behave in congruence with their ethical intentions, whereas others crumble in the face of apparently minimal situational forces. We hope that students’ exposure to and subsequent reflection upon their PET, by means of the exercise we present, will foster the development of their moral courage. (shrink)

Examining to what extent physicians are, or ought to be, defined by the profession when giving advice to patients, this commentary seeks to offer a better understanding of the potential conflicts that the American Medical Association’s (AMA’s) “Opinion 1.1.7, Physician Exercise of Conscience,” addresses. This commentary conceptualizes the professions as knowledge communities, and situates the physician-patient relationship within this larger conceptual framework. So doing, it sheds light on how and when specialized knowledge is operationalized in professional advicegiving. Physicians (...) communicate the knowledge community’s insights to the patient. Thus, departures from professional knowledge as a matter of the professional’s personal conscience are appropriately circumscribed by the knowledge community. (shrink)

Until recently, moral case deliberation (MCD) sessions have mostly been facilitated by external experts, mainly professional ethicists. We have developed a train the facilitator programme for healthcare professionals aimed at providing them with the competences needed for being an MCD facilitator. In this paper, we present the first results of a study in which we evaluated the programme. We used a mixed methods design. One hundred and twenty trained healthcare professionals and five trainers from 16 training groups working in (...) different healthcare organisations throughout the Netherlands were included. After completion of the programme, participants feel sufficiently confident and equipped to facilitate an MCD session. Feeling competent does not mean that participants have no doubts or questions left. Rather, they are aware of their limitations and see the need for continuous learning. According to the respondents, the actual exercise of facilitating MCD during and in between the training sessions contributed most to the development of competences necessary for being an MCD facilitator. Respondents without prior experience of participating in MCD sessions felt less competent after the training than those who had participated in MCD sessions before. Self-attributed competence varied between participants with different professional backgrounds. (shrink)

We rely on doctors, accountants, engineers, and other professionals to be committed to the basic values of their professions and to exercise their ex­pertise in competent, reliable ways, even when no one is watching them do their work. That is, we expect them to have professional integrity. Children obviously do not yet have professional integrity, even if someday they will become professionals. Nevertheless, the moral development of children who will become professionals plays an important role in the (...) eventual emergence of their professional integrity. We will discuss both what this integrity involves and how the basic moral development of children contributes to its emergence in professional life. (shrink)

The main roles of libraries are developing and providing access to collections of cultural heritage. While the specific policies necessary to accomplish these roles may vary across different types of libraries, these institutions have at their core a dual role in preserving and supporting access to documents illustrating an era of knowledge and culture. Libraries are thus significant institutions in the process of learning, but also in that of remembering and forgetting at a social level. This article provides an overview (...) of the structure and organization of the public library system in the last two decades of the Communist regime in Romania. As part of a larger information history project, the research discusses the characteristics of this system created to support mass education and the ways in which public libraries also became institutions of memory in Communist Romania. The description of the library system structure is enriched by an overview of the professional training available for librarians and descriptions of the main library services related to access to collections and memories. The analysis of archival materials and oral history interviews with librarians document how these services were implemented and delve into the challenges encountered. Partial access to knowledge and information was a core part of the offered library services. As a consequence, services that were part of the Communist library system could be a source of long-term memory impairment at the social level. (shrink)

Sport and physical activity is an area that remains relatively unexplored by contemporary bioethics. It is, however, an area in which important ethical issues arise. This paper explores the case of the participation of people with anorexia nervosa in exercise. Exercise is one of the central features of anorexia. The presence of anorexics in exercise classes is becoming an increasingly sensitive issue for instructors and fitness professionals. The ethics of teaching exercise to anorexics has, however, seldom, (...) if ever, been addressed. Codes of ethics and legislation do not offer guidelines pertinent to the case and it is left unclear whether anorexics should be allowed to participate in exercise classes. It is shown by this paper that there are strong ethical reasons to let anorexics participate in exercise classes. However, the paper also explains why, despite these apparently cogent ethical reasons, there is no moral obligation to allow a person with anorexia to take part in exercise/sports activities. (shrink)

To meet modern society's demands, highly qualified professionals are driving the reformulation of the teaching-learning model in universities. The framework of the Tec21, the Educative Model of the Tecnologico de Monterrey, provides the focus over the training programs on the relationship between the student and the environment for the development of personal and professional competencies through the resolution of challenges linked to real-world scenarios. In this work, we present information about a challenging experiential activity for students with an undergraduate (...) professional curriculum. The core elements were a soap company, a higher education institution (Tecnologico de Monterrey), and the federal government (Mexico); it was consistent with specific problems to be solved in the soap company in Mexico by inserting students in it. Based on the framework of the experiential study of the company, constitution and characterization of the processes, in individual surveys, students recognized a better learning in a real context, and they recognized that the importance of the challenging activity through ten indicators and that this exercise contributed to the development of transversal competencies: co-responsibility, social responsibility, and sustainability. These results reinforce the importance of the development of transversal competencies in the training of professionals. (shrink)

This article considers John Harris’ work on autonomy, specifically reproductive autonomy, outlined in The Value of Life and developed throughout his career. Harris often used the concept of reproductive autonomy to make the case for liberal approaches to developments in reproductive and genetic technologies. Harris argued that reproductive autonomy should be highly valued, and therefore we need compelling arguments to justify limiting it in anyway. When discussing reproductive autonomy, Harris focused mainly on restrictions on the potential users of reproductive technologies (...) autonomy, that is, prospective parents. This article extends the discussion of autonomy and the appropriate limits to individuals exercising their autonomy to medical professionals working in this area. Given reproductive technologies have become part of routine medical practice, this article considers whether the current restrictions on both patients and clinicians, as imposed by regulators and professional guidelines, remain ethically justified. (shrink)

General practitioners (GPs) have to negotiate a range of challenges when they suspect child abuse or neglect. This article details findings from a Delphi exercise that was part of a larger study exploring the conflicts of interest that arise for UK GPs in safeguarding children. The specific objectives of the Delphi exercise were to understand how these conflicts of interest are seen from the perspectives of an expert panel, and to identify best practice for GPs. The Delphi (...) class='Hi'>exercise involved four iterative rounds with questionnaires completed by an expert panel. Results from each round were distilled and findings sent to panel members until consensus was reached. Panel members shared insights regarding their understanding of conflicts of interest in relation to GPs and safeguarding children and responses when conflicts of interests arise. Findings suggested a broader understanding of conflicts of interest (intrapersonal, interpersonal, interprofessional and interagency), the importance of professional judgement in uncertain situations when both action and inaction have potentially negative consequences and the importance of trust. The Delphi exercise was an effective means to bring together a wide range of professional and disciplinary perspectives on a complex topic. Findings caution against the oversimplification of the conceptual and practical issues, emphasise the importance of professional judgement, and support the development of open and trusting relationships with families and among professionals in health and social care agencies. (shrink)

Only too often critical realist contributions to understanding and explaining social phenomena fall into one of two discrete categories: exercises in philosophy or social theory, or empirical research that strikes as more or less atheoretical. This paper continues a long-term project to build bridges between abstruse issues of philosophy and theory and attempts to grasp the ‘how’ and ‘why’ of actual social events. The topic selected is elite professional rugby union and the principal theme is its emergence as an (...) extreme sport and the risk of serious injury. It is argued that the injurious nature of elite rugby has its causal genesis in the professionalization of the sport and that a critical realist-oriented sociology has an important contribution to make in framing and gasping how and why this is. (shrink)

Not all actions that are legal are necessarily morally correct. However, there are few protections for providers who are pressured to comply with actions and procedures that infringe on their religious beliefs regarding human dignity. The right of health care providers to freely act on religious convictions and refrain from cooperating with morally reprehensible tasks is often eschewed in favor of political correctness or is branded as discrimination. Adequate safeguards are urgently needed for health care workers at all levels to (...) ensure that they can continue to care for the sick and most vulnerable members of the community without violating the dictates of their conscience. This article examines the free exercise of religion as it pertains to medical provider conscience protections. The author argues for conscience protection legislation with a right of action. (shrink)

There are no moral cookbooks—no algorithms for whipping up moral confections to suit every occasion. But more modest and flexible tools might still be useful for practical ethics. One team describes how professionals can be taught to use a framework for understanding moral problems.

Professional ethics has currently raised its public profile in the UK as part of social anxiety around governance of health and social care, fuelled by catastrophically bad practice identified in particular healthcare facilities. Professional ethics is regulated by compliance with abstracted, normative codes but experienced as contextualised exercise of personal qualities, understanding and engagement. This study examined how practitioners from one speciality of occupational therapy, an Allied Health Profession, develop ethical practice through dialogical engagement in local OT (...) communities of practice, supporting and modifying understanding of and approaches to specific situations experienced as ethically difficult and individual reflection on the personal bildungsroman underpinning their own professional practice. Engagement in community of practice and personal reflection contributed to ethical development for participating OTs. Opportunities to engage in peer OT groups and professional reflection should be considered by employers as integral to productive practice and not a distraction from it. (shrink)

Creating what sort of professional? Master's level nurse education as a professionalising strategy This paper reports on a detailed analysis of selected findings from a larger study of master's level nurse education. It locates some features of such education within the contemporary situation of nursing as a profession and interprets the role of master's level nurse education as a professionalising strategy. In‐depth interviews were undertaken with a purposive sample of 18 nurse lecturers drawn from eight universities in the United (...) Kingdom. The interview agenda explored participants’ perspectives of the characteristics of master's level performance in practice. Interview transcripts were interpreted by drawing upon hermeneutic methodology.The following themes emerged. (a) The credibility of the master's level nurse was of central importance. In terms of the literature of professionalisation, this may be interpreted as a factor in enhancing the legitimacy of nursing as an occupation. (b) The clinical capability attributed to the nurse is interpreted as leading to an increase in the authority commanded by the expert professional. Thus, the individual capability of the master's level nurse enhances the attribution of autonomous skill to the occupation as a whole. (c) The master's level nurse is seen to exercise influence and leadership and this strengthens the power and status of nursing.Nursing does not have the appearance of a ‘traditional’ profession, neither has it a clear stance as a ‘new profession’. Rather it appears to be especially responsive to the tide of public opinion manifest through government edicts. While nursing is employing rhetoric that espouses both positions, the direction of master's level education is anomalous. (shrink)

Euthanasia has once again become headline news in the UK, with the announcement by Dr Michael Irwin, a former medical director of the United Nations, that he has helped at least 50 people to die, including two between February and July 1997. He has been quoted as saying that his ‘conscience is clear’ and that the time has come to confront the issue of euthanasia. For the purposes of this article, the term ‘beneficent voluntary active euthanasia’ (BVAE) will be used: (...) beneficent from the prima facie principle of beneficence, to do good, and voluntary to indicate that this must be carried out at the request of a competent client. This implies adherence to another prima facie principle, that of respect for autonomy. Active implies that something is done or given with the intention of hastening death. The word euthanasia itself simply means ‘good death’. This article examines the moral positions of two nurses and one junior doctor towards the subject of BVAE and an attempt is made to represent the main conflicting moral positions. The central arguments against BVAE and counterarguments are presented. The conclusion reached is that consenting adults should not be prevented from availing themselves of BVAE if another consenting adult (a medical doctor) is available and capable of carrying out their wishes. This being the case, it is suggested that BVAE should be available as an option in hospices and in the community. The aims of this article are: to generate debate among professionals; to present a three-way discussion that might be useful as a focus for educational purposes, particularly at undergraduate level; to challenge professionals to confront the issue of euthanasia; and to plead the case of those who request assistance in exercising autonomy by gaining control over their own deaths. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Artist as Professional in JapanKazuyo Nakamura and Akio OkazakiThe Artist as Professional in Japan, edited by Melinda Takeuchi. Stanford, Calif.: Stanford University Press, 2004, 262pp., $45.00 cloth.With the increase of cross-cultural academic exchange in our time, more accurate information on art from other cultures has become more easily available, and curriculum development of art education directed toward multiculturalism has been brought to realization. There is (...) need emerging among art educators for academic resources for teaching cross-cultural subject matters, and The Artist as Professional in Japan provides historical information helpful in gaining a critical understanding of the nature of Japanese art discourse. The volume is edited from a fresh sociocultural perspective by Melinda Takeuchi, professor of Japanese art at Stanford University.Takeuchi, noticing that few scholarly books on the profession of Japanese artists are available to students of art history in the United States, set about the volume in concerted efforts with her colleagues. The volume consists of individual case studies on different Japanese artists; they are well-known sculptors, painters, potters, printmakers, and architects and are recognized in Japan as representative in different eras from the seventh to the twentieth century. Running through the individual studies, there is a concern for political forces that shaped art discourse and the identity of the Japanese artist. The following questions are asked: What degree of control did the artists exercise over their métier? What were some of the dynamics operating in the production, consummation, and evaluation of art and artist? How was the image of the artist formed during various periods? Working with these questions, seven case studies address issues of canon formation of art by looking into the terrain of the meaning of a critical word, Shoku-nin; it literally means people (nin) with an occupation (shoku) and denotes the collective artisan class.Different art historians and art theorists take a unique approach for developing each case study in the volume. Donald F. McCallum's study in chapter 2 is on the Buddhist Icons of the Shaka Triad during the Asuka Period (ca.590-ca.650), and it is asked what were the political forces working on the production of the [End Page 118] icons. In contrary to orthodox view, it is argued that the icons were produced not by an individual sculptor named Tori-busshi but by the guilds of which the supervisor was Tori. Also, it is argued that the icons were produced with the patronage of soga clan, the dominant political force of the time, not by the imperial family, including Shotoku Taishi.Karen L. Brock in chapter 3 examines the case of E'nichibo Jonin (active ca.1211-ca.1243), the painter of Saint Myoe. The case shows that the ateliers of temples, such as Kozanji in Kyoto, played a central role in producing and distributing sacred images. This study makes clear that few individual painters, such as those named ebusshi, participated in the formation of the canon of Japanese painting, but collective political forces, such as Kozanji ateliers, exercised power in bringing out sacred objects.In chapter 4 Melinda Takeuchi takes up the case of Tosa Mitsunobu (1434-ca.1523), an artisan painter active in Kyoto court circles. It shows a historical fact particular to Japanese art discourse—that later artists manipulated the names of earlier ones for professional or cultural merits. Taking notice of the fact that Mitsunobu's name late became synonymous with a production unit that shares secret techniques of products, Takeuchi concludes, "In the end, the name of an artist transcends time, space, materiality, and ultimately discourse itself" (101).The study of Louise Allison Cort in chapter 5 is on the case of Morita Kyuemon in the seventeenth century, a warrior trained as a potter and running the Odo pottery in the Tosa domain. By exploring the motivations of the Tosa domain in trying to transform local products into refined and stylish pottery worthy of formal presentation to other domain rulers (daimyo), to government officials, and to the shogun in Edo, this chapter demonstrates how both the potter and the ruler actively sought to join the aesthetic mainstream of their own day.In... (shrink)

This paper does not attempt to lay out the arguments relating to male circumcision for non-medical reasons. Rather, the aim is to focus more on the process and the problems of a professional body ) attempting to produce any consensus guidelines for its members on an issue which clearly polarises doctors as much as it divides society as a whole. The legal and ethical considerations of male circumcision are inevitably touched upon here but are not the central issue. In (...) 2003, the BMA published professional guidance on this subject. Some thought this a pointless exercise; others saw it as an initiative which simply failed to go far enough. Reservations centred on the fact that the BMA’s guidance—like that of the statutory body, the General Medical Council—explored the issues without either firmly rejecting or accepting non-therapeutic male circumcision. Was it then a fruitless project or a brave start to grasping the nettle? (shrink)

_This practical and forward-focused book presents a framework that uses social infrastructure to produce effective and inclusive professional development options in education._ Although technology has increased our capacity for social networking both in the digital space and face-to-face, Kira J. Baker-Doyle contends that most professional development opportunities for educators are still fundamentally asocial. She calls for the adoption of humanizing network practices to create meaningful continuing education experiences that leverage the collective knowledge, expertise, and social capital of educators (...) to spark educational change. Baker-Doyle shows how the critical network literacy (CNL) framework overlays critical theory, multiliteracies theory, and social network theory in a way that encourages critical reflection and collaboration among participants. She draws from sources including empirical studies of teacher educators and teacher activists, meta-analytical studies of social network research in education, and professional experience with collective organizing efforts, to detail the many benefits of cultivating CNL in educational spaces. Baker-Doyle provides evidence of how the framework’s practices and protocols can increase transparency, improve representation, and incorporate affirming and restorative discourse. Her work demonstrates how CNL helps create environments that honor teachers’ social identities, their social networks, and the broader social context in which they work. This thought-provoking book is filled with exercises that reinforce social competencies, questions that prompt dialogue and understanding, and real-world examples that underscore the framework's relevance to key educational practices. The generous guidance offered in _Critical Network Literacy_ can be used as a launching point to promote innovation and leadership in teaching. (shrink)

Knowledge of pedagogy and social studies content influences a teacher's decision making and helps teachers conduct sound instructional practices despite the influence of high-stakes testing policies. Using national data from the Survey of the Status of Social Studies (S4), this study examined the associations of teachers’ professional characteristics, school environmental factors, and state testing policy on self-reported levels of authority that secondary level social studies teachers (grades 6–12) hold over key classroom tasks. Through hierarchical multiple regression analysis, key findings (...) from this study indicated that greater minority enrollments are associated with lower levels of instructional authority. Teachers who worked in states where a state-mandated social studies test was administered reported less freedom to choose what to teach and how to teach than those in non-testing states. Also, this study showed that in-field status, the type of licensure, and years of teaching experience are important factors in exercising social studies teachers’ instructional authority (e.g., their ability to balance effectively the demands of state-mandated reforms with teaching for meaningful student learning). This study recommends that schools with high minority enrollments, especially if these districts exist in a high stakes testing environment, should invest in teachers with high-quality social studies preparation. (shrink)

This article, the first of a two-part series, examines how Saint Ignatius of Loyola’s (1548/ 1991 ) nearly 500 year-old approach to the transformation of others in their leadership journeys is still being actualized, with applications to transformations in workplaces and the graduate education of business leaders, by drawing upon both the handbook Ignatius wrote to guide his work—called the _Spiritual Exercises_—and upon the account of his own transformation experience captured in his _Autobiography_. Our exploratory prelude to practice is guided (...) by the following questions that approximate (both in content and order) Ignatius of Loyola’s approach to personal and spiritual transformation: First, “What are my deepest desires?” (and this question has two distinct parts: “What don’t I want?” and “What do I want?”); once that has been clarified, the next question is “What does this require of me?” (In other words, what must be done to avoid the things you don’t want and achieve the things that you do want?); and finally, the last question requires an answer that lasts a lifetime: “How does this shape the person I am becoming?”. After characterizing the stages of Ignatius of Loyola’s (1548/ 1991 ) own transformation as: Deconstruction (the cannonball at Pamplona); Choice (while convalescing at Loyola); Reconstruction (during his retreat at Montserrat); and Integration (actualized by his mystical experience in Manresa), our contribution concludes by returning to the questions that frame our interrogative inquiry, but with an eye toward the professional formation of online graduate students of organizational leadership. In the second article (Tran and Carey 2023 ), our exploration continues by integrating academic theory with andragogical practice. Particular attention is paid to the qualitative reflections from online graduate leadership education students at a Jesuit university in the Inland Northwest of the United States. (shrink)

This paper presents a short classroom exercise to stimulate student discussion about the rights of shareholders versus the rights of stakeholders. Students are challenged to identify and evaluate their preconceived notions of what constitutes excessive profits. The exercise illustrates why the realization of a large return on investment cannot be used as prima facie evidence that a firm exploited employees, customers, or other stakeholders. This concept is illustrated using datafrom the pharmaceutical industry.

Ethics education in higher education often uses a model that allows students to apply ethical theories to a hypothetical dilemma in order to make a decision. However, it is rare that students directly experience the effects of unethical decision making by others. This paper presents an in-class exercise that provides a concrete experience. The exercise gives students the experience of being the victim of unethical behavior, and subsequently allows them to apply basic ethicaltheories to a real life situation. (...) It is suitable for courses in legal environment of business, ethics, and organizational behavior, at the undergraduate or graduate level. When used in a business ethics class, more emphasis can be placed on developing various ethical constructs. A narrative for how this exercise was used in an undergraduate Legal Environment of Business class is provided, along with a list of other experiential exercises that are available to teach ethics. (shrink)

Creative Ways to Learn Ethics is an accessible, easy-to-read guide that compiles a variety of ethics trainings to help professionals stimulate their minds, relieve stress, and increase engagement and memory retention. The book uses a range of experiential and thought-provoking approaches, including contemplative exercises, expressive arts, games, and media. Each chapter contains objectives, detailed procedures, adaptations for different audiences, and handouts. Trainers, educators, clinicians, and other mental health professionals can use these exercises in various settings and modify them to meet (...) the needs of their clients. (shrink)

The urgency of the resuscitation and the impaired ability of the patient to make a reasonable autonomous decision both conspire against adequate consideration of the principles of medical ethics. Informed consent is usually not possible for these reasons and this leads many to consider that consent is not required for resuscitation, because resuscitation brings benefit and prevents harm and because the patient is not in a position to give or withhold consent. However, consent for resuscitation is required and the common (...) models employed for this purpose are presumed consent or consent from a patient proxy. However, if we are to honour the principles of respect for patient autonomy, as well as beneficence and non-maleficence, when starting and continuing resuscitation we must try and achieve the best balance between benefit and harm from the patient's perspective. The concept of professional substituted judgment involves the resuscitators gathering as much information about the patient as they possibly can, including any previously expressed attitudes towards such a situation, and combining this with their acquired professional knowledge of the likely benefits and harms of the resuscitation endeavour and then exercising their moral imagination, imagining themselves as the patient, and asking "would I want this treatment?" By employing professional substituted judgment resuscitators should recognise when the balance of benefit and harm becomes unfavourable from the patient's perspective and at this point they have a moral obligation to withdraw resuscitation as they can no longer presume the patient's consent. In this way the principles of beneficence, non-maleficence and respect for patient autonomy are more favourably balanced than under other resuscitation decision making processes. (shrink)

ObjectiveTo assess the impact of the closure of group-based cardiac rehabilitation training during the first COVID-19 lockdown in spring 2020 on patients’ physical activity, cardiorespiratory fitness, and cardiovascular risk, and to describe the patient experience of lockdown and home-based exercise training during lockdown.DesignMixed methods study. Prospectively collected post-lockdown measurements were compared to pre-lockdown medical record data. Quantitative measurements were supplemented with qualitative interviews about the patient experience during lockdown.SettingOutpatient CR centre in Salzburg, Austria.ParticipantsTwenty-seven patients [six female, mean age 69 (...) years] who attended weekly CR training sessions until the first COVID-19 lockdown in March 2020.Outcome MeasureQuantitative: exercise capacity, cardiovascular risk. Qualitative: individual semi-structured interviews.ResultsExercise capacity had significantly reduced from pre- to post-lockdown: mean power in maximal ergometry 165 vs. 151, p < 0.001; submaximal ergometer training 99 vs. 97, p = 0.038. There was no significant difference in Framingham risk score and other cardiovascular risk factors. Qualitative data showed that almost all patients had kept physically active during lockdown, but 17 said they had been unable to maintain their exercise levels, and 15 felt their cardiorespiratory fitness had deteriorated. Many patients missed the weekly CR training and the motivation and sense of community from training together with others. Several patients stated that without professional supervision they had felt less confident to carry out home-based exercise training at high intensity.ConclusionThis study highlights the importance of group-based supervised exercise training for patients who engage well in such a setting, and the detrimental impact of disruption to this type of CR service on physical activity levels and exercise capacity. Additionally, learning from the COVID-19 pandemic may inform the development and implementation of remote CR modalities going forward. (shrink)

To study hospital physicians’ awareness and perceptions of the legal and financial regulations, and their impact on professional discretion regarding equity in access to treatment and quality of care. A sample of 637 physicians in the Norwegian specialist healthcare services selected from a survey conducted by the Institute for Studies of the Medical Profession. The paper investigates how legal and financial policy instruments affect the application of professional discretion regarding the prioritisation of specialist health services. Descriptive statistics and (...) regressions were conducted for the analyses. Compared with financial incentives, legal regulations (laws, priority rules and guidelines) were assessed to be less negative external interventions in the exercise of medical and professional judgement. The empirical analyses revealed a positive tendency in physicians’ assessments of the impact of legal regulations on treatment equity and healthcare quality, but negative attitudes towards financial instruments. The variations revealed are attributable to various structural and epistemic features of the legal–bureaucratic and economic models of administration in this area of the welfare state. Legal and financial regulations are imposed to achieve certain social goals and values. The findings of this study can provide further insight for the health authorities in other countries concerning implementation of such regulations in the specialist healthcare services. (shrink)

Simple mindfulness practices to help your child (ages 5-12) deal with anxiety, improve concentration, and handle difficult emotions—with a 60-minute audio CD of guided exercises Mindfulness—the quality of attention that combines full awareness with acceptance of each moment, just as it is—is gaining broad acceptance among mental health professionals as an adjunct to treatment. This little book is a very appealing introduction to mindfulness meditation for children and their parents. In a simple and accessible way, it describes what mindfulness is (...) and how mindfulness-based practices can help children calm down, become more focused, fall asleep more easily, alleviate worry, manage anger, and generally become more patient and aware. The book contains eleven practices that focus on just these scenarios, along with short examples and anecdotes throughout. Included with purchase is an audio CD with guided meditations, voiced by Myla Kabat-Zinn, who along with her husband, Jon Kabat-Zinn, popularized mindfulness-based stress reduction (MBSR) as a therapeutic approach. Continue your mindfulness practice with Eline Snel through her other mindfulness meditation titles, including Sitting Still Like a Frog Activity Book, which offers 75 fun mindfulness games and activities for children, and The Little Frog Awakes, which offers tools and advice for mindfully responding to younger children ages 18 months to 4 years. (shrink)

Despite revisions to curriculum in ethics education in business schools, there continues to be high profile examples of unethical decision making regularly spotlighted in the media. Rather than simply teaching about behaviors and how they might impact decision makers and stakeholders, we describe a suite of activities used to highlight various behaviors and biases that impact the decisions individuals might make. These activities are intertwined with course materials regarding ethics and corporate governance to remind and help students better understand how (...) decision making can be influenced and challenged by personal ethics. We provide lesson planning suggestions including adapting to remote delivery, and student handouts. This suite of activities can be incorporated into any undergraduate or graduate level course that has content dealing with ethical decision making. (shrink)

Coaching is a systematic and goal-oriented one-on-one intervention by a coach aimed to guide clients in their professional and personal development. Previous research on coaching has demonstrated effects on a number of positive outcomes, including well-being and performance, yet little is known about the processes that underlie these outcomes, such as the type of questions coaches use. Here, we focus on three different types of coaching questions, and aim to uncover their immediate and sustained effects for affect, self-efficacy, and (...) goal-directed outcomes, using a between-subjects experiment. One hundred and eighty-three medical residents and PhD students from various medical centers and healthcare organizations in the Netherlands were recruited to participate in a self-coaching writing exercise, where they followed written instructions rather than interacting with a real coach. All participants were randomly allocated to one of three conditions: either one of two solution-focused coaching conditions or a problem-focused coaching condition. Self-report questionnaires were used to measure key outcomes of coaching, that is positive and negative affect, self-efficacy, goal orientation, action planning and goal attainment. Two follow-up measurements assessed if the effects of the self-coaching exercise led to problem-solving actions within an initial follow-up period of 14 days and a subsequent follow-up period of 10 days. Findings showed that participants experienced more positive affect, less negative affect, and higher approach goal orientation after the solution-focused coaching exercise compared to the problem-focused coaching exercise. In all conditions, goal attainment increased as a consequence of the self-coaching intervention. We discuss the implications of our findings for the science and practice of contemporary coaching. (shrink)

As practicing clinicians, physicians are expected to uphold the ethical norms of their profession, including fidelity to patients and respect for patients’ self-determination. At the same time, as individuals, physicians are moral agents in their own right and, like their patients, are informed by and committed to diverse cultural, religious, and philosophical traditions and beliefs. In some circumstances, the expectation that physicians will put patients’ needs and preferences first may be in tension with the need to sustain the sense of (...) moral integrity and continuity that grounds a physician’s personal and professional life. This article examines the implications for patients, physicians, and the medical profession when tensions arise between a physician’s professional commitments and his or her deeply held personal moral beliefs. It offers guidance on when a physician’s professional commitments should outweigh personal beliefs as well as when physicians should have freedom to act according to the dictates of conscience while still protecting patients’ interests. (shrink)

OBJECTIVES: This study was designed to identify and compare the attitudes of patients and health care professionals towards advance directives. Advance directives promote recognition of the patient's autonomy, letting the individual exercise a certain measure of control over life-sustaining care and treatment in the eventuality of becoming incompetent. DESIGN: Attitudes to advance directives were evaluated using a 44-item self-reported questionnaire. It yields an overall score as well as five factor scores: autonomy, beneficence, justice, external norms, and the affective dimension. (...) SETTING: Health care institutions in the province of Québec, Canada. Survey sample: The sampling consisted of 921 subjects: 123 patients, 167 physicians, 340 nurses and 291 administrators of health care institutions. RESULTS: Although the general attitude of each population was favourable to the expression of autonomy, multivariate analysis of variance (MANOVA) indicated that physicians attached less importance to this subscale than did other populations (p < .001). Above all, they favoured legal external norms and beneficence. Physicians and administrators also attached less importance to the affective dimension than did patients and nurses. Specifically, physicians' attitudes towards advance directives were shown to be less positive than patients' attitudes. CONCLUSION: More attention should be given to the importance of adequately informing patients about advance directives because they may not represent an adequate means for patients to assert their autonomy. (shrink)

The article explores the communist ideology that has guided the formation of professional ethics of medicine in China. It first explores the constitutions of the People’s Republic of China and the Chinese Communist Party and codes of practice for medicine enforced since 1949, showing that the core of the ideology in relation to health provision and doctor–patient relationship has always been ‘serving the people wholeheartedly’. The ideological undertaking, however, has never been successfully exercised. In the pre-reform era, the bureaucratisation (...) of health professionals led to the emergence of ‘bureaucratic medicine’ featuring negligence of patients’ interests. In the reform era, the prevailing commercialisation of health care is in fundamental conflict with the ideological commitment to serving the people. As a result, the socialist professional ethics of medicine has not been satisfactorily practiced in reality. (shrink)