The purpose of this article is to describe the main ethical issues in paediatric nontherapeutic qualitative pain research. It is based on an analysis of the research literature related to ethical issues in research and on experiences from a family interview study focusing on pain assessment and management in children aged 1-6 years. In addition, different views concerning obtaining informed consent from children, as published in the research literature, are compared. Ethical challenges occur during all (...) stages of qualitative research. The risks of emotional distress and possible benefits of the results must be assessed prior to conducting a study. However, risks and harm are difficult to avoid in a study in which the research area, pain, raises emotional distress in both parents and children. The children’s assent and parental permission are both required. It is essential to obtain informed consent from all family members when family research is conducted. Participants’ privacy and confidentiality should be protected during data collection, analysis and publication. Protecting children from harm may be impossible during pain research in which they are required to recall a painful postoperative period. However, after data collection they can be assisted to focus on pleasant activities, for example, by engaging in playful activities with them. Finally, the role of the nurse and the researcher should be carefully assessed, especially in qualitative research, in order to be able to analyse the data and report the findings in an unbiased manner. (shrink)

The use of human subjects in research comes with lots of ethical challenges. The purpose of this review is to assess the various ethical issues that have been associated with biomedical research in Nigeria. This article also finds out the possible ways of improvement of this scenario. Pubmed/Medline, Google Scholar, JSTOR, and AJOL search were the possible search engine for literature from 2000 to 2020. Key words were used including, ethical issues, biomedical research and Nigeria. (...) Of the 113 publications were found., A total of 18(15.9%) articles fulfilled the study inclusion criteria and were included in this review. Twelve ethical issues were highlighted including Informed consent (12 studies), autonomy and voluntariness (8 studies), beneficence (8 studies), counseling (5 studies), compensation (4 studies), professional behavior and attitudes (2 studies), confidentiality (2 studies), social, cultural and religious practices (2 studies), scientific integrity (1 study), communitarianism (1 study), equity (1 study), and trust (1 study). We found that there are ethical issues in biomedical research in Nigeria of which informed consent is most widely studied. Also, participants had varying degree of understanding of their rights as research subjects. As a result, there is need to enhance the capacity of investigators to better understand these issues and also increase their explanatory skill to help participants achieve complete understanding of their various rights and process. (shrink)

This study examined the ethical issues experienced by nurses working in a small group of elderly persons’ care settings in the UK, using a survey questionnaire previously used in other countries for examining the cultural aspects of ethical issues. However ‘culture’ relates not only to ethnicity but also the organizational culture in which care is delivered. Nurses working in elderly persons’ care settings described a range of issues faced when caring for elderly terminally ill people, (...) which illustrated the different needs of patients, relatives, professionals and society. These issues related to the unique needs of elderly people (such as dementia sufferers) and could have an impact on patients’ quality of death. (shrink)

Terminally ill people might want to discuss the options they have of hastening their deaths with their psychologists who should therefore know the law that regulates euthanasia in the jurisdictions where they practice. The legal, and therefore ethical, situation that influences psychologists’ position and terminally ill people’s options, however, differs notably across jurisdictions. Our aim is to provide a brief moral-legal historical context that explains how the law reform processes in different jurisdictions created these different legal contexts and options (...) that, in turn, influence psychologists’ ethical position. We conclude by considering 8 specific ethical issues at a conceptual level that might confront psychologists irrespective of where they practice. (shrink)

Different opinions are expressed in the literature regarding when children and adolescents can start to make decisions to participate in research and give informed consent. Nurses are frequently involved in research, either as investigators or caregivers, and must therefore have a thorough understanding of consent and related issues. In this article the issues are explored from a Canadian perspective. The argument is put forward that adolescents may be capable of a greater involvement in the research consent process than (...) is the norm. Increasing adolescents’ involvement in research has the potential to enhance their growing autonomy and capabilities. Adolescents appreciate being treated with respect and dignity by adults. This can be achieved in an environment in which protection from harm does not also mean prevention from decision making. The use of empowering processes by nurses to enhance adolescent involvement will provide benefit to adolescents in their transition to adult levels of responsibility. (shrink)

Contributed articles presented at the national seminar entitled "Ethical Issues in Anthropological Research", organized by Department of Anthropology, West Bengal State University during 19-20 January 2012.

This research was conducted to study the ethical issues involved in managing change-related issues and assess whether people in organizations perceive them to be ethical. Besides assessing people's perceptions of ethicality, it also explored the reasons people give for judging a situation as ethical or unethical. Research was conducted using scenarios involving ethical dilemmas related to lay offs, skills obsolescence, misinfor mation and preference for younger over older employees. Results show that the respondents were (...) divided over three situations, namely, lay offs, misinformation and preference for younger employees. The issue of skills obsolescence was considered unethical by most. The reasons given for judging a situation were different, implying that the ethical and unethical were not treated as two ends of a continuum. (shrink)

Background: Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress. Objectives: The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home (...) and to explore staffs’ experiences of ethical issues. Methods: Using a systematic approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home. Findings: The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work. Conclusions: The review highlighted a need for improved ethics education for care-providers. (shrink)

The Scottish Mental Health Arts and Film Festival has seen hundreds of arts, public and community groups coproduce over 300 events to over 25,000 audience members. Integral to this arts-based approach, in contrast to social marketing or public education models, is the notion that mental health is an essentially contested concept whereby meanings are negotiated and debate encouraged. With emerging evidence that the festival is an ef ective way of engaging people intellectually and emotionally, we explore ethical issues, (...) challenges and paradoxes that have emerged as the festival has developed. Consideration is given to issues of power, purpose, opportunity costs, reach, impact, programming risks, and participation from those with experience of mental ill-health. Throughout, we explore practical implications for funding, managing, programming, marketing and evaluation of this and similar endeavours. (shrink)

In this volume of Leys Lectures, the third collection of Wayne Leys Memorial Lectures, six distinguished essayists demonstrate the relevance of ethics to contemporary concerns by constructively exploring major ethical issues deeply embedded in our society. The essays, written by noted scholars Tom Regan, Carol C. Gould, James Rachels, James P. Sterba, Louis P. Pojman, and David L. Norton, focus on issues of feminism, the exploitation of animals, economic injustice, racial prejudice, naive moral relativism, and the failure (...) of public education. _Tom Regan_ and _Louis P. Pojman_ both address the issue of animal rights. Regan directs his attention to an ethic-of-care feminism, which contends that the ideology of male superiority—not only to women but to all creatures—must be destroyed. By means of a "consistency argument," he extends ethic-of-care feminism to the treatment of animals, insisting that we must not permit to be done to animals "in the name of science" what we would not allow to be done to human beings. Pojman, on the other hand, addresses the question of animal rights through a critical analysis of seven theories of the moral status of animals, arguing that while animals have no natural "rights" since they are unable to enter into contracts, they do deserve to be treated kindly. In his view, much animal research could be abandoned without significant loss. What rethinking of democracy in terms of freedom and equality is required by economic justice? _Carol C. Gould_ offers an answer to this question by arguing that economic justice requires that workers control the production process as well as the distribution process. Such justice would provide the basis of "positive freedom" as self-development without ignoring the importance of the absence of constraints. Taking racial prejudice as his paradigm, _James Rachels_ explores the deeper meaning of prejudice and what equality of treatment involves. Noting the subtlety of prejudicial reasoning, he examines how stereotypes, unconscious bias, and the human tendency toward rationalization make it difficult even for people of good will to prevent prejudice from influencing their actions. _James P. Sterba_ invites the reader to consider a different and more general problem of how to persuade people to act for moral reasons. To accomplish this aim he shows morality to be a requirement of rationality and "the welfare liberal ideal" to be a fusion of the practical ends of five ideals—liberty, fairness, common good, androgyny, and equality. For _David L. Norton_, one of our most pressing problems is the failure of our educational system. The system fails to enable students to make wise "life-shaping" choices involving vocation, marriage, children, and friendship. In order to make good choices, human beings must live and work in an environment that provides experiences that authenticate "personal truths" indispensable to worthy living. These personal truths include direct acquaintance with vocational alternatives and participation in actual service to others. Collectively, these essays bring into sharp focus the urgent moral issues confronting our society and the need for ongoing discussion and examination of these issues in order to gain deeper understanding of and possible solutions to the problems they present. (shrink)

A good deal of concern is generated when a person with dementia wanders. One putatively easy technological remedy is to consider electronic tagging. This possibility, however, raises a dif erent set of ethical concerns. In this paper we report the results of a survey that was intended to elicit people’s views about the ethical issues surrounding the topic of tagging in dementia. There was broad agreement in response to the scenario used in the survey that electronic tagging (...) could be an ethically reasonable way to deal with wandering in people who are confused. It was seen as considerably better than locking doors as a way to maintain a person’s safety. There were, however, concerns and uncertainties about principles relating to civil liberties, stigma and dignity. And there appeared to be some weight behind the view that electronic tagging of confused people who wander requires professional involvement, the nature of which would need to be decided. population in general. (shrink)

Qualitative methods associated with historical sociology have enjoyed a revival. Yet, the ethical issues raised by these methods have not been adequately explored. This paper fills this gap through a short skit performed by a researcher, a qualitative research methods textbook, and the Tri-Council Policy. The researcher in the skit is conducting archival research on the historical involvement of women in Canadian labour struggles. By employing a scripted narrative, this paper challenges conventional writing on method and ethics. Through (...) this innovative approach many of the ethical issues and tensions that socio-historical researchers encounter in their research are captured. Questions about the ethics of socio-historical archival research, as well sociological research more generally, are raised. (shrink)

The ethical issues related to the possible future creation of machines with general intellectual capabilities far outstripping those of humans are quite distinct from any ethical problems arising in current automation and information systems. Such superintelligence would not be just another technological development; it would be the most important invention ever made, and would lead to explosive progress in all scientific and technological fields, as the superintelligence would conduct research with superhuman efficiency. To the extent that ethics (...) is a cognitive pursuit, a superintelligence could also easily surpass humans in the quality of its moral thinking. However, it would be up to the designers of the superintelligence to specify its original motivations. Since the superintelligence may become unstoppably powerful because of its intellectual superiority and the technologies it could develop, it is crucial that it be provided with human-friendly motivations. This paper surveys some of the unique ethical issues in creating superintelligence, and discusses what motivations we ought to give a superintelligence, and introduces some cost-benefit considerations relating to whether the development of superintelligent machines ought to be accelerated or retarded. (shrink)

August 2006 marked the 10th anniversary of landmark legislation when Israel’s parliament passed the unique Patient’s Rights Law. This law underscores the importance of medical ethics in Israeli society. During a seminar at the Shaare Zedek School of Nursing, third-year students performed a qualitative research study investigating ethical issues arising in the field of nursing, and how nursing staff dealt with these issues in relation to the law. The research was conducted using semistructured questionnaires. The results showed (...) that the staff participants knew the law, but did not differentiate between legal and ethical problems. The establishment of a framework for dealing with these issues would help to promote professional ethics, encourage broad-based agreements related to ethical decisions, reduce ethical conflict, and increase implementation of the law on patients’ rights. (shrink)

This case study appeared in full in the last issue of Research Ethics Review (2005); 1(4): 134). It concerned the design of a randomized controlled trial to examine dietary practices among South Asian women during pregnancy.

This case study appeared in full in the last issue of Research Ethics Review (2006; 2(1): 28). It concerned a new approach to the management of asthma in children in which there was random allocation of hospital admissions to either the untested treatment ‘B’ or the standard treatment ‘A’.

Training and development activities are perhaps the aspects of HRM that are least likely to come under ethical scrutiny. However, despite an espousal of ethical humanism, and various attempts to develop professional standards, training and development activities can be vulnerable to unethical practice.

In recent years and months, human stem cell research has dominated many scientists' interests, the media, public debate, and social policy. This paper aims to consider, first, the major scientific data on stem cell research that are available. Second, I reflect on them by examining how they shaped policies in Europe and the United States. I also point to current changes in policy-making concerning the creation of ad hoc committees to address this novel issue and how, in a few instances, (...) different ethical positions are part of the documents produced. In other words, diverse approaches are not solved but kept in tension. Finally, I suggest that the current state of research on human stem cell will benefit from an ethics of risk. (shrink)

"Keeping pace with recent developments, almost a third of the Eighth Edition is new. Ethical Issues in Business offers a mix of case studies - nine of which are new to this edition - and theoretical articles - ten of which are new to this edition. The articles range from classics in moral theory and economics, to modern commentaries by business executives."--BOOK JACKET.

This research aims to identify the ethical issues perceived by intensive care nurses in their everyday practice. It also aims to understand why these situations were considered an ethical issue and what interventions/strategies have been or are expected to be developed so as to minimize them. Data were collected using a semi-structured interview with 15 nurses working at polyvalent intensive care units in 4 Portuguese hospitals, who were selected by the homogenization of multiple samples. The qualitative content (...) analysis identified end-of-life decisions, privacy, interaction, team work, and health-care access as emerging ethical issues. Personal, team, and institutional aspects emerge as reasons behind the experience of these issues. Personal and team resources are used in and for solving these issues. Moral development and training are the most significant strategies. (shrink)

The ninth edition of Media Ethics: Issues and Cases has been updated to reflect the most pressing ethical issues in media. Featuring 25 new cases on hot topic issues from fake news to drones and a new chapter on social justice, this authoritative case book gives students the tools to make ethical decisions in an increasingly complex environment.

Transgender issues and transgender rights have become increasingly a matter of media attention and public policy debates. Reflecting changes in psychiatric perspectives, the diagnosis of “trans‐sexualism” first appeared in the International Statistical Classification of Diseases and Related Health Problems in 1975 and shortly thereafter, in 1980, in the Diagnostic and Statistical Manual of Mental Disorders. Since that time, international standards of care have been developed, and today those standards are followed by clinicians across diverse cultures. In many instances, treatment (...) of older adolescents and adults is covered by national health care systems and, in some cases, by private health insurance. Most recently, the Medicare ban on coverage for gender reassignment surgery was lifted in 2014.In contrast to the relative lack of controversy about treating adolescents and adults, there is no expert clinical consensus regarding the treatment of prepubescent children who meet diagnostic criteria for what was referred to in both DSM‐IV‐TR and ICD‐10 as gender identity disorder in children and now in DSM‐5 as gender dysphoria. One reason for the differing attitudes has to do with the pervasive nature of gender dysphoria in older adolescents and adults: it rarely desists, and so the treatment of choice is gender or sex reassignment. On the subject of treating children, however, as the World Professional Association for Transgender Health notes in their latest Standards of Care, gender dysphoria in childhood does not inevitably continue into adulthood, and only 6 to 23 percent of boys and 12 to 27 percent of girls treated in gender clinics showed persistence of their gender dysphoria into adulthood. Further, most of the boys’ gender dysphoria desisted, and in adulthood, they identified as gay rather than as transgender.In an effort to clarify best treatment practices for transgender individuals, a recent American Psychiatric Association Task Force on the Treatment of Gender Identity outlined three differing approaches to treating prepubescent gender dysphoric children. (shrink)

Involving patients in decisions on primary prevention can be questioned from an ethical perspective, due to a tension between health promotion activities and patient autonomy. A nurse-led intervention for prevention of cardiovascular diseases, including counselling (risk communication, and elements of shared decision-making and motivational interviewing) and supportive tools such as a decision aid, was implemented in primary care. The aim of this study was to evaluate the nurse-led intervention from an ethical perspective by exploring in detail the experiences (...) of patients with the intervention, and their views on the role of both the nurse and patient. The study had a qualitative design. 18 patients who had received the intervention participated. Data were gathered by in-depth interviews. The interviews were analysed using directed content analysis. The findings revealed that patients perceived the consultations not as an infringement on their autonomy, but as supportive to risk reduction efforts they tried but found hard to realise. They specifically emphasised the role of the nurse, and appreciated the nurse's realistic advice, encouragement, and help in understanding. Patients' views on and experiences with risk management are in line with notions of relational autonomy, caring cooperation and communicative action found in the literature. We conclude that patients define the relationship with the nurse as shared work in the process of developing a healthier lifestyle. (shrink)

This study appeared in full in the last issue of Research Ethics Review (2007; 3 (2): 53). John Harris is investigating the effectiveness of a new regime for the treatment rheumatoid arthritis. His role involves asking patients to fill out a questionnaire that normally takes about 35 minutes to complete. The case study outlines three events: a patient whose eyesight is poor, another who cannot read and a receptionist who is discovered reading some of the completed questionnaires.

This article presents results of a critical review of the literature discussing the ethical issues arising in humanitarian work, following the method proposed by McCullough, Coverdale and Chervenak. Our aim was primarily to focus on how the ethical issues arising in humanitarian work are conceptualized within the literature we reviewed. We think that properly conceptualizing the ethical issues which humanitarian workers may face can provide avenues to better respond to them. We analysed 61 documents, (...) as part of a literature review, which revealed that there truly is a need, amongst the authors and in humanitarian work, to discuss ethics. Indeed, even if only a small number of authors define explicitly the words they use to discuss ethics, the great quantity that we have uncovered in the documents seem to suggest vast and rich grounds upon which to address ethical issues. We believe it to be important that the ethical issues of humanitarian work are increasingly addressed in the literature and argue that it would be helpful for the vocabulary used by authors to be employed and developed even more rigorously, so that their discussions show more precision, coherence, relevance, exhaustiveness, and sufficiency. The review of the literature, as well as the resulting analysis in this article, is part of a broader project to suggest a way to conceptualize the ethical issues of humanitarian work based on the strengths and innovations of this and other studies. (shrink)

This study appeared in full in the last issue of Research Ethics Review (2007; 3(1): 18). Rowena Jones is an obstetrician working in a busy hospital for women. Her research focuses on changes in women's brains during pregnancy1. Rowena plans to use magnetic resonance imaging to record images of the brains of women in the second and third trimesters and after birth at 6 and 24 weeks. Her sample consists of two groups of healthy women with uncomplicated and singleton pregnancies, (...) the first primigravid and the second multiparous. There will be a minimum of five and a maximum of ten women in each group. (shrink)

ABSTRACT Nanotechnologies are an expression of the human ability to control and manipulate matter on a very small scale. Their use will enable an even and constant monitoring of human organisms, in a new and perhaps less invasive way. Debates at all levels – national, European and international – have pointed out the common difficulty of giving a complete, clear definition of nanotechnologies. This is primarily due to the variety of their components, to the fact that there is not just (...) one technology but several. The most significant medical applications of nanotechnologies are in the diagnostic and the therapeutic fields, eg biosensors and molecular imaging, providing diagnosis and drug delivery with no invasive methods involved. Like any other emerging field, such technologies imply new possibilities for improving health but, on the other hand, they are still at an experimental stage and therefore should be implemented under rigorous safety testing before going on general release. For this purpose, the ethical, legal and social implications (ELSI) of nanotechnologies have been elaborated by study groups, in order to develop solutions before the results of the tests are diffused into medical practice. The aim of this paper is to define some of the ethical issues concerning biomedical applications and to evaluate whether there is a need for new or additional guidelines and regulations. (shrink)

Translational research is a main focus of current health policy (Albani and Prakken 2009; PLoS Medicine 2008). Translation of biomedical research knowledge to effective clinical treatment is essential to the public good (Lavis et al. 2003). Only 5% of basic science studies showing significant therapeutic promise are successfully translated into clinical application (Contopoulos-Ioannidis, Ntzani, and Ionannidis 2003; FDA 2004). As Hall (2001) observes, this is a problem: "When too many important discoveries lie dormant, the public good suffers" (p. G1127). Recent (...) health policy initiatives intended to foster the translation of basic science into clinical advances must consider the unique bioethical issues raised by .. (shrink)

Resumen Las interfaces cerebro-computadora (ICCs) son tecnologías que proveen herramientas para la comunicación entre el ser humano y las computadoras. Dado que las nuevas técnicas asociadas a ICCs podrían influir en la autorregulación emocional, la memoria autobiográfica, el sentido del yo, la identidad, la autonomía, la autenticidad y las atribuciones de responsabilidad presentan importantes objeciones éticas. Entender las consecuencias a largo plazo de estas nuevas tecnologías puede ser difícil. Por lo tanto, los aspectos éticos vinculados a las ICCs necesitan ser (...) continuamente revisados a la par de los avances técnicos en el área. El personalismo ontológicamente fundado se ha formalizado como un camino de reflexión que tiene como referencia una antropología que defiende el valor de la vida física corpórea, la relación libertad-responsabilidad y la adecuada interacción individuo y sociedad y brinda pautas éticas que permitan formular normas de conducta acordes con la dignidad de la persona humana. Por lo tanto, en este artículo se aplican los principios de la bioética personalista al ámbito de las ICCs, de modo tal de dar directrices generales para la acción que puedan contribuir a elaborar un juicio ético acerca del desarrollo y uso de estas neurotecnologías. Abstract Brain-computer interfaces (BCIs) are technologies that provide tools for communication between humans and computers. Since the new techniques associated with BCIs could influence emotional self-regulation, autobiographical memory, sense of self, identity, autonomy, authenticity, and attributions of responsibility present important ethical objections. Understanding the long-term consequences of these innovative technologies can be difficult. Therefore, the ethical aspects linked to BCIs need to be continuously reviewed in line with technical advances in the area. Ontologically grounded personalism has been formalized as a path of reflection that has as its reference an anthropology that defends the value of corporeal physical life, the relationship between freedom and responsibility, and the appropriate interaction between the individual and society. This approach provides ethical guidelines for the formulation of norms of conduct in accordance with the dignity of the human person. Therefore, in this article, the principles of personalist bioethics are applied to the field of BCIs, in order to provide general guidelines for action that can contribute to the elaboration of an ethical judgment about the development and use of these neurotechnologies. (shrink)

Evidence suggests that psychedelics bring about their therapeutic outcomes in part through the subjective or qualitative effects they engender and how the individual interprets the resulting experiences. However, psychedelics are contraindicated for individuals who have been diagnosed with certain mental illnesses, on the grounds that these subjective effects may be disturbing or otherwise counter-therapeutic. Substantial resources are therefore currently being devoted to creating psychedelic substances that produce many of the same biological changes as psychedelics, but without their characteristic subjective effects. (...) In this article, we consider ethical issues arising from the prospect of such potential “nonsubjective” psychedelics. We are broadly supportive of efforts to produce such substances for both scientific and clinical reasons. However, we argue that such nonsubjective psychedelics should be reserved for those special cases in which the subjective effects of psychedelics are specifically contraindicated, whereas classic psychedelics that affect subjective experience should be considered the default and standard of care. After reviewing evidence regarding the subjective effects of psychedelics, we raise a number of ethical concerns around the prospect of withholding such typically positive, meaningful, and therapeutic experiences from most patients. (shrink)

The care of elderly people with dementia poses ethical problems in several respects. This paper considers the problems in relation to treatment, withdrawal of treatment (including nutrition and hydration) in terminal care, and consent to involvement in research. It is ultimately the responsibility of the physician to take the decision about whether or not to proceed with treatment, according to the best interests of the patient, but nurses, families and significant others can be involved in making the decision. When (...) withdrawal of treatment or withdrawal of nutrition and hydration in the terminal stages of dementia are being considered it is necessary to take into account the nature of the treatment, whether or not it is extraordinary, and the goals of continued nutrition. In some circumstances it may be possible for them to be withdrawn. Only research which is aimed at evaluating treatment for dementia may involve subjects who are suffering from dementia. Soigner des personnes âgés souffrant de la démence pose plusieurs problèmes éthiques. Cet article considère les problèmes concernant le traitement, cessation de traitement (y inclus nutrition et hydration) dans la phase terminale, et consentement de participation dans les recherches. C'est ultimement la décision du docteur si oui ou non de continuer avec le traitement selon les meilleurs intérêts du malade, mais les infirmiers/ères, les familles et les personnes importantes autour du malade peuvent jouer un rôle dans les décisions. Si la cessation de traitement ou cessation de nutrition et hydration dans la phase terminale de démence est envisagée il est nécessaire de tenir compte de la nature du traitement, s'il est 'extraordinaire' ou non, et le but de nutrition si on continuait. Dans quelques circonstances il est possible de les discontinuer. Seuls les recherches qui ont pour but d'évaluer les traitements pour la démence peuvent utiliser des personnes souffrant de démence. Die Pflege von älteren Personen mit Demenz stellt einige ethische Probleme. Dieser Artikel betrachtet die Probleme in Beziehung auf die Pflege, Zurückziehung von Pflege (auch von Nahrung und Getrank) der Sterbenden und der Entscheidung, in der Forschung beteiligt zu sein. Der Arzt hat die schlussendliche Verantwortung über die Entscheidung ob mit der Pflege weitergefahren werden soll oder nicht nach dem besten Interesse der Patienten. Aber das Krankenpflegepersonal, die Familie und bedeutende Andere können auch an dieser Entscheidung teilnehmen. Wenn es sich um Zurückziehung der Pflege, oder Zurückziehung von Nahrung oder Getrank in der Sterbepflege von Personen mit Demenz handelt, is es nötig, das Wesen der Pflege und die Ziele einer fortfahrenden Nahrung zu kennen. In gewissen Fällen ist es möglich, diese zurück zu ziehen. Es sollen nur Patienten mit Demenz an Forschungen teilnehmen die über die Pflege der Demenz einschätzt. (shrink)

Neuromarketing is a recent interdisciplinary field which crosses traditional boundaries between neuroscience, neuroeconomics and marketing research. Since this nascent field is primarily concerned with improving marketing strategies and promoting sales, there has been an increasing public aversion and protest against it. These protests can be exemplified by the reactions observed lately in Baylor School of Medicine and Emory University in the United States. The most recent attempt to stop ongoing neuromarketing research in France is also remarkable. The pertaining ethical (...) issues have been continuously attracting much attention, especially since the number of neuromarketing companies has exceeded 300 world-wide. This paper begins with a brief introduction to the field of neurotechnology by presenting its current capabilities and limitations. Then, it will focus on the ethical issues and debates most related with the recent applications of this technology. The French Parliament’s revision of rules on bioethics in 2004 has an exemplary role in our discussion. The proposal by Murphy et al. has attracted attention to the necessity of ethical codes structuring this field. A code has recently been declared by the Neuromarketing Science and Business Association. In this paper, it is argued that these technologies should be sufficiently discussed in public spheres and its use on humans should be fully carried out according to the ethical principles and legal regulations designed in line with human rights and human dignity. There is an urgent need in the interdisciplinary scientific bodies like ethics committees monitoring the research regarding the scientific and ethical values of nonmaleficence, beneficence, autonomy, confidentiality, right to privacy and protection of vulnerable groups. (shrink)

Background Frontline nurses who care for patients with COVID-19 work in stressful environments, and many inevitably struggle with unanticipated ethical issues. Little is known about the unique, ethically sensitive issues that nurses faced when caring for patients with COVID-19. Aim To better understand how frontline nurses who care for patients with COVID-19 experience ethical issues towards others and themselves. Methods Systematic review of qualitative evidence carried out according to the Preferred Reporting Items for Systematic reviews (...) and Meta-analyses on ethical literature (PRISMA-Ethics). The electronic databases PubMed, Embase, Cinahl, Web of Science, Philosopher's Index, and Scopus were queried to identify candidate articles. Articles appearing from March 1, 2020 to December 31, 2022 were considered if they met the following inclusion criteria: (1) Published qualitative and mixed method studies and (2) ethical issues experienced by nurses caring for patients with COVID-19. We appraised the quality of included studies, and data analysis was guided by QUAGOL principles. Findings Twenty-six studies meeting our inclusion criteria for how nurses experience ethical issues were characterised by two key themes: (1) the moral character of nurses as a willingness to respond to the vulnerability of human beings and (2) ethical issues nurses acted as barriers sometimes, impeding them from responding to requests of vulnerable human beings for dignified care. Conclusion Our review provides a deeper understanding of nurses’ experiences of ethically sensitive issues, while also highlighting the critical need for adjustments to be made at organisational and societal levels. Ethical issues that emerged in situations where organisational and situational constraints impeded nurses' ethical responses to patients’ appeals suggests that early practical support should be made available to resolve ethical issues recognised by nurses. Such support contributes to protecting and promoting not only the dignity of patients with COVID-19 but also of fellow humans in need during crisis. (shrink)

First published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.

In the context of academic research, a diversity of ethical issues, conditioned by the different roles of members within these institutions, arise. Previous studies on this topic addressed mainly the perceptions of researchers. However, to our knowledge, no studies have explored the transversal ethical issues from a wider spectrum, including other members of academic institutions as the research ethics board (REB) members, and the research ethics experts. The present study used a descriptive phenomenological approach to document (...) the ethical issues experienced by a heterogeneous group of Canadian researchers, REB members, and research ethics experts. Data collection involved socio-demographic questionnaires and individual semi-structured interviews. Following the triangulation of different perspectives (researchers, REB members and ethics experts), emerging ethical issues were synthesized in ten units of meaning: (1) research integrity, (2) conflicts of interest, (3) respect for research participants, (4) lack of supervision and power imbalances, (5) individualism and performance, (6) inadequate ethical guidance, (7) social injustices, (8) distributive injustices, (9) epistemic injustices, and (10) ethical distress. This study highlighted several problematic elements that can support the identification of future solutions to resolve transversal ethical issues in research that affect the heterogeneous members of the academic community. (shrink)

Medical communication in Western-oriented countries is dominated by concepts of shared decision-making and patient autonomy. In interactions with Roma patients, these behavioral patterns rarely seem to be achieved because the culture and ethnicity have often been shown as barriers in establishing an effective and satisfying doctor–patient relationship. The study aims to explore the Roma’s beliefs and experiences related to autonomy and decision-making process in the case of a disease with poor prognosis. Forty-eight Roma people from two Romanian counties participated in (...) semi-structured interviews, conducted by a research team from the University of Medicine and Pharmacy of Iasi. Participants were recruited among the chronically ill patients and caregivers. The Roma community opposes informing the terminal patients about their condition, the “silence conspiracy” being widely practiced. The family fully undertakes the right of decision making, thus minimizing the patient’s autonomy. We identified ethical dilemmas concerning autonomy, lack of patients’ real decision-making power, and paternalistic attitudes exerted firstly by the family and, on demand, by the physician. Instead, the Roma patient benefits from a very active support network, being accompanied at the hospital by numerous relatives. The patient’s right to make autonomous decisions promoted in the Western countries and stipulated by the Romanian law has diminished value in the Roma community. For the Roma, the understanding of dignity is not simply individual and personal, but it is closely related to their cultural particularities. Ignoring their cultural values could create conflicts between healthcare providers and community. (shrink)

BackgroundGenome-wide association studies (GWAS) provide a powerful means of identifying genetic variants that play a role in common diseases. Such studies present important ethical challenges. An increasing number of GWAS is taking place in lower income countries and there is a pressing need to identify the particular ethical challenges arising in such contexts. In this paper, we draw upon the experiences of the MalariaGEN Consortium to identify specific ethical issues raised by such research in Africa, Asia (...) and Oceania.DiscussionWe explore ethical issues in three key areas: protecting the interests of research participants, regulation of international collaborative genomics research and protecting the interests of scientists in low income countries. With regard to participants, important challenges are raised about community consultation and consent. Genomics research raises ethical and governance issues about sample export and ownership, about the use of archived samples and about the complexity of reviewing such large international projects. In the context of protecting the interests of researchers in low income countries, we discuss aspects of data sharing and capacity building that need to be considered for sustainable and mutually beneficial collaborations.SummaryMany ethical issues are raised when genomics research is conducted on populations that are characterised by lower average income and literacy levels, such as the populations included in MalariaGEN. It is important that such issues are appropriately addressed in such research. Our experience suggests that the ethical issues in genomics research can best be identified, analysed and addressed where ethics is embedded in the design and implementation of such research projects. (shrink)

In this essay, a new approach to the ethics of emerging information technology will be presented, called anticipatory technology ethics (ATE). The ethics of emerging technology is the study of ethical issues at the R&D and introduction stage of technology development through anticipation of possible future devices, applications, and social consequences. In the essay, I will first locate emerging technology in the technology development cycle, after which I will consider ethical approaches to emerging technologies, as well as (...) obstacles in developing such approaches. I will argue that any sound approach must centrally include futures studies of technology. I then present ATE and some applications of it to emerging information technologies. In ATE, ethical analysis is performed at three levels, the technology, artifact and application levels, and at each levels distinct types of ethical questions are asked. ATE analyses result in the identification and evaluation of a broad range of ethical issues that can be anticipated in relation to an emerging information technology. This ethical analysis can then be used for ethical recommendations for design or governance. (shrink)

As the field of clinical ethics consultation sets standards and moves forward with the Quality Attestation process, questions should be raised about what ethical issues really do arise in practice. There is limited data on the type and number of ethics consultations conducted across different settings. At Loyola University Medical Center, we conducted a retrospective review of our ethics consultations from 2008 through 2013. One hundred fifty-six cases met the eligibility criteria. We analyzed demographic data on these patients (...) and conducted a content analysis of the ethics consultation write-ups coding both the frequency of ethical issues and most significant, or key, ethical issue per case. Patients for whom ethics consultation was requested were typically male, white, between 50 and 69 years old, of non-Hispanic origin, and of Roman Catholic faith. Nearly half were in the intensive care unit and 44.2 % died in the hospital. The most frequent broad ethical categories were decision-making, goals of care/treatment, and end-of-life. More specifically, capacity, patient’s wishes/autonomy, and surrogate decision maker were the most frequent particular ethical issues. The most common key ethical issues were withdrawing/withholding treatment, patient wishes/autonomy, and capacity. Our findings provide additional data to inform the training of clinical ethics consultants regarding the ethical issues that arise in practice. A wider research agenda should be formed to collect and compare data across institutions to improve education and training in our field. (shrink)