This article explores what an ethicfor organic animal husbandry might look like,departing from the assumption that organicfarming is substantially based in ecocentricethics. We argue that farm animals arenecessary functional partners in sustainableagroecosystems. This opens up additional waysto argue for their moral standing. We suggestan ethical contract to be used as acomplementary to the ecocentric framework. Weexpound the content of the contract and end bysuggesting how to apply this contract inpractice. The contract enjoins us to share thewealth created in (...) the agroecosystem (by ourjoint contributions) by enjoining us to carefor the welfare and needs of the individualanimal, and to protect them from exploitation(just as human co-workers should not beexploited). The contract makes promoting goodanimal welfare a necessary condition forbenefiting farm animals. Animals for their partare guaranteed coverage under the contract solong as they continue to contribute to thesystem with products and services. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 14.1 (2004) 47-54 [Access article in PDF] Ethical Guidelines for Human Embryonic Stem Cell Research*(A Recommended Manuscript) Adopted on 16 October 2001Revised on 20 August 2002 Ethics Committee of the Chinese National Human Genome Center at Shanghai, Shanghai 201203 Human embryonic stem cell (ES) research is a great project in the frontier of biomedical science for the twenty-first century. Be- cause the (...) research involves the use of human embryos, it triggers serious debate on ethical issues. Opponents consider the embryo to be an early form of human life that should be respected and not destroyed. However, the majority of scientists support embryonic stem cell research, believing that it offers good prospects for the treatment of diseases that have remained incurable until now and so will benefit humankind. The Ethics Committee of the Department of Ethical, Legal, and Social Implications of the Chinese National Human Genome Center at Shanghai seriously discussed the ethical debate initiated by embryonic stem cell research. We concluded that we should support the scientists of our country in actively carrying out human embryonic stem cell research for the noble cause of "medicine being a beneficent art." For the healthy and orderly development of human embryonic stem cell research in our country, we put forward the following recommended Ethical Guidelines for Human Embryonic Stem Cell Research as a reference for leaders, administrative departments, and related scientists. Preface Article 1. Human embryonic stem cells are the primitive cells that play the main role in the growth and development of a human body. These [End Page 47] primitive cells have the potential for infinite proliferation, self-renewal, and multi-directional differentiation. If scientists can discover the mechanism of differentiation of human embryonic stem cells, it will be possible to induce differentiation of human embryonic stem cells to form various types of human cells for clinical cell therapy. If human embryonic stem cell research can be integrated with modern biomedical engineering techniques, it also will be possible to make repair and replacement of human tissues and organs a reality. Article 2. There are two ways to classify human embryonic stem cells. One way is to classify them according to their potential for differentiation. There could be three kinds of stem cells: totipotent stem cells, pluripotent stem cells, and unipotent stem cells.A totipotent stem cell has the potential to develop into a whole individual. It can differentiate into the more than 200 cell types in the whole body, construct any tissue or organ of the body, and finally develop into a whole individual. The fertilized egg and the cleavage cells at the very early stage of embryonic development are totipotent stem cells.A pluripotent stem cell has the potential to differentiate into many cell types derived from the three embryonic layers. However, it has lost the capacity to develop into a complete organism.A unipotent stem cell is derived from the further differentiation of the pluripotent stem cell. It can differentiate only into one cell type such as a hematopoietic stem cell, neural stem cell, and others.The other way is to classify human stem cells according to their source. There could be two kinds of human stem cells: embryonic stem cells and tissue stem cells (also called adult stem cells). The former involves experimentation with embryos, which has serious ethical implications. Ethical issues associated with the latter are mainly expressed in the various opinions regarding the allocation of health resources. Article 3. Human embryonic stem cells are the group of cells called the blastocyst inner cell mass during the early stage of embryonic development. They are the main source of totipotent stem cells, and hence the focal and hot point in stem cell research. Studies on the clinical application of embryonic stem cells probably will involve use of the somatic cell nucleus transfer (SCNT) technique, which destroys the early human embryo. At present, the ethical and moral debate is very serious in human embryonic stem cell research regarding whether the research will develop... (shrink)

Following the global financial crisis, banks have become more regulated to advance ethical sales cultures throughout the sector. Based on case studies of three retail banks, we find that they construct the ‘appropriate advisor’ in different ways. Inspired by Bakhtin’s work on ethics, we propose a vocabulary of relational ethics centered on the ‘answerable self.’ We argue that this vocabulary is apt for studying and discussing how organizations advance ethical sales cultures in ways that instead of encouraging (...) value congruence and alignment allow for ethical openness. In such cultures, employees—as moral agents—are morally questioning, critically self-reflexive, and answerable for their own actions toward others in their social relationships. Our paper makes three theoretical contributions, namely, problematizing the idea of cultural alignment and value congruence, demonstrating that identity regulation can both comprise and support the ‘answerable self,’ and advancing our understanding of the interdependence of ethical openness and ethical closure in fostering ethical sales cultures. (shrink)

While solid organ transplantation for patients with substance use issues has attracted ethical discussion, a typology of the ethics themes has not been articulated in the literature. We conducted a scoping review of peer-reviewed literature on solid organ transplantation and substance use published between January 1997 and April 2016. We aimed to identify and develop a typology of the main ethical themes discussed in this literature and to identify gaps worthy of future research. Seventy articles met inclusion criteria (...) and underwent inductive content analysis. Four main ethical themes were identified: (1) personal responsibility; (2) utility; (3) moral character; and (4) fairness. Each theme had multiple sub-themes and there was substantial overlap between themes. This scoping review identified a disproportionate emphasis in the literature regarding personal responsibility, which was referenced by each of the other themes, and a narrow focus on alcohol and liver. We recommend future research further investigate these connections between ethical themes and focus on ethical issues associated with transplants from organ groups other than liver for patients who use substances other than alcohol. (shrink)

The main aim of this article is to clarify the answer to the question: "What does it mean to measure the efficiency (or effectiveness) of an ethical code? Is this efficiency measurable?" Although this phrase is frequently used, it covers difficulties, both conceptual and of implementation. The proposed solution is to abandon the above question and redirect our attention towards a more complex one: What does it mean to measure the "efficiency" of a moral enhancement program, grounded on a (...) code of ethics and having as the objective to increase the organization's "moral content"? This outcome is brought about by "encapsulating" and dissolving the immoral behavior according to the guide of the seven institutional virtues identified by Kaptein. After introducing the "praxiological" concept of "moral efficiency", in which the "efficiency of the ethical code" is substituted by the "efficiency of moral programs", one shows how is it possible to measure the efficiency of the moral enhancement programs introduced to strengthen the moral content of an organization. (shrink)

Background Health advocacy is crucial for both patients and healthcare professionals. However, nurses who recognize the importance of health advocacy may experience heightened moral distress, particularly in complex donation and transplantation cases where patient autonomy, respect, and advocacy are paramount. Aim To identify the factors contributing to moral distress among nurses working in solid organ transplant units at a university hospital in São Paulo, with a focus on health advocacy. Research Design This descriptive, cross-sectional study employs both quantitative and qualitative (...) methods. For this, the quantitative phase of the study was conducted utilizing the Moral Distress Scale, while the qualitative phase was executed through focus group discussions. Participants and Research Context The quantitative phase involved 15 nurses using the Moral Distress Scale. The qualitative phase consisted of a focus group with 5 nurse managers/coordinators from the transplant units. Quantitative data were analyzed using R® software, while qualitative data were analyzed using Bardin’s Content Analysis. Ethical Considerations The study was approved by the Research Ethics Committee of the Ribeirão Preto College of Nursing, University of São Paulo. Participation was voluntary and confidentiality was ensured. Results A significant correlation was found between moral distress and the factors of “disregard for patient autonomy” ( p =.0100) and “therapeutic obstinacy” ( p =.0492). Conclusion The primary determinants associated with moral distress in the context of health advocacy were identified as “disregard for patient autonomy” and “therapeutic obstinacy.”. (shrink)

The use of drones (or unmanned aerial vehicles, UVAs) in humanitarian action has emerged rapidly in the last decade and continues to expand. These so-called ‘humanitarian drones’ represent the first wave of robotics applied in the humanitarian and development contexts, providing critical information through mapping of crisis-affected areas and timely delivery of aid supplies to populations in need. Alongside these emergent uses of drones in the aid sector, debates have arisen about potential risks and challenges, presenting diverse perspectives on the (...) ethical, legal, and social implications of humanitarian drones. Guided by the methodology introduced by Arksey and O’Malley, this scoping review offers an assessment of the ethical considerations discussed in the academic and gray literature based on a screening of 1,188 articles, from which we selected and analyzed 47 articles. In particular, we used a hybrid approach of qualitative content analysis, along with quantitative landscape mapping, to inductively develop a typology of ethical considerations associated with humanitarian drones. The results yielded 11 key areas of concern: (1) minimizing harm, (2) maximizing welfare, (3) substantive justice, (4) procedural justice, (5) respect for individuals, (6) respect for communities, (7) regulatory gaps, (8) regulatory dysfunction, (9) perceptions of humanitarian aid and organizations, (10) relations between humanitarian organizations and industry, and (11) the identity of humanitarian aid providers and organizations. Our findings illuminate topics that have been the focus of extensive attention (such as minimizing risks of harm and protecting privacy), traces the evolution of this discussion over time (i.e., an initial focus on mapping drones and the distinction of humanitarian from military use, toward the ethics of cargo drones carrying healthcare supplies and samples), and points to areas that have received less consideration (e.g., whether sustainability and shared benefits will be compromised if private companies’ interest in humanitarian drones wanes once new markets open up). The review can thus help to situate and guide further analysis of drone use in humanitarian settings. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Living Organ Donors’ Stories: (Unmet) Expectations about Informed Consent, Outcomes, and CareElisa J. Gordon, Symposium EditorKeywordsEthics, informed consent, kidney, liver, living donor, narrative, transplantationLiving donor organ transplantation has become standard treatment for patients with end-stage kidney or end-stage liver disease. Live donors comprised approximately 5,769 (34%) and 247 (4%) of all kidney and liver transplants in 2011, respectively (OPTN/UNOS). The reasons why people donate, the perception that donating (...) does not entail a decision per se, and the attendant fears and anxieties living donors feel about donating, have all been previously well investigated (Lennerling, Forsberg, Meyer, & Nyberg, 2004; Papachristou, Walter, Frommer, & Klapp, 2010). But much less is known about how donors experienced the overall donation process including the donor evaluation, preparation, appreciation of risks, decision-making, informed consent, post-operative, recovery processes, and the impact of donating on all aspects of their life, from their point of view. Thus, a narrative approach is essential for gaining insights into these less well known phenomena.There is good reason to remain concerned about the safety and ethical basis of living donation considering that living donors undergo serious health risks for no direct medical benefit to themselves (Ethics Committee of the Transplantation Society, 2004; Laird, 2012; Neergaard, 2011; Ratner & Sandoval, 2010; Shelton, 2011). The situation raises serious ethical questions specifically about nonmaleficence and informed consent, and more broadly about using people as a means to an end. The absence of long-term information may not undermine a willing donor’s commitment to save a loved one’s life, but is certainly cause for concern among transplant clinicians who want to be sure to disclose information that may be material for donors in order to provide adequate informed consent. In other words, the disjuncture between what transplant clinicians find important to disclose to donors and what prospective donors need to know—which follows along the lines of what Elliot Mishler referred to as the ‘voice of medicine’ versus the ‘voice of the lifeworld’(1984)—seems to complicate donors’ preparation for donation. Donors’ stories are important for addressing these concerns by identifying risks that typically do not get reported in the scientific literature—perhaps owing to a different [End Page 1] conceptualization of what should be construed as noteworthy risks—as well as by demonstrating how personal situations can enhance or detract from the experience overall.This issue of Narrative Inquiry in Bioethics (NIB) affords a unique entrée into both the often heard and unheard stories of living organ donors. A set of topical areas were presented for the authors’ consideration that relate to the donation process in general and the informed consent process more specifically: whether donors were prepared to donate; comprehended what they were told; could have understood the process better, as well as, the impact of donation on health, employment, finances, and personal relationships (Table 1). When soliciting donors’ stories, every effort was made to include a full range of experiences—both good and bad—from a variety of donors: kidney donation, liver donation, adult-to-adult and adult-to-child donation, related, unrelated, directed and anonymous (also known as ‘altruistic’ or ‘good Samaritan’ donors), paired chain exchange, and list exchange (Table 2)—in order to present a balanced perspective on live donation. Additionally, this issue includes a full breadth of stories about the donor experience, ranging from positive to mixed to negative (Table 3). While donors were given tremendous leeway in what stories they told, they were asked to focus their narratives on the lesser known dimensions of donation—the experience of it. While additional stories from liver donors would have helped to underscore common concerns among liver donors, we only received a few. Some of the donors are themselves health care professionals, active in the United Network for Organ Sharing (UNOS) or their local OPO, or have leveraged their experiences to help others by becoming a donor buddy or donor advocate. Given that we received more stories than Click for larger view View full resolutionTable 1.Topical areas to address[End Page 2] Click for larger view View full resolutionTable 2.Forms of Living Donation Click for larger view View... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Organ Transplant AllocationPat Milmoe McCarrick (bio)The introduction of the antibiotic, cyclosporin, which enhances the success rate of transplantation surgery, has resulted in the steady growth of organ transplantation since the mid-1980s. This growth increasingly focuses ethical interest on both the procurement and the allocation of human organs. Not everyone who might benefit from organ transplants can receive them since the number of patients in need of organs (...) far exceeds the number of organs available. Each year the waiting list for transplants increases by 20 percent, but the number of donated organs has remained stable for the past five years (Lawry 1994).Organ transplantation surgery performed on rock stars, sports heroes, politicians, and television celebrities brings questions about the fair allocation of scarce resources to the attention of everyone. Abigail Trafford, editor of Washington Post Health, wonders whether "new livers for hard livers" can be deserved when not enough organs are available for everyone who needs them. Writing about the dilemma of just allocation of organs, she calls famous recipients "poster patients" or "health care celebrities of medical catastrophe" (Trafford 1994). Personal responsibility—the viewpoint that "medical treatment should not be an entitlement program for profligate living"—is an emerging moral consideration according to Trafford. Deciding whose standards and values should apply to the allocation of organs raises many questions. Popular arguments for keeping the current criteria for allocation include: these patients are sick and therefore should be treated, regardless of the cause of their illness; former substance abusers should be able to benefit from their present abstention; physicians should treat anyone who is ill; and although many human illnesses may be caused by individual behavior, such behavior is not always used as a reason to deny care (Trafford 1995).Prior to 1984, when the government established regulations governing organ transplantation, organs routinely were given to the patients of the surgeons who excised them (Prottas 1994). In an effort to achieve a more equitable method of distribution, Congress passed the National Organ Transplant Act of 1984 (Pub. [End Page 365] L. No. 98-507, amended by Pub. L. No. 100607 and Pub. L. No. 101-616), which established a national Organ Procurement and Transplantation Network (OPTN) to improve the effectiveness of organ procurement, organ distribution, and transplant activities. The United Network for Organ Sharing (UNOS) received the federal government contract to be the OPTN.UNOS and its 66 regional organ procurement organizations (OPOs) around the nation have carried out the mandate since 1986. It requires hospitals that receive Medicare or Medicaid funds and perform transplants to belong to the network and to allocate organs according to network policies. UNOS maintains the national computer registry to match donor organs with individual recipients. In distributing organs, UNOS is required by law to use a fair and equitable system based on accepted medical criteria. UNOS regularly reevaluates its policies to ensure that organ donation and recipient selection meet criteria of efficiency and equity (UNOS Update 11 (8), 1995).At the end of June 1995, 278 transplant centers were in operation in the United States: almost all of them (247 centers) transplanted kidneys; 167 did hearts; 119, pancreases; 114, livers; 93, heart-lung; 88, lungs; 26, intestines; and only 19 centers performed pancreas islet cell transplants (UNOS Update 11 (8): 28, 1995). The number of patients waiting for organ transplants in July 1995 totalled 41,075: 29,274 were waiting for a kidney transplant; 4,937, liver; 3,298, heart; 1,816, lung; 1,223 kidney-pancreas; 240, pancreas; and 211, heart-lung (UNOS Update 11 (8): 40-41, 1995).OPOs are located in different geographic areas across the country, each with different organ needs, lengths of waiting lists, or with lists in areas with large older populations making it more difficult to find suitable donors. Black recipients often wait longer due to complex reasons including sensitization or rarer blood and antigen types (UNOS 11 (8): 31-32, 1995). When an organ becomes available, the OPO involved identifies a potential recipient from the UNOS list and offers it to the patient's surgeon. If no match can be made locally, the organ is next offered within a UNOS region, and finally, to... (shrink)

The prevalence of ethics training in organizations rose from 50% in 2003 to 76% in 2011 (Ethics Resource Center 2012). This paper reviews the current state of ethics training in organizations and proposes a new conceptual model for designing effective ethics training programs based on Rest’s (1986) model of ethical decision-making. We argue that it is not the content of ethics training that fails to produce ethical behavior; it is the method by which ethics training (...) is delivered. Most organizations utilize training methods designed to disseminate information or facilitate ethical dilemma recognition. Few organizations utilize methods that allow for trainees to actually practice making an ethical decision. We argue that a comprehensive approach to ethics training should be used, so trainees may practice all aspects of making an ethical decision. This practice should then enhance transfer of ethics training to the job. We conclude with suggestions for how research could be conducted to empirically support these arguments and inform ethics training method choices. (shrink)

Background Increasing social pluralism adds to the already existing variety of heterogeneous moral perspectives on good care, health, and quality of life. Pluralism in social identities is also connected to health and care disparities for minoritized patient (i.e. care receiver) populations, and to specific diversity-related moral challenges of healthcare professionals and organizations that aim to deliver diversity-responsive care in an inclusive work environment. Clinical ethics support (CES) services and instruments may help with adequately responding to these diversity-related moral challenges. (...) However, although various CES instruments exist to support healthcare professionals with dealing well with morally challenging situations in healthcare, current tools do not address challenges specifically related to moral pluralism and intersectional aspects of diversity and social justice issues. This article describes the content and developmental process of a novel CES instrument called the Diversity Compass. This instrument was designed with and for healthcare professionals to dialogically address and reflect on moral challenges related to intersectional aspects of diversity and social justice issues that they experience in daily practice. Methods We used a participatory development design to develop the Diversity Compass at a large long-term care organization in a major city in the Netherlands. Over a period of thirteen months, we conducted seven focus groups with healthcare professionals and peer-experts, carried out five expert interviews, and facilitated four meetings with a community of practice consisting of various healthcare professionals who developed and tested preliminary versions of the instrument throughout three cycles of iterative co-creation. Results The Diversity Compass is a practical, dialogical CES instrument that is designed as a small booklet and includes an eight-step deliberation method, as well as a guideline with seven recommendations to support professionals with engaging in dialogue when they are confronted with diversity-related moral challenges. The seven recommendations are key components in working toward creating an inclusive and safe space for dialogue to occur. Conclusions The Diversity Compass seeks to support healthcare professionals and organizations in their efforts to facilitate awareness, moral learning and joint reflection on moral challenges related to diversity and social justice issues. It is the first dialogical CES instrument that specifically acknowledges the role of social location in shaping moral perspectives or experiences with systemic injustices. However, to make healthcare more just, an instrument like the Diversity Compass is not enough on its own. In addition to the Diversity Compass, a systemic and structural approach to social justice issues in healthcare organizations is needed in order to foster a more inclusive, safe and diversity-responsive care and work environment in health care organizations. (shrink)

Background Requirements for organ donation after cardiac or imminent death have been introduced to address the transplantable organs shortage in the United States. Organ procurement organizations (OPOs) increasingly use the Internet for organ donation consent. Methods An analysis of OPO Web sites available to the public for enrollment and consent for organ donation. The Web sites and consent forms were examined for the minimal information recommended by the United States Department of Health and Human Services for informed consent. (...) class='Hi'>Content scores were calculated as percentages of data elements in four information categories: donor knowledge, donor consent reinforcement, donation promotion, and informed consent. Results There were 60 Web sites for organ donation enrollment serving the 52 states. The median percent (10 percentile-90 percentile) content scores of the Web sites for donor knowledge, donor consent reinforcement, and donation promotion were 33% (20–47), 79% (57–86), and 75% (50–100), respectively. The informed consent score was 0% (0–33). The content scores for donor knowledge and informed consent were significantly lower than donor consent reinforcement and donation promotion for all Web sites (P < .05). The content scores for the four categories were similar among the 11 regions of the United Network for Organ Sharing. Conclusion The Web sites and consent forms for public enrollment in organ donation do not fulfill the necessary requirements for informed consent. The Web sites predominantly provide positive reinforcement and promotional information rather than the transparent disclosure of organ donation process. Independent regulatory oversight is essential to ensure that Internet enrollment for organ donation complies with legal and ethical standards for informed consent. (shrink)

Background: Nurse managers have responsibilities relating to the quality of care, the welfare of the staff and running of the organization. Ethics plays significant role in these responsibilities. Ethical problems are part of daily management, but research in this area is limited. Objective: The aim of this study was to identify and describe ethical problems nurse managers encounter in their work to get more detailed and extensive view of these problems. Methods: The data consisted of nine interviews with (...) nurse managers at different management levels in primary healthcare and specialized healthcare organizations, and it was analysed by inductive content analysis. Ethical considerations: Permission to conduct the interviews including ethical approval was given at all participating organizations according to national standards. The respondents were informed about the aim of the study, and voluntary participation, anonymous response and confidentiality were explained to them. Findings: Four main categories were found: conflicts in practical situations, lack of appreciation, disregard of problems and experienced inadequacy. Problems could also be divided to patient-related, staff-related, organization-related and other problems. Discussion: The findings correspond with results from earlier studies but add knowledge of the nature and details of nurse managers’ ethical problems. New information is produced related to the ethical problems with nurse managers’ own courage, motivation and values. Conclusion: Nurse managers identified a variety of different ethical problems in their work. This information is useful in the development of ethics in nursing management. Further research about the frequency and intensity of nurse managers’ ethical problems is needed as well as possible differences in different levels of management. (shrink)

This book broadens the range of theoretically informed empirical research on business ethics (using data from major American corporations) and addresses the underlying questions about business ethics scholarship. It culminates a decade’s work by the authors—individually, jointly, and with others. The first part of the book addresses the major theoretical questions involved in doing empirical research about normative issues. It addresses the boundaries—methodological, conceptual, and institutional—that too easily separate philosophical and social scientific approaches to business ethics and reviews various ways (...) in which those approaches can be brought close together to benefit research and practice. The second part of the book describes and explains the increasing institutionalization of formal systems designed to manage ethics in organizations. It reviews the state of the art initiatives to foster ethical business conduct and also looks at the relative roles of executives and external policies (e.g., government regulations) in creating meaningful ethical initiatives. In the third part, the focus shifts to individual ethical behavior and how organizations influence it, describing in detail some of the outcomes of organizational ethics initiatives. It also looks at successes, failures, and new prospects in the effort to identify and explain the multiple factors that influence individual ethical behavior. (shrink)

Abstract:This field survey focused on two constructs that have been developed to represent the ethical context in organizations: ethical climate and ethical culture. We first examined issues of convergence and divergence between these constructs through factor analysis and correlational analysis. Results suggested that the two constructs are measuring somewhat different, but strongly related dimensions of the ethical context. We then investigated the relationships between the emergent ethical context factors and an ethics-related attitude (organizational commitment) (...) and behavior (observed unethical conduct) for respondents who work in organizations with and without ethics codes. Regression results indicated that an ethical culture-based dimension was more strongly associated with observed unethical conduct in code organizations while climate-based dimensions were more strongly associated with observed unethical conduct in non-code organizations. Ethical culture and ethical climate-based factors influenced organizational commitment similarly in both types of organizations. Normative implications of the study are discussed, as are implications for future theorizing, research and management practice. (shrink)

Background: The family interview context is permeated by numerous ethical issues which may generate conflicts and impact on organ donation process. Objective: This study aims to analyze the family interview process with a focus on principlist bioethics. Method: This exploratory, descriptive study uses a qualitative approach. The speeches were collected using the following prompt: “Talk about the family interview for the donation of organs and tissues for transplantation, from the preparation for the interview to the decision of the family (...) to donate or not.” For the treatment of qualitative data, we chose the method of content analysis and categorical thematic analysis. Participants: The study involved 18 nurses who worked in three municipal organ procurement organizations in São Paulo, Brazil, and who conducted family interviews for organ donation. Ethical considerations: The data were collected after approval of the study by the Research Ethics Committee of the School of Nursing of the University of São Paulo. Results: The results were classified into four categories and three subcategories. The categories are the principles adopted by principlist bioethics. Discussion: The principles of autonomy, beneficence, non-maleficence, and justice permeate the family interview and reveal their importance in the organs and tissues donation process for transplantation. Conclusion: The analysis of family interviews for the donation of organs and tissues for transplantation with a focus on principlist bioethics indicates that the process involves many ethical considerations. The elucidation of these aspects contributes to the discussion, training, and improvement of professionals, whether nurses or not, who work in organ procurement organizations and can improve the curriculum of existing training programs for transplant coordinators who pursue ethics in donation and transplantation as their foundation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:“Unduly Iterative Ethical Review?”Franklin G. MillerMadam:Renée C. Fox and Nicholas A. Christakis have written a provocative article, “Perish and Publish: Non-Heart-Beating Organ Donation and Unduly Iterative Ethical Review” (KIEJ, December 1995). The language of their argument and some of the implicit assumptions on which it rests deserve critical scrutiny. They describe the articles presenting and commenting on the University of Pittsburgh protocol as “disquieting” because the (...) display “trial-and-error ethics.” To dismiss “trial-and-error ethics” implies that we antecedently possess all the moral knowledge we need to evaluate and regulate developments in medicine. Should we summarily reject experimentation in ethics, particularly with respect to complex issues involving scientific and technological changes? For if we need to reconsider and possibly revise what counts as moral knowledge, the proposing an experimental approach to the ethics of a novel practice, which is presented publicly and made open to revision, as in the Pittsburgh protocol, may be precisely the best way to proceed.Fox and Christakis resort to invidious insinuation in their criticism of ethicists who have written, and journals that have published, articles about non-heart-beating organ donation. Publication on this issue has given ethicists the opportunity of “adding numerous items to their vitae.” Their appraisal of the vitae-boosting behavior represents an interesting rhetorical specimen: “Although there is nothing inherently dishonorable about this it does create tension between two motives: conviction about the importance of perfecting ethical conduct, on the one hand, and the desire to advance one’s professional career, on the other” (p. 340). I am not sure what the authors mean by “perfecting ethical conduct.” Yet they suggest that a group of reputable scholars, who have taken diverse positions on the ethics of non-heart-beating organ donation, have come perilously close to venality.Finally, in order to avoid further legitimating what they consider to be an ethically objectionable practice, the authors advocate that journals exercise “restraint” in publishing articles about this topic. Perhaps in a future pronouncement they will enlighten us about how enforcing a publication policy that avoids the vice of “unduly iterative ethical review” might work without compromising freedom of discussion. Moral dogmatism and censorship have a long history of association.Franklin G. MillerCenter for Biomedical Ethics University of Virginia Charlottesville, VACopyright © 1996 The Johns Hopkins University Press... (shrink)

This collection reflects the result of interactive academic work initiated by Johann Heinrich Pestalozzi University Inc., Miami, Florida, during the academic year 2018, and also the scholarly work of academics supporting our University. The authors include international academics from the United States of America, Great Britain, Croatia, Bosnia-Herzegovina, Switzerland, Austria, Serbia and Macedonia. Table of Contents: About the Authors; Craig Paterson--Contextualism & the History of Philosophy; Darko Bekic--Triangle Concept of Unification-Demilitarization Neutralisation of Korea: An Outline; Orlando Mardner--Economic Dimensions of Armed (...) Groups & Intra-State Terrorism: Preventions Through Geostrategic Changes in the International Laws of Financial Systems; Stephan U. Breu--The Challenge of Educating Refugee Children to Avoid Creating Tomorrow's Extremists; Hatidza Berisa--Historical Context of Military Interventionism; Parvis Hanson--The Future of Globalization: Help or Hurt the World's Poor; Joseph P. Garske--Common Law & Civilian Legal Cultures: Finding A Language of Law for the Global Age; Craig Paterson--The Societas Civilitas, Hate Speech & State Imposed Restrictions; Elmar Kuhn --Education as the Key for a Global Society in Peace & Freedom; Manish Sharma--Global Ecology & Sustainable Development: A Study in Gandhian Perspective; Paul Borrow-Longain--Law of Heraldic Arms; Craig Paterson--William Tyndale's Publication of The New Testament in the English Vernacular; Milka Ristova & Sanja Angelovska--The Contributions of International Law & NonGovernmental Organizations in Facilitating the Peaceful Reunification of the Korean Peninsula; Stephan U. Breu--Blockchains & Cybercurrencies Challenging Anti-Trust & Competition Law; Zoran R. Vitorovic--Preventive Diplomacy as a Key for the Reduction of Asymetric Conflicts; Stephan U. Breu--International Law Under Attack by Geostrategic Tensions Between Leading Nations. (shrink)

In their book Spare Parts, published in 1992, Fox and Swazey criticized various aspects of organ transplantation, including the routinization of the procedure, ignorance regarding its inherent uncertainties, and the ethos of transplant professionals. Using this work as a frame of reference, we analyzed articles on organ transplantation published in internal medicine and transplantation journals between 1995 and 2008 to see whether Fox and Swazey’s critiques of organ transplantation were still relevant.

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 13.1 (2003) 51-52 [Access article in PDF] Congress Considers Incentives for Organ Procurement Alexander S. Curtis [Tables]During the 108th Congressional session, several bills pertaining to ethical incentives for organ donation likely will be introduced. In some cases, they will be similar to bills before the 107th Congress (see Table 1). Bills in both the House of Representatives and the Senate address the (...) establishment and maintenance of donor registries, financial reimbursements for medical and nonmedical expenses incurred by qualifying donors, the presentation of commemorative medals, and tax credits.A bill entitled "Gift of Life Congressional Medal Act" (introduced last year by Senate majority leader Bill Frist (R-TN) as Senate Bill 325), and its corresponding bill of the same title (passed in the House of Representatives last year as H.R. 708), would establish a congressional commemorative medal honoring "any organ donor, or the family or family member of any organ donor." The medal is to be designed and struck with "suitable emblems, devices, and inscriptions" by the Secretary of the Treasury. The eligible donor or donor's family member would be presented with the medal by the Secretary of Health and Human Services. This bill would establish qualifying donations as those of human kidneys, livers, hearts, lungs, pancreases, or any other organ, but excludes corneas and eyes.Another bill, introduced by Representative Michael Bilirakis (R-FL) entitled "Organ Donation Improvement Act" (H.R. 624), would award grants or contracts to states, transplant centers, and qualified organ procurement organizations for the purpose of providing travel, subsistence, and incidental nonmedical expenses to individuals who make living donations. In order to receive reimbursement, the donating individuals must reside in states other than the states in which the intended recipients reside and the annual income of those receiving the organs cannot exceed $35,000. The bill also would appropriate $15,000,000 to make grants to states and public and nonprofit entities for the purpose of carrying out studies, public education demonstrations, and outreach activities "designed to increase the number of organ donors within the state." The bill would be effective from time of enactment through 2005. [End Page 51]Two other bills proposed within the House of Representatives in 2002 called for amendment to the Internal Revenue Code. The "Gift of Life Tax Credit Act (introduced as H.R. 1872 by Representative James Hansen (R-UT)) and the "Help Organ Procurement Expand Act" (introduced as H.R. 2090 by Representative Chris Smith (R-NJ)) present a refundable credit to individuals or to the estates of those who agree either to be living donors or to donate their organs upon death. The "Gift of Life Tax Credit Act" refunds $10,000 to the estates of eligible individuals "for the taxable year which includes the date of the individual's death." The "Help Organ Procurement Expand Act" offers a refund of $2,500 to qualified persons. Donations of kidneys, livers, pancreases, islet cells, lungs, and intestines are accepted, however several conditions restrict permissible donors. The "Gift of Life Tax Credit Act" requires that the legally competent individual's death not be due to a suicide and that the intention to donate was clearly declared. The "Help Organ Procurement Expand Act" prohibits donations from individuals who were killed with physician assistance, died as a result of a suicide, have been indicted or convicted of a felony or a misdemeanor offense, or are actively under criminal investigation for a possible felony offense. The "Help Organ Procurement Expand Act" also restricts procuring organs from unborn children or human fetuses and under circumstances in which the living donor would be subject to "unacceptable levels of medical risk of death or permanent debilitation." Alexander S. Curtis is a research assistant at the Kennedy Institute of Ethics, Georgetown University, Washington, DC. He received his bachelor's degree from Miami University.... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Asian American Christian Ethics: Voices, Methods, Issues eds. by Grace Y. Kao and Ilsup AhnAlex MikulichAsian American Christian Ethics: Voices, Methods, Issues Edited by Grace Y. Kao and Ilsup Ahn WACO, TX: BAYLOR UNIVERSITY PRESS, 2015. 355 PP. $44.95This volume opens new horizons in Christian ethics. Editors Grace Y. Kao and Ilsup Ahn suggest two ways of conceptualizing Asian American Christian ethics. They describe the first as (...) "agency- or advocacy-centered" and the second as "bringing Western and Asian philosophical, theological, and cultural traditions together in critical dialogue and for selective retrieval for Asian American Christian ethics" (11). While the contributors to this book rightfully develop agency and advocacy-centered approaches within complex histories of colonialism and oppression, they also emulate Michael Walzer's "connected critic" who is not naïvely or uncritically "neutral" or dispassionate. The contributors appropriately use co-critical approaches that make possible "new and creative 'traditioning'" that does not uncritically reinscribe some "purer" Asian past or "undefiled by Western contact" (15).Nearly every chapter unpacks the deeply problematic term "Asian American" that was originally employed by activists who sought a new identity as "self-determining subjects rather than as 'oriental objects' in the United States" (4). But the term obfuscates multiple diversities within richly divergent national, geographical, colonial, and cultural histories and traditions.Hoon Choi explores the complexity of gender and sexual identities through a richly textured intersectional approach, examines how these identities become intertwined in double and triple binds, and reinterprets Christ as the fullness of humanity against Western hegemony and Eastern sexism. Choi's vibrant reinterpretation of Jesus Christ is complemented by a wise and compassionate pastoral approach.Sharon M. Tan calls for a reinterpretation both of Christian and Asian traditions of marriage, family, and parenting that will "entail a bicultural approach to life" and "creative new ways of retelling their stories and imagining their futures" (42). Tan underscores the difficulty of describing a Pan-Asian approach to marriage, family, and parenting by exploring the complexities of "Tiger Mothers," multigenerational households, the "special case of refugees," transnational families, and biculturality and adaptation.Hannah Ka deconstructs a wide range of Christian approaches to environmental ethics and reinterprets Sallie McFague's Body of God ecological theology through a distinctive Asian American approach. Drawing on beautiful and challenging stories from her own family as well as Confucian and Taoist [End Page 215] thought, Ka suggests a reinterpretation both of existential and functional indebtedness between human beings and all living things. She contends that "humans cannot survive even a day without … all other inorganic and organic existents on earth, while [other existents] can flourish without humans. The life of the human species is not merely interdependent with, but utterly indebted to, all the other existents on earth, rendering humans more vulnerable than others" (221).These are only a few examples of how this volume exemplifies clear, cogent, and constructive Christian ethics. Chapters by Ilsup Ahn ("Virtue Ethics"), Keun-Joo Christine Pae ("Peace and War"), Christina A. Astorga ("Wealth and Prosperity"), Ki Joo (KC) Choi ("Racial Identity and Solidarity"), SueJeanne Koh ("Health Care"), Hak Joon Lee ("Immigration"), Irene Oh ("Education and Labor"), and Jonathan Tran ("Cosmetic Surgery") all expand the horizons of contemporary ethics. I highly recommend this text for scholars to engage new horizons of Christian ethics and to use for a wide variety of upper level undergraduate and graduate courses in Christian ethics as well as constructive and pastoral theology.Alex MikulichLoyola University New OrleansCopyright © 2017 Society of Christian Ethics... (shrink)

Crisis management can be simultaneously a content specific problem solving process and an opportunity for stimulating and enabling an organization's ethical tradition. Crisis can be an opportunity for ethical organizational development. Kierkegaardian "upbuilding" dialog method builds from within the internal ethical tradition of an organization to respond to crises while simultaneously adapting and protecting the organization's tradition. The crisis itself may not be a directly ethical crisis, but the method of responding to the crisis is (...) built upon the ethical foundations of an organization's tradition. A limitation of this method is that it may be less applicable to organizations with questionably ethical traditions. The concept of "upbuilding" dialog is derived from Kierkegaard, but here is applied to organizational crisis management. The method is illustrated and discussed in the context of a wrongful death crisis of the Dana- Farber Cancer Institute, a non-profit organization, and an economic survival crisis at Ben and Jerry's, a business organization. (shrink)

Background Several ethical issues are associated with providing living organ transplantation services, and there is limited information on these issues faced by the teams providing service to refugees or asylum seekers. Aim To determine the challenges healthcare professionals face in organ transplant centers providing services to Syrians under temporary protection status and discern whether these difficulties align with ethical issues in living organ transplantation. Research design This study employed a qualitative design and conducted individual semi-structured, in-depth interviews with (...) 18 transplant team members in Istanbul between September and November 2022. Data analysis was based on Braun and Clarke’s thematic analysis. Participants and research context The participants comprised 18 healthcare professionals, including 6 physicians and 12 nurses working in organ transplant teams in Istanbul. Ethical considerations The University’s Ethics Committee provided approval. Participants were informed regarding confidentiality and signed an informed consent form. Results Three themes emerged from the data on ethical issues faced by organ transplantation services to Syrians: (a) beneficence or double equipoise, (b) autonomy, and (c) justice. Transplant teams experience problems related to preserving double equipoise in the provision of living donor organ transplantation because of language barriers, poor socioeconomic conditions, and cultural factors, which increases transplant teams’ individual and indirect social burden. Although problems arise from the language barrier when obtaining informed consent in the autonomy theme, institutional and national policies in preventing donor abuse have a comforting effect. Health workers had the least problems with the justice theme, wherein national health policies are determined. Conclusion Fewer issues related to autonomy and justice were reported in providing organ transplantation services to Syrians, with the most intense reported issues being maintaining double equipoise. The results revealed the need to develop institutional, national, and international policies with individual solutions to prevent difficulties healthcare professionals face in this process. (shrink)

Data science skills are rapidly becoming a necessity in modern science. In response to this need, institutions and organizations around the world are developing research data science curricula to teach the programming and computational skills that are needed to build and maintain data infrastructures and maximize the use of available data. To date, however, few of these courses have included an explicit ethics component, and developing such components can be challenging. This paper describes a novel approach to teaching data (...) ethics on short courses developed for the CODATA-RDA Schools for Research Data Science. The ethics content of these schools is centred on the concept of open and responsible science citizenship that draws on virtue ethics to promote ethics of practice. Despite having little formal teaching time, this concept of citizenship is made central to the course by distributing ethics content across technical modules. Ethics instruction consists of a wide range of techniques, including stand-alone lectures, group discussions and mini-exercises linked to technical modules. This multi-level approach enables students to develop an understanding both of “responsible and open science citizenship”, and of how such responsibilities are implemented in daily research practices within their home environment. This approach successfully locates ethics within daily data science practice, and allows students to see how small actions build into larger ethical concerns. This emphasises that ethics are not something “removed from daily research” or the remit of data generators/end users, but rather are a vital concern for all data scientists. (shrink)

We review and synthesize over two decades of research on ethical culture in organizations, examining eighty-nine relevant scholarly works. Our article discusses the conceptualization of ethical culture in a cross-disciplinary space and its critical role in ethical decision-making. With a view to advancing future research, we analyze the antecedents, outcomes, and mediator and moderator roles of ethical culture. To do so, we identify measures and theories used in past studies and make recommendations. We propose, inter (...) alia, the use of validated measures, application of a wider range of theories, adoption of longitudinal studies, and study of group-level data in organizations. We explore research possibilities in new and emergent forms of organizations, ways of organizing work, and technology in ethical decision-making, such as the role of artificial intelligence. We also recommend the study of a broad range of leadership styles and their influence in shaping ethical cultures in organizations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 13.1 (2003) 53-64 [Access article in PDF] Incentives for Providing Organs Patricia Milmoe McCarrick and Martina Darragh After a contentious debate at its 2002 annual meeting, the American Medical Association's House of Delegates voted to endorse the opinion of its Council on Ethical and Judicial Affairs that the impact of financial incentives on organ donation should be studied (Josefson 2002). The shortage (...) of organs for transplantation has been an ongoing problem for more than 20 years. In June1981, Representative Philip Crane (R-IL) introduced legislation in the U.S. House of Representatives proposing a $25,000 income tax deduction and a $25,000 estate tax exclusion for donating an organ (Tax Incentives 1981). Still the National Organ Transplant Act enacted in October 1984 prohibited the offering of any "valuable consideration" in return for organs (United States 1984).The developments of a legal market for tissues in the United States and a black market for organs around the world have raised the question of whether donation without compensation is the only ethically viable option. Some critics of the current system claim reliance on donation actually promotes a black market in organs (Kaserman and Barnett 2002, p. 38; Palmer 1999, p. 36). In addition, a new set of compensation issues has arisen as living kidney donor transplantations begin to rival those performed with cadaveric organs (United States 2001).As a result, current suggestions for incentives go far beyond the traditional death benefit payment to include such ideas as medals of honor for donors, reimbursement for funeral expenses, exchange programs for organ donation, and special medical insurance for living organ donors. Numerous bills introduced into the 107th Congress have proposed such incentives (Delmonico et al. 2002.) In October 2002, the U.S. Department of Health and Human Services awarded $5.2 million in grants to study both clinical and behavioral interventions for increasing organ donations that do not involve incentives. The inspiration for some of the funded proposals comes from the successes of Spain's social services and the United Kingdom's clinical administration of organ procurement programs (Robeznieks 2002). [End Page 53]With a nod to evidence-based medicine, the underlying concern expressed in much of the current literature is that no idea for increasing the supply of organs should be discounted before it is studied. This bibliography provides a short introduction to the range of opinions expressed on the issue of incentives for providing organs.al-Mousawi, M.; Samhan, M.; al-Mezairee I.; Razzak, M.A.; and Khawari, F. Cadaver Organ Procurement in Kuwait. Transplantation Proceedings 31 (8): 3375-76, 1999.The authors describe a protocol that significantly increased cadaveric organ donation and credit it with fostering the expansion of an organ sharing program among the Arab Gulf states. Developed by Kuwaiti neurologists and anesthetists after a continuing education course on transplantation, the protocol places a special emphasis on the role of local transplant coordinators who facilitate the investigation of brain death cases by neurologists.Arnold, Robert; Bartlett, Steven; Bernat, James; et al. [Ethics Committee of the American Society of Transplant Surgeons] Financial Incentives for Cadaver Organ Donation: an Ethical Reappraisal. Transplantation 73 (8): 1361-67, 27 April 2002.To prepare for proposed studies of financial incentives for organ donation, the American Society of Transplant Surgeons convened a panel to develop a methodology for evaluating the ethics of such research. Comprised of organ procurement organization executives, physicians, surgeons, and ethicists, the panel generated a list of nine criteria for use in judging any incentives proposal. While opposed to direct payment or tax incentives for organ donation, a majority of the members support funeral expense reimbursement or charitable contributions as incentives that would not violate or undermine the ideal of altruism.Cameron, J. Stewart, and Hoffenberg, Raymond. The Ethics of Organ Transplantation Reconsidered: Paid Organ Donation and the Use of Executed Prisoners as Donors. Kidney International 55 (2): 724-32, February 1999.After reviewing arguments for and against payment for organ procurement, the authors apply these arguments to the specific case of obtaining organs from executed... (shrink)

The environmental degradation caused by industrial agriculture, as well as the resulting social and health consequences, creates an urgency to rethink food production by expanding the moral imagination to include agricultural practices. Agricultural practices presume human use of the earth and acknowledge human dependence on the biotic community, and these relations mean that agriculture presents a separate set of considerations in the broader field of environmental ethics. Many scholars and activists have argued persuasively that we need new stories to rethink (...) agricultural practice, however, the link—the story that does and can shape agricultural practice—has not yet been fully articulated in environmental discourse. My analysis explores how language has shaped existing agricultural models and, more important, the potential of story to influence agricultural practice. To do this, I draw upon cognitive theory to illustrate how metaphoric and narrative language structures thought and influences practice, beginning with my contention that industrial agriculture relies on a discourse of mechanistic relations between humans and a passive earth, language that has naturalized the chemically intensive monocultures prevalent in much of the American Midwest. However, alternative agricultures, including organic agriculture, agro-ecology, and ecological agriculture, emphasize qualities such as interdependence and reciprocity and do so as a deliberate response to the perceived inadequacies of industrial agriculture and its governing narrative. Exploring the different discourses of agricultural systems can help us think through different modalities for human relations with the biotic community and demonstrate story’s potential role in altering practice. (shrink)

This article evaluates a family of criticism of how engineering ethics is now generally taught. The short version of the criticism might be put this way: Teachers of engineering ethics devote too much time to individual decisions and not enough time to social context. There are at least six version of this criticism, each corresponding to a specific subject omitted. Teachers of engineering ethics do not (it is said) teach enough about: 1) the culture of organizations; 2) the organization (...) of organizations; 3) the legal environment of organizations; 4) the role of professions in organizations; 5) the role of organizations in professions; or 6) the political environment of organizations. My conclusion is that, while all six are worthy subjects, there is neither much reason to believe that any of them are now absent from courses in engineering ethics nor an obvious way to decide whether they (individually or in combination) are (or are not) now being given their due. What we have here is a dispute about how much is enough. Such disputes are not to be settled without agreement concerning how we are to tell we have enough of this or that. Right now we seem to lack that agreement—and not to have much reason to expect it any time soon. (shrink)

The Routledge Companion to Ethics, Politics and Organizations synthesizes and extends existing research on ethics in organizations by explicitly focusing on 'ethico-politics' - where ethics informs political action. It draws connections between ethics and politics in and around organizations and the workplace, examines cutting-edge areas and sets the scene for future research. Through a wealth of international and multidisciplinary contributions this volume considers the broad range of ways in which ethics and politics can be conceived and understood. (...) The chapters look at various ethical traditions, as well as the discursive deployment of ethical terminology in organizational settings, and they also examine large scale political structures and processes and how they relate to different forms of politics which affect behaviour in organizations. These many possibilities are united by a focus on how ethics can be used to inform and justify the exercise of power in organizations. This collection will be a valuable reference source for students and researchers across the disciplines of organizational studies, ethics and politics. (shrink)

This article examines and synthesizes two different approaches to determining the content of business ethics courses and the manner in which they ought to be taught. The first approach, from a political perspective, argues that the institutional framework within which business operates ought to be tested by theories of distributive justice. The second approach, from the perspective of virtue theory, argues that we ought to examine the character of individual employees and the responsibilities associated with the roles which these (...) individuals play within organizations. I argue that Gadamer's interpretation of Aristotle's notion of phronesis shows an inseparable, bidirectional, conceptual link between the approaches of politics and virtue as well as providing insight into how business ethics might best be taught. (shrink)

Grounded upon the late 1970s phrase "institutionalizing ethics into business," I present a multi-component model and research agenda to enhance our understanding of organizations' efforts to integrate ethics into the daily decision-making process of employees. Three research foci are emphasized: (I) the need to establish consistent categorical frameworks to describe business organizations' efforts in the field, (2) the study of the interrelationships between the various components presented in the model, and (3) the exploration of the linkage between organizational (...) efforts to institutionalize ethics and ethical employee behavior. Research and organizational implications evolving from these research foci are discussed. (shrink)

The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) requires as a condition of accreditation that every health care institution -- hospital, nursing home, or home care agency -- have a standing mechanism to address ethical issues. Most organizations have chosen to fulfill this requirement with an interdisciplinary ethics committee. The best of these committees are knowledgeable, creative, and effective resources in their institutions. Many are wellmeaning but lack the information, experience, and skills to negotiate adequately (...) the complex ethical issues that arise in clinical and organizational settings. Handbook for Health Care Ethics Committees is the first resource designed to address the range of work performed by ethics committees as part of their multiple responsibilities, including education, case consultation, and policy development. It features an eight-chapter curriculum reviewing the content of contemporary health care bioethics and discussing the ethical foundations of clinical practice, with each subsequent section focusing on a set of ethical issues that commonly arise in the clinical setting. Through case studies, the authors explore issues such as informed consent and refusal, decision making and decisional capacity, truth telling, decision-making concerns of minors, end-of-life issues, palliation, justice in and access to health care services, and organizational ethics. They offer sample policies and procedures, draft guidelines and protocols, and key legal cases. Providing both a strong theoretical foundation and practical applications, this handbook will be essential reading for every member of a health care ethics committee. (shrink)

Although there is a growing body of research on social media, only few studies have considered organic products. Therefore, this study mapped the diffusion path of the social media resources for organic products in Mexico and South Korea through Twitter and compared the contents of tweets about organic products in terms of their semantic and hyperlink networks using webometric methods. The results indicate that for organic products, Koreans sent tweets much more frequently than Mexicans. Mexican tweets focused on basic food (...) products in street markets, whereas Korean tweets highlighted promotions and firms, revealing the corporatist structure of its economy. In both cases, the findings support Twitter as a useful tool for Word-of-Mouth Communication on the online environment, among product consumers, and between consumers and enterprises. (shrink)

My contention is that considering a person to be co-located with an organism, or one of its\nspatial or temporal parts, gives rise to a host of problems as a result of there then being too many\nthinkers. These problems, which Olson has emphasized, can be mitigated (somewhat) by a\nNoonan-style pronoun revisionism. But doing so will have very unwelcome consequences for\nbioethics as autonomy, informed consent, advance directives and substituted judgment will be\nimpossible for the human animal. I count it as a point in (...) favor of Olson’s answer to the\nmetaphysical question “What are we?” that it avoids such ethical quandaries. But his animalism -\nwith its Parfit-inspired claim that it is not identity that matters in survival but the continuation of\nour psychology even if someone else is its subject - appears to be at odds with our self-conception\nand practical concerns. And if the only argument for this thesis is the fission scenario, then the\nthesis is further undermined as Parfit’s account of fission runs afoul of Wiggins’s Only a and b\nrule. What I will very tentatively suggest is that we explore two (incompatible) accounts of\nanimalism which deny that being identical to a future being is only of derivative importance to us. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Organizational Ethics and Health Care: Expanding Bioethics to the Institutional Arena **Laura Jane Bishop (bio), M. Nichelle Cherry (bio), and Martina Darragh* (bio)In 1995, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) expanded its patient rights standards to include requirements for assuring that hospital business practices would be ethical. Renamed “Patient Rights and Organization Ethics,” these standards are based on the realization that a hospital’s (...) obligation to its patients is derived from two relationships: the patient-provider relationship governed by “clinical ethics,” and the customer-supplier relationship governed by “business ethics.” “[This] boundary between ‘clinical’ ethics and ‘business’ ethics is not clear and in many cases is nonexistent. While marketing and admission practices are seen as issues related to ‘business’ ethics, they can lead to unneeded admissions or demand for unneeded services, both of which can unnecessarily expose the patient to the risk of side effects or complications. Likewise, underutilization of needed services is likely to lead to less than optimal health outcomes” (I. Schyve 1996, p. 17). “These new standards arose out of well-publicized concerns about abuses in which patients were admitted to hospitals unnecessarily and were discharged or transferred only after their insurance expired” (I. Schyve 1996, pp. 15–16).These abuses also sparked eloquent protests against threats to patient well-being and to the nature of the patient-provider relationship in the bioethics literature. The fiduciary responsibility of the provider to inform and to protect the patient was fragmented by insurer business practices such as gag clauses and economic credentialing of providers (VII. Scope Note 31, 1996). The background role that the institution plays, though poorly articulated historically, has been brought sharply into focus by the explosive growth of the managed practice of medicine. The context of medical ethics is no longer limited to the resolution of individual cases, but instead encompasses the adoption of institutional structures to protect and promote patient welfare (IV. Emanuel 1995, p. 335). In this new configuration, the institution and the providers are co-fiduciaries for populations [End Page 189] of patients, and the medicine that is practiced is “appropriately economically disciplined.” The expression “My patient always comes first” is no longer “... intellectually serious or morally responsible.” But, “... to be sure, both conceptually and in practice, being an economically disciplined fiduciary professional or institution is ethically unstable.... The task is to identify the boundaries outside of which institutional policy and behavior will not count as an ethically defensible form of being... [a] fiduciary.” (IV. McCullough 1997, pp. 143–44). This process of delimiting and enforcing boundaries requires the development of “... a language for talking about the ethical values of the organization. If such a language does not exist, discussions about ethics become cumbersome and unlikely to occur” (IV. Cleveland Clinic Foundation 1998, p. 2).As with bioethics generally, the literature addressing organizational ethics is multidisciplinary. JCAHO’s compliance guide for its revised standards, Ethical Issues and Patient Rights, draws on a wealth of ideas from both clinical ethics and business ethics. This is often an awkward alliance. “Because the study of organizational ethics is in its infancy compared to other areas of healthcare ethics, discussions about it often seem like hot air with no palpable payoff” (I. Boyle 1998, p. 2). The fact that “... there is an ancient history that reflects widespread doubt about the moral probity of business” (II. Frederick 1995, p. 209) does not help. To begin, “Aristotle had rude things to say about business” (II. Jackson 1998, p. 401). A brief review of introductions to several of the business ethics textbooks cited in this bibliography reveals that a rebuttal of “business ethics as an oxymoron” is the standard opening paragraph. This stigma is unfounded, and “increased stability” has characterized the state of business ethics literature during the 1990s (II. Beauchamp and Bowie 1997, p. ix). Significant attention has been given to elaborating two often overlapping theories—stakeholder and social contractarian.Originating in the 1960s as a pun on “stockholder,” proponents of stakeholder theory claim that a corporation’s fiduciary responsibility extends beyond increasing its profitability to protecting the rights of individuals or groups affected by its actions. Popular as a strategic planning tool in the... (shrink)

This scoping review synthesized evidence on research ethics capacity development in Anglophone West Africa, aimed at evaluating approaches, achievements, and challenges, offering recommendations for future research ethics training in the sub-region. The “Population-Concept-Context” Framework guided eligibility criteria with searches conducted in EBSCOhost, Medline, PubMed, CINAHL, Cochrane Library, JBI Database of Systematic Review, and Google Scholar. Records available from 2000 to July 2024 were screened and abstracted in COVIDENCE. The review was conducted and reported per JBI methodology for scoping reviews and (...) PRISMA-ScR. Sixteen sources describing eight research ethics training programs in Anglophone West Africa were identified. Stakeholders involved in these capacity development programs included local institutions and organizations collaborating with institutions from the Global North. Funding was mainly from the Global North. Training programs were either degrees, fellowships, or workshops and contents were on research ethics, research integrity, research methods, community engagement, and protocol review. Challenges reported include trainees’ untimely completion of research projects, high cost of fees, and internet connectivity. Achievements were an increase in participants’ knowledge, their involvement in the entire research system, and the introduction of degree programs in local universities. Future research ethics capacity development should pay attention to local funding and South-South collaboration. There is a need to increase capacity development activity in the region. Such training activities will need to be reported, and lessons shared through open-access journals and databases thus reaching a wider audience. (shrink)

As value chains become longer with increases in outsourcing and subcontracting, the challenges of fixing responsibility become more difficult. Using concepts from the literature on social networks, this paper considers issues of diffusion of responsibility and plausible deniability in such relationships. Specifically, this paper isolates three sources of denial of – or defense against – attributions of responsibility: connection, control and knowledge. It goes on to consider the effects on network density and actor centrality as third parties (tertius illuminans) alter (...) the structure of these networks. Finally, preliminary conclusions are considered including suggestions for addressing these new challenges as well as the potential for conceptual cross-fertilization between network analysis and organizationalethics. (shrink)

Personalized medicine aims to tailor disease prevention, diagnosis, and treatment to individuals on the basis of their genes, lifestyle and environments. Patient and interest organizations may potentially play an important role in the realization of PM. This paper investigates the views and perspectives on PM of a variety of PIOs. Semi-structured telephone interviews were conducted among leading representatives of 13 PIOs located in Europe and North-America. The data collected were analysed using a conventional content analysis approach. The PIO (...) representatives supported the realization of PM but feared that many financial, structural and organizational challenges may delay its realization. They encouraged strategies to modernize drug licencing mechanisms, develop research and data sharing infrastructures, and educate patients and health care professionals in PM. Notably, they emphasized the importance of developing PM in an equitable way and taking into consideration the patients’ needs, values and personal situation. Despite varying levels of awareness regarding PM, the PIO representatives expressed willingness to engage in the PM agenda and recommended that PIOs work closely with policy-makers to design PM in a way that truly addresses the needs and concerns of patients. PIOs have the potential to become central drivers of the PM agenda. Collaborations should be further developed between PIOs, researchers, drug developers and health care authorities. (shrink)

This paper explores the relationship between declining organizations and unethical behavior. Data from a four month long management simulation indicate that declining organizations demonstrate a greater propensity for unethical activities than do more successful companies. The results indicate that: 1) organizations in decline are more likely to be involved in unethical activities; 2) the more severe the decline is, the more unethical the behavior is likely to be; and 3) it is organizational decline and not initial propensities (...) toward unethical conduct that explains the unethical behavior. The paper also discusses the implications of these findings and outlines future streams of research.Honesty is the best policy - When there is money in it. - Mark Twain. (shrink)

Chinese authors are the third most frequent submitters to the JME. However, as will be apparent from the content published in the journal, relatively fewer papers from China are accepted. That is not due to a lack of important scholarship in China. We recently contributed to a highly successful conference with Professor Xiaomei Zhai at Peking Union Medical College, Beijing and were impressed by the increasing awareness, analysis and progress of medical ethics in China, including in the area of (...) organ transplantation. However, few of these presentations make it into print. It is therefore important to make the criteria that inform editorial judgements as transparent as possible. There are several reasons why the acceptance rates for the JME are higher in some countries than others. Some of them are related to different views about what constitutes medical ethics or research. In some contexts, articles are not recognised as research unless they are empirical and the bulk of papers submitted from some countries have no ethical argument. Philosophical traditions vary across countries and papers that are primarily exegetical, in the sense that they describe what a famous philosopher would say about an issue, usually do not make it into the JME. There are other journals that accommodate different views about what counts as research or ethics, so authors should match their papers to the content that a journal publishes. However, academic journals can be opaque about how authors should pitch their papers so as to maximise their chances of publication. …. (shrink)

Background/Objective The act of surgery involves harming vulnerable patients with the intent that the results will improve their health and, ultimately, help the patients. Such activities will inevitably entail moral decisions, yet the ethics of surgery has only recently developed as a field of medical ethics. Within this field, it is striking how few accounts there are of actions within the operating room. The aim of this systematic review was to investigate how much of the scientific publications on surgical ethics (...) focus on what take place inside the operating room and to explore the ethical issues included in the publications that focus on medical ethics in the operating room. Methods We conducted a systematic search of the Medline and Embase databases using a PICO model and the search terms “surgery”, “ethics” and “operating room”. Papers were included if they focused on doctors, entailed activities inside the operating room and contained some ethical analysis. Thematic synthesis was used for data extraction and analysis. Findings Fewer than 2% of the scientific publications on surgical ethics included activities inside the operating room. A total of 108 studies were included in the full-text analysis and reported according to the RESERVE guidelines. Eight content areas covered 2/3 of the included papers: DNR orders in the OR, overlapping surgery, donation of organs, broadcasting live surgery, video recordings in the OR, communication/teamwork, implementing new surgical technology, and denying blood to Jehovah’s Witness. Discussion/Conclusions This systematic review indicates that only a small fraction of scientific publications on the ethics of surgery focus on issues inside the operating room, accentuating the need for further research to close this gap. The ethical issues that repeatedly arose in the included papers included the meaning of patient autonomy inside the operating room, the consequences of technological advances in surgery, the balancing of legitimate interests, the dehumanising potential of the OR, and the strong notion of surgeon responsibility. (shrink)

Background: Ambulance professionals often address conflicts between ethical values. As individuals’ values represent basic convictions of what is right or good and motivate behaviour, research is needed to understand their value profiles. Objectives: To translate and adapt the Managerial Values Profile to Spanish and Swedish, and measure the presence of utilitarianism, moral rights and/or social justice in ambulance professionals’ value profiles in Spain and Sweden. Methods: The instrument was translated and culturally adapted. A content validity index was calculated. (...) Pilot tests were carried out with 46 participants. Ethical considerations: This study conforms to the ethical principles for research involving human subjects and adheres to national laws and regulations concerning informed consent and confidentiality. Findings: Spanish professionals favoured justice and Swedish professionals’ rights in their ambulance organizations. Both countries favoured utilitarianism least. Gender differences across countries showed that males favoured rights. Spanish female professionals favoured justice most strongly of all. Discussion: Swedes favour rights while Spaniards favour justice. Both contexts scored low on utilitarianism focusing on total population effect, preferring the opposite, individualized approach of the rights and justice perspectives. Organizational investment in a utilitarian perspective might jeopardize ambulance professionals’ moral right to make individual assessments based on the needs of the patient at hand. Utilitarianism and a caring ethos appear as stark opposites. However, a caring ethos in its turn might well involve unreasonable demands on the individual carer’s professional role. Since both the justice and rights perspectives portrayed in the survey mainly concern relationship to the organization and peers within the organization, this relationship might at worst be given priority over the equal treatment and moral rights of the patient. Conclusion: A balanced view on ethical perspectives is needed to make professionals observant and ready to act optimally – especially if these perspectives are used in patient care. Research is needed to clarify how justice and rights are prioritized by ambulance services and whether or not these organization-related values are also implemented in patient care. (shrink)

In a recent issue of the Cambridge Quarterly of Healthcare Ethics, Emily Carroll and Parker Crutchfield published a paper entitled, “The Duty to Protect, Abortion, and Organ Donation.” They argued that a prohibition on abortion is morally equivalent to a positive mandate for parents to donate organs to their children and that opponents of abortion must be prepared to accept these mandates to remain consistent.

In lieu of an abstract, here is a brief excerpt of the content:Teaching Ethics in the Health Care SettingPart II: Sample SyllabusMary Carrington Coutts (bio)The National Reference Center for Bioethics Literature at the Kennedy Institute of Ethics receives many inquiries from instructors at institutions that are just beginning to teach medical ethics. In an effort to assist those individuals, we have devised a syllabus that could be adapted for many uses. This is intended to be an introductory level syllabus, (...) perhaps one that would be appropriate for continuing staff education in a hospital or for an undergraduate college course. Of course, every instructor has his or her own style and preference for course content. This is offered merely as a place to start.Recognizing that participants bring a variety of backgrounds to a course, four possible text books and two casebooks have been selected as texts for a course in health care ethics. There are a number of other books that also could have been chosen. Some of these are listed in Scope Note 15: Basic Resources in Bioethics (published in the Kennedy Institute of Ethics Journal 1 (1): 75-90, March 1991). Other video selections are listed in Scope Note 9: Bioethics Audiovisuals: 1982-Present (1988); (available directly from the National Reference Center for Bioethics Literature). Additional recommendations for works that provide cross-cultural or international views of medical ethics appear in the supplemental readings list at the end of this syllabus.TextbooksBiomedical Ethics. Edited by Thomas A. Mappes and Jane S. Zembaty. 3rd ed. New York: McGraw-Hill, 1990, 641 pp. Cited: (M&Z). This text is well-suited for undergraduate education, with selected readings by philosophers, lawyers, and physicians. Includes 45 brief case studies to [End Page 263] illustrate various units of readings.Contemporary Issues in Bioethics. Edited by Tom L. Beauchamp and LeRoy Walters. 3rd ed. Belmont, CA: Wadsworth Pub. Co., 1989, 655 pp. Cited: (B&W). Appropriate for upper-level undergraduate or graduate education, this text includes selected readings by important philosophers, lawyers, physicians, and organizations. Includes the abridged texts of many significant court cases and government or organizational documents. Does not include case studies.Ethical Issues in Modern Medicine. Compiled by John Arras and Nancy K. Rhoden. 3rd ed. Mountain View, CA: Mayfield, 1989, 585 pp. Cited: (A&R). This text is suitable for upper-level undergraduate or graduate studies. It includes selections from well-respected lawyers, philosophers, and a few physicians. Includes excerpts from important court cases and policy documents. Provides only a few hypothetical case studies but does relate some authentic cases that are relevant to the various sections.Taking Sides: Clashing Views on Controversial Bioethical Issues. Edited by Carol Levine. 3rd ed. Guilford, CT: Dushkin Pub. Group, 1989, 370 pp. Cited: (L). A compilation of contrasting readings from the popular Hastings Center Report, this book is appropriate for undergraduate or continuing health care education. It does not include an introduction to basic biomedical ethical theory. Perhaps less systematic in its approach to bioethics than the previous textbooks, this book covers twenty topics relating to reproduction, death and dying, human and animal experimentation, and selected public policy issues. Provides pro and con arguments for each issue.CasebooksCases in Bioethics: Selections from the Hastings Center Report. Edited by Carol Levine. Rev. and updated ed. New York: St. Martin's Press, 1989, 291 pp. Cited: (HCR). This text includes cases studies taken from the well-known Hastings Center Report. Two or three commentaries usually accompany each case.Pence, Gregory E. Classic Cases in Medical Ethics: Accounts of the Cases That Have Shaped Medical Ethics, With Philosophical, Legal, and Historical Backgrounds. New York: Mc-Graw-Hill, 1990, 398 pp. Cited: (CC). This book describes a collection of famous (and infamous) cases from the history of biomedical ethics. The accounts of the cases here are more detailed than in other texts, and the style is more casual. [End Page 264]Course OutlineBelow are possible topics for discussion, listed with the relevant portions for each book. It is anticipated that only one textbook and one casebook would be chosen for a course. Whenever possible, price information for video purchase or rentals has been included, however this information is subject to change.Session 1... (shrink)

In view of the scope and scale of the latest scandals, e.g. Enron's maximum breaking bankruptcy, the re-discovery of ethics in business has received an impressive boost. By now even car salesmen have written ethics, a Code of Conduct, e.g. in the USA or Poland. But there is no clear aim of the role ethics obtains in organizational settings as we may show in some small cases of practical approaches to deal with ethics in organizations. We discuss how ethics (...) is the prerequisite to conduct any business and what advantages may be realized if a clear set of ethics is followed. We will discuss three practical examples. In cases of ethics-based values-added management of Siemens (Germany), Boeing (U.S.) and SAP (Germany) we explain the mechanisms of ethics in management to strengthen organizational success. We emphasize the importance of clear ethics-related communication processes in organizations. We explain the use of communication theories inside organizational processes to clarify communication about such an abstract topic as ethics. Finally, we point out how a management of ethical ideas and cultural values should be designed in business enterprises. (shrink)

Drawing on the findings of a series of empirical studies undertaken with boards of directors and CEOs in the United States, this groundbreaking book develops a new paradigm to provide a structured analysis of ethical healthcare governance. Governance Ethics in Healthcare Organizations begins by presenting a clear framework for ethical analysis, designed around basic features of ethics - who we are, how we function, and what we do - before discussing the paradigm in relation to clinical, organizational (...) and professional ethics. It goes on to apply this framework in areas that are pivotal for effective governance in healthcare: oversight structures for trustees and executives, community benefit, community health, patient care, patient safety and conflicted collaborative arrangements. This book is an important read for all those interested in healthcare management, corporate governance and healthcare ethics, including academics, students and practitioners. (shrink)

The purpose of World Humanism: Cross-cultural Perspectives on Ethical Practices in Organizations is to discover what is distinctive about humanistic management practices around the world. It examines the nature and occurrence of humanistic management practices within businesses and other organizations across the world.

The practice of transplantation of vital organs from “brain-dead” donors is in a state of theoretical disarray. Although the law and prevailing medical ethics treat patients diagnosed as having irreversible total brain failure as dead, scholars have increasingly challenged the established rationale for regarding these patients as dead. To understand the ethical situation that we now face, it is helpful to revisit the writings of the philosopher Hans Jonas, who forcefully challenged the emerging effort to redefine death in the (...) late 1960s. (shrink)

This paper seeks to establish whether the categories of MacIntyrean virtue ethics as applied to business organizations are meaningful in a non-western business context. It does so by building on research reported in Moore : 363–387, 2012) in which the application of virtue ethics to business organizations was investigated empirically in the UK, based on a conceptual framework drawn from MacIntyre’s work. Comparing these results with an equivalent study in Sri Lanka, the paper finds that the categories are (...) meaningful but that there are both similarities to and considerable differences in the content of these categories from the UK study. The paper draws on aspects of institutional theory to explore and explain these findings. Overall, there is supportive evidence that the categories of MacIntyrean virtue ethics are generalizable, and so can be used to characterize problems of organizational virtue and vice around the world, while providing evidence that there may be polities which are more conducive to the ‘practice-like conduct of production’ : 77–91, 2008). (shrink)