Zusammenfassung Verschiedene Studien zur Sportpartizipation zeigen auf, dass insbesondere Mädchen und Frauen mit Migrationshintergrund in Sportvereinen proportional untervertreten sind. Während die Ursachen für die geringe Teilhabe am organisierten Sport in zahlreichen Analysen auf Seiten der Mädchen und Frauen mit Migrationshintergrund verortet werden, wird hingegen die Integrationsfähigkeit von Sportvereinen bislang kaum differenziert betrachtet. Der vorliegende Beitrag nimmt darum den Sportverein in seinen spezifischen Organisationsstrukturen in den Blick. Auf der Grundlage eines organisationstheoretischen Zugangs werden die Strukturen von Sportvereinen dahingehend be­leuchtet, inwieweit diese (...) Integration überhaupt zulassen. Im Zuge dieser Analyse werden Barrieren identifiziert, die die Integration von Mädchen und Frauen mit Migrationshintergrund in den Verein stören, erschweren oder verhindern können. Gleichzeitig werden Möglichkeitsbedingungen für die Integration der Zielgruppe benannt und in der Organisationsstruktur von Sportvereinen verortet. (shrink)

Background: Compassionate care is an international priority of healthcare professionals. There is little understanding about how workplace issues impact provision of compassionate care in nursing practice. Therefore, it is important to address the workplace issues and organizational factors which may hinder compassionate care delivery within nursing practice. Objective: The aim of this study was to explore workplace and organizational barriers to compassionate care from the nurses’ perspective. Research design: The study used a qualitative exploratory design, and data were analyzed (...) by conventional content analysis. Participants and research context: A total of 15 nurses working in different fields of nursing were recruited from four hospitals at northwest of Iran. Participants were selected by purposive sampling. Semistructured interviews were conducted for data collection. Ethical consideration: Ethical approval of this study was gained from the Ethical Review Board of Tabriz University of Medical Sciences. Findings: The main theme which emerged from data analysis was “unsupportive organizational culture.” This theme had two main categories including “excessive workload alongside inadequate staffing” and “the lack of value on compassionate care.” Discussion: Organizational barriers to development of compassionate in clinical practice were identified in this study. A closer examination of these barriers is required to move compassionate practice from an individual responsibility to a collective responsibility that is owned and shared by organizations. Conclusion: For compassionate care to flourish, policy makers, managers, and healthcare providers must foster an organizational atmosphere conducive to compassionate care. (shrink)

In the current literature, institutional adoption of Corporate Social Responsibility (CSR) governance standards is mainly understood in a binary sense (adoption versus no adoption), and existing research has hitherto focused on inducements as well as on barriers of related organizational change. However, little is known about often invisible internal adoption patterns relating to institutional entrepreneurship in the field of CSR. At the same time, additional information about these processes is relevant in order to systematically assess the outcomes of institutional (...) entrepreneurship and to differentiate between substantive versus symbolic implementation. In this paper, we contribute a comparative intraorganizational differentiation of institutional adoption processes in the field of CSR, and we distinguish between broad and narrow organizational institutional adoption across different management functions relating to institutions of a similar type. Our study is based on a quantitative survey among members of the United Nations Global Compact Network Germany, as well as on qualitative interviews. We analyze different institutional adoption patterns and derive ten theoretical predictors of diverse institutional adoption choices and thereby inform the literatures on institutional entrepreneurship, CSR governance, and Multi-Stakeholder Initiatives. Besides our theoretical contributions, our findings serve as a source of information for practitioners engaged in CSR governance as they provide new insights into the managerial perception and assessment of different CSR standards and initiatives. (shrink)

Science, engineering and technology are still male-dominated fields, and thus all over Europe much effort is expended on activities which, it is hoped, will lead to a sustainable gender balance. Scholarly work has frequently focused on the topic of how to motivate women to enter SET fields or to choose a corresponding education. In contrast to this one-sided approach, recent scholarly contributions have begun to emphasize the vital role of gendered structures and indirect exclusion mechanisms of technological institutions and their (...) professional self-understandings which discourage women from entering or staying in SET organizations. In particular, taken-for-granted knowledge as a mechanism for maintaining specific norms and values is considered a primary hindrance towards more inclusive and less oppressive organizational cultures. Since this taken-for-granted knowledge is often implicit, a primary goal of research can be said to make the invisible visible. Thus this article presents selected empirical results of a research project which makes use of an investigative tool called mind-scripting. Here the aim is to identify the main barriers, in terms of unquestioned taken-for granted knowledge, currently hindering an open and critical review of gendered structures and gender codes in the SET field, or in organizations in general, particularly with respect to professional norms. (shrink)

Negative gender-role stereotypes continue to pervade the careers of many women. The current study examines the careers of female National Health Service (NHS) nurses in the United Kingdom. The study identifies organizational mindsets which militate against women's career advancement. These mindsets form the basis of the "ethic of discrimination" which both maintains and perpetuates unequal outcomes for women in NHS nursing. We examine the implications for management in promoting non-discriminatory decision making, and the barriers that are faced in overcoming (...) the "ethic of discrimination". (shrink)

Globally, women have more access to positions of authority and participate more in decision-making, regardless of context and rank, than a few years back. This is because of on-going global campaigns supported by various national and international laws and declarations. Increasingly, women have been exercising their rights and obligations to actively participate in politics and become visible in governance. Within Nigerian society, the efforts of women in governance, especially in the pre-colonial era, cannot be overlooked. Over the years, women in (...) Nigeria have moved from the back seat to the roles of bread-winners, decision-makers and leaders of their immediate families. Irrespective of these progressive developments, women's contributions to national development still have minor impact on decisions that affect society as a whole, due to the perceived marginalization which still holds strong in most developing countries like Nigeria. Cultural and social norms, glass ceiling effects, and other exclusionary factors continue to dictate relegation of the presence and voice of women to a lower rank in public life. Against this background, this paper attempts to shed light on the role of civil organizations in enhancing women's participation in politics and decision-making in governance issues in Nigeria. The paper examines strategies employed by a Muslim women civil organization in contributing to the decision-making that affect women generally in the society, and possible challenges facing women active participation in this political era. Using documented researched materials, the findings of the study show that women's intellectual, and political capabilities irrespective of the religious background, are vital components of every society. (shrink)

ABSTRACTAs a result of intensive mobility and migration over the last twenty-five years, multiculturalism and multilingualism have become a reality in European prisons. This “superdiversity” poses a serious challenge to the various stakeholders who need efficient and reliable communication. Yet this topic has been underresearched. According to statistics for the year 2014 issued by the Council of Europe, Belgium has a high rate of foreign inmates. Against this background, the aim of this exploratory research is to describe how the Flemish (...) penitentiary system tackles this linguistic challenge. Data were gathered through qualitative research methods such as desktop research and in-depth interviews with 8 stakeholders. Due to the scarcity of financial resources and the presence of organizational hurdles, the Ministry of Justice rarely assigns jobs in prison to interpreters; instead, they are replaced by cheaper and immediately available... (shrink)

Numerous studies have revealed that health care transitions for chronically ill older adults are frequently poorly managed, often with devastating human and economic consequences. And poorly managed transitions and their consequences also occur among younger, relatively healthy individuals who have adequate resources and are prepared to advocate on their own behalf. Despite the rich base of research confirming that evidence‐based transitional care enhances patients’ experiences, improves health and quality of life, and reduces costs, organizational, regulatory, financial, and cultural barriers (...) have, until recently, prevented widespread adoption of these proven approaches. Provisions of the Affordable Care Act, such as reductions in Medicare payments to hospitals with very high thirty‐day rehospitalization rates, have reduced barriers, but uptake of evidence‐based transitional care beyond demonstration projects continues to be sporadic and far too slow. With a rich understanding about how to better anticipate and respond to the compelling problems experienced by patients, family caregivers, and health care professionals throughout episodes of acute illness, the time has come to frame transitional care as a system's ethical responsibility in an aging society. Embedding transitional care within the ethical obligations of a health care system requires the perspectives and involvement of nurses and nursing because of this profession's integral role in every aspect of care transitions. (shrink)

Laws, ordinances, regulations, and executive orders create the powers and duties of public health agencies and modify the complex community conditions that affect health. Appropriately trained legal counsel serving as legal advisors on the health officer's team facilitate clear understanding of the legal basis for public health interventions and access to legal tools for carrying them out.Legal counsel serve public health agencies via different organizational arrangements — e.g., internal staff counsel, external counsel from the state attorney general's office, state health (...) department, county or city, or private counsel under contract, or in combination. As of 2011, most state health departments employ their own counsel, and 56% use AG counsel, while 17% contract with independent attorneys; most local health departments work with attorneys and legal staff assigned by local government, by the state health agency, or contract with outside attorneys and legal staff. (shrink)

This paper provides a stagewise overview of the important issues that play a role in technology adoption and use in organizations. In the current literature, there is a lack of consistency and clarity about the different stages of the technology adoption process, the important issues at each stage, and the differentiation between antecedents, after-effects, enablers, and barriers to technology adoption. This paper collected the relevant issues in technology adoption and use, mentioned dispersedly and under various terminologies, in the recent (...) literature. The qualitative literature review was followed by thematic analysis of the data. The resulting themes were organized into a thematic map depicting three stages of the technology adoption process: pre-change, change, and post-change. The relevant themes and subthemes at each stage were identified and their significance discussed. The themes at each stage are antecedents to the next stage. All the themes of the pre-change and change stages are neutral, but the way they are managed and executed makes them enablers or barriers in effect. The thematic map is a continuous cycle where every round of technology adoption provides input for the subsequent rounds. Based on how themes have been addressed and executed in practice, they can either enhance or impair the subsequent technology adoption. This thematic map can be used as a qualitative framework by academics and practitioners in the field to evaluate technological changes. (shrink)

This study sheds new light on why healthcare organisations are having difficulty responding to the growing pressure from stakeholders to proactively address their responsibility to deliver high-quality services without harming the environment. Basing our work on past research on stakeholder pressure and environmental barriers, we conceptualise and empirically test the effect of the interplay between stakeholder pressure and internal barriers on healthcare organisations’ adoption of proactive environmental strategies. To test the proposed hypotheses, a survey was carried out among (...) medical directors of Italian healthcare organisations in 2012. Our results show that the lack of commitment to environmental issues within the organisation represents the main barrier to healthcare organisations’ implementing PESs. Furthermore, the difficulties in evaluating the impacts of advanced environmental practices negatively moderate the influence of stakeholders on developing PESs. Our findings contribute to extending previous knowledge on PESs in two ways: focusing on the healthcare sector, our study investigates the phenomenon in a research context that has been largely overlooked in the sustainability literature; and cross-cutting previous research on stakeholder pressure and internal barriers, the study conceptualises and tests a more complete framework for understanding the adoption of PESs. (shrink)

While women represent the vast majority of participants in religious organizations in the United States, their participation in top leadership positions within Christian congregations remains remarkably low. In this article, the author uses the National Congregations Study to examine the situations that lead to this “stained glass ceiling” effect, prohibiting women from attaining top congregational leadership positions. The author also investigates similar barriers that exist at other levels of congregational leadership. The results suggest that while a queue-like process appears, (...) the specifically religious nature of these organizations produces barriers that are quite different from the traditional glass ceiling conceptualization. (shrink)

Measuring outcomes using quantitative analytic methods is the hallmark of scientific research in healthcare. For clinical ethics support services (CESS), tangible outcome metrics are lacking and literature examining CESS quality is limited to evaluation of single cases or the influence on individual healthcare professional’s perceptions or behaviour. This represents an enormous barrier to implementing and evaluating ethics initiatives to improve quality. In this context, Kok _et al_ propose a theoretical framework for how moral case deliberation (MCD) can drive quality at (...) an organisational-level, termed _morisprudence_ 1. By offering mechanistic insights into how MCD can lead to organisational learning and quality improvement (QI), they provide a roadmap for actionable items to measure quality. As conceptualised, _morisprudence_ follows accumulation of organisational practical wisdom from a repertoire of ‘paradigmatic’ MCDs, aiding identification of patterns of morally important features. Here, there are parallels between healthcare professionals’ clinical judgement, where past experience... (shrink)

Warning behaviour prior to an act of severe targeted school violence was often not recognized by peers and school staff. With regard to preventive efforts, we attempted to identify barriers to information exchange in German schools, and understand mechanisms that influenced the recognition, evaluation, and reporting of warning behaviour through a teacher or peer. Our analysis is based on inquiry files from eleven cases of German school shootings that were obtained during the three-year research project “Incident and case analysis (...) of highly expressive targeted violence (TARGET)". We conducted a qualitative retrospective case study to analyze witness reports from school staff and peers. Our results point to subjective explanations used by teachers and peers towards conspicuous behaviour (e.g., situational framing, typical adolescent behaviour), as well as reassuring factors that indicated harmlessness (e.g., no access to a weapon). Additionally, we found organizational barriers similar to those described in US-American case studies (e.g., organizational deviance). (shrink)

Despite efforts to foster gender equality in academia, women are vastly under-represented in tenured professorships, specifically in STEM disciplines. While previous research investigated structural and organizational barriers for women in academia, we explored professors’ subjective view on attributes required before and after reaching tenure. The perspective of professors is needed as they are gatekeepers when it comes to the career advancement of junior researchers. Hence, we interviewed 25 tenured STEM professors in Germany about which attributes they personally consider to (...) be required pre- versus post-tenure and analyzed whether these attributes are associated with gender stereotypes. We found that different attributes are mentioned in the pre- versus the post-tenure career stage and that the required attributes can be associated with gender stereotypes: While agentic–stereotypically male–attributes were mentioned more frequently than communal attributes in the pre-tenure career stage, communal–stereotypically female–attributes were reported slightly more often than agentic attributes after reaching tenure. Based on these novel findings, we discuss important implications for gender research and practice to contribute to more diversity and transparency in academic career advancement. (shrink)

In this paper, we conceptually explore the role of empathy as a connectedness organising mechanism. We expand ideas underlying positive organisational scholarship and examine leading-edge studies from neuroscience and quantum physics that give support to our claims. The perspective we propose has profound implications regarding how we organise and how we manage. First, we argue that empathy enhances connectedness through the unconscious sharing of neuro-pathways that dissolves the barriers between self and other. This sharing encourages the integration of (...) affective and cognitive consciousness which facilitates the ability to find common ground for solution building. Second, empathy enhances connectedness through altruistic action. In giving to others, feelings of joy and harmony are activated. This in turn allows personal freedom to be enriched and transcendence from the rational ego-self is reduced to develop a more expansive, integrated and enlightened state underlying connectedness. Finally, empathy enhances connectedness which results in sharing the quantum field of coherence where there is little separation between self and other. This means living beyond self-interest in a coherent world based upon interdependent wholeness rather than atomization and separation. Empathy allows us to find that state of coherent connectedness. (shrink)

MACDONALD SE, NEWBURN‐COOK CV, ALLEN M and REUTTER L.Nursing Inquiry2013;20: 30–41 Embracing the population health framework in nursing researchIndividuals’ health outcomes are influenced not only by their knowledge and behavior, but also by complex social, political and economic forces. Attention to these multi‐level factors is necessary to accurately and comprehensively understand and intervene to improve human health. The population health framework is a valuable conceptual framework to guide nurse researchers in identifying and targeting the broad range of determinants of health. (...) However, attention to the intermediate processes linking multi‐level factors and use of appropriate multi‐level theory and research methodology is critical to utilizing the framework effectively. Nurse researchers are well equipped to undertake such investigations but need to consider a number of political, societal, professional and organizational barriers to do so. By fully embracing the population health framework, nurse researchers have the opportunity to explore the multi‐level influences on health and to develop, implement and evaluate interventions that target immediate needs, more distal factors and the intermediate processes that connect them. (shrink)

Evaluating the feasibility and first perceived outcomes of a newly developed clinical ethics support instrument called CURA. This instrument is tailored to the needs of nurses that provide palliative care and is intended to foster both moral competences and moral resilience. This study is a descriptive cross-sectional evaluation study. Respondents consisted of nurses and nurse assistants (n = 97) following a continuing education program (course participants) and colleagues of these course participants (n = 124). Two questionnaires with five-point Likert scales (...) were used. The feasibility questionnaire was given to all respondents, the perceived outcomes questionnaire only to the course participants. Data collection took place over a period of six months. Respondents were predominantly positive on most items of the feasibility questionnaire. The steps of CURA are clearly described (84% of course participants agreed or strongly agreed, 94% of colleagues) and easy to apply (78–87%). The perceived outcomes showed that CURA helped respondents to reflect on moral challenges (71% (strongly) agreed), in perspective taking (67%), with being aware of moral challenges (63%) and in dealing with moral distress (54%). Respondents did experience organizational barriers: only half of the respondents (strongly) agreed that they could easily find time for using CURA. CURA is a feasible instrument for nurses and nurse assistants providing palliative care. However, reported difficulties in organizing and making time for reflections with CURA indicate organizational preconditions ought to be met in order to implement CURA in daily practice. Furthermore, these results indicate that CURA helps to build moral competences and fosters moral resilience. (shrink)

Background Unit-based critical care nurse leaders (UBCCNL) play a role in exemplifying ethical leadership, addressing moral distress, and mitigating contributing factors to moral distress on their units. Despite several studies examining the experience of moral distress by bedside nurses, knowledge is limited regarding the UBCCNL’s experience. Research aim The aim of this study was to gain a deeper understanding of the lived experiences of Alabama UBCCNLs regarding how they experience, cope with, and address moral distress. Research design A qualitative descriptive (...) design and inductive thematic analysis guided the investigation. A screening and demographics questionnaire and a semi-structured interview protocol were the tools of data collection. Participant and research context Data were collected from 10 UBCCNLs from seven hospitals across the state of Alabama from February to July 2023. Ethical considerations This study was approved by the Institutional Review Board at the University of Alabama in Huntsville. Informed consent was obtained from participants prior to data collection. Findings UBCCNLs experience moral distress frequently due to a variety of systemic and organizational barriers. Feelings of powerlessness tended to precipitate moral distress among UBCCNLs. Despite moral distress resulting in increased advocacy and empathy, UBCCNLs may experience a variety of negative responses resulting from moral distress. UBCCNLs may utilize internal and external mechanisms to cope with and address moral distress. Conclusions The UBCCNL’s experience of moral distress is not dissimilar from bedside staff; albeit, moral distress does occur as a result of the responsibilities of leadership and the associated systemic barriers that UBCCNLs are privier to. When organizations allocate resources for addressing moral distress, they should be convenient to leaders and staff. The UBCCNL perspective should be considered in the development of future moral distress measurement tools and interventions. Future research exploring the relationship between empathy and moral distress among nurse leaders is needed. (shrink)

This article discusses which barriers hamper access to, and participation in, cultural life for members of vulnerable groups, in particular persons belonging to old and new minorities and persons with disabilities in the context of digitization. It then examines what role public authorities can play in addressing and dismantling these barriers. The article adopts a bottom-up approach, in that it is based on a qualitative study, which gives voice to vulnerable groups. The qualitative research involved interviews with different (...) organisations representing, or working with, vulnerable groups in 12 European Union Member States (Belgium, Croatia, Denmark, Estonia, Finland, France, Germany, Hungary, Ireland, Italy, Malta and Spain). In that regard, the article approaches vulnerability from a distinct conceptual standpoint, identifying vulnerability as a condition caused by structural barriers. On the whole, the article shows that, while digitization of cultural content, goods and services, offers increased opportunities for culture to be democratised and for its consumption by wider and more varied audiences to be enhanced, it also engenders structural barriers and creates additional challenges. Furthermore, while digitisation has ensured more diverse representation in cultural content, vulnerable groups still face stereotypical and negative portrayals within mainstream cultural content. The thematic analysis of the qualitative interviews also captures different dimensions of access to digital cultural and supports the identification of effective policy measures to bridge the ‘digital divide’ and assist in the fulfilment of cultural rights of vulnerable groups. (shrink)

Low-wage migrant workers in Singapore are legally entitled to healthcare provided by their employers and supported by private insurance, separate from the national UHC (universal health coverage) system. In practice, they face multiple barriers to access. In this article, we describe this policy-practice gap from the perspective of HealthServe, a non-profit organisation that assists low-wage migrant workers. We outline the healthcare financing system for migrant workers, describe commonly encountered barriers, and comment on their implications for the global UHC (...) movement’s key ethical concepts of fairness, equity, and solidarity. (shrink)

Les rencontres de Royaumont de 1998 ont donné naissance à un superbe volume, richement illustré, faisant le point sur l’histoire des femmes au sein de l’ordre cistercien, du Moyen Âge jusqu’à nos jours. Cet ouvrage vient à point nommé pour enrichir l’historiographie de cet ordre, largement dominée jusqu’ici par le masculin. Les communications, nombreuses et variées, se sont réparties en deux journées selon deux thèmes centraux. Le premier s’intéresse à l’architecture et à l’organisation de l’...

Standardisation is increasingly seen as a means to insert ethics in innovation processes. We examine the institutionalisation of responsible innovation in de jure standardisation as this is an important but unexplored research area. In de jure standardisation, stakeholders collaborate in committees to develop standards. We adopt the anticipation, inclusion, reflexivity, and responsiveness responsible innovation framework as our theoretical lens. Our study suggests that responsible standardisation processes should embody forms of these four dimensions. We investigate the institutionalisation of these dimensions and (...) identify 96 factors that can motivate, hinder, or facilitate responsible standardisation. Factors were found through in-depth interviews with managers of a standard developing organisation. These are subsequently validated/rejected using surveys completed by committee representatives. The results suggest that the social desirability of standards is not self-evident. This study could pave the way for future research on responsible standardisation processes, complementing research on legitimacy, responsible innovation, and standardisation. (shrink)

BackgroundCervical cancer disproportionately burdens disadvantaged women. Organised cervical screening aims to make cancer prevention available to all women in a population, yet screening uptake and cancer incidence and mortality are strongly correlated with socioeconomic status. Reaching underscreened populations is a stated priority in many screening programs, usually with an emphasis on something like ‘equity’. Equity is a poorly defined and understood concept. We aimed to explain experts’ perspectives on how cervical screening programs might justifiably respond to ‘the underscreened’.MethodsThis paper reports (...) on a grounded theory study of cervical screening experts involved in program organisation. Participants were 23 experts from several countries and a range of backgrounds: gynecology; epidemiology; public health; pathology; general practice; policy making. Data were gathered via semi-structured interview and concepts developed through transcript coding and memo writing.ResultsMost experts expressed an intuitive commitment to reducing systematic differences in screening participation or cancer outcomes. They took three different implicit positions, however, on what made organised programs justifiable with respect to underscreened populations. These were: 1) accepting that population screening is likely to miss certain disenfranchised groups for practical and cultural reasons, and focusing on maximising mainstream reach; 2) identifying and removing barriers to screening; and 3) providing parallel tailored screening services that attended to different cultural needs. Positions tended to fall along country of practice lines.ConclusionsExperts emphasised the provision of opportunity for underscreened populations to take up screening. A focus on opportunity appeared to rely on tacit premises not supported by evidence: that provision of meaningful opportunity leads to increased uptake, and that increased uptake of an initial screening test by disadvantaged populations would decrease cervical cancer incidence and mortality. There was little attention to anything other than the point of testing, or the difficulties disadvantaged women can have in accessing follow up care. The different approaches to ‘improving equity’ taken by participants are differently justified, and differently justifiable, but none attend directly to the broader conditions of disadvantage. (shrink)

Background: Healthcare personnel in the municipal healthcare systems experience many ethical challenges in their everyday work. In Norway, 243 municipalities participated in a national ethics project, aimed to increase ethical competence in municipal healthcare services. In this study, we wanted to map out what participants in ethics reflection groups experienced as promoters or as barriers to successful reflection. Objectives: To examine what the staff experience as promoters or as barriers to successful ethics reflection. Research design: The study has (...) a qualitative design, where 56 participants in municipal healthcare participated in 10 different focus-group interviews. Ethical considerations: The data collection was based on the participants’ informed consent and approved by the Data Protection Official of the Norwegian Centre for Research Data. Results: The informants had different experiences from ethics reflection group. Nevertheless, we found that there were several factors that were consistently mentioned: competence, facilitator’s role, ethics reflection groups organizing, and organizational support were all experienced as promoters and as a significant effect on ethics reflection groups. The absence of such factors would constitute important barriers to successful ethics reflection. Discussion: The results are coincident with other studies, and indicate some conditions that may increase the possibility to succeed with ethics reflection groups. A systematic approach seems to be important, the systematics of the actual reflections, but also in the organization of ethics reflection group at the workplace. Community healthcare is characterized by organizational instabilities as many vacancies, high workloads, and lack of predictability. This can be a hinder for ethics reflection group. Conclusion: Both internal and external factors seem to influence the organization of ethics reflection group. The municipalities’ instabilities challenging this work, and perceived as a clear inhibitor for the development. The participants experienced that the facilitator is the most important success factor for establishing, carrying out, and to succeed with ethics reflection groups. (shrink)

This paper addresses the foundational aspects of the theory of Gen inertia. We attempt to emphasize the cognitive factors that accounts for learning inertia in organizations, and that which prevents employees from generating and absorbing new knowledge. The novel concept of Gen inertia helps us to understand the causes behind inertia in learning among the knowledge workers under organizational settings. This concept of 'Gen inertia' is distinct from the pre-existing concept of organizational knowledge inertia. In this paper, we attempt to (...) identify and underline the factors that act as impediments to effective organizational learning processes. It deals with the existing causes that are responsible for knowledge (learning) inertia in knowledge organizations. We model several scenarios that presumably act as constraints, and therefore, they help us to uncover the existing barriers and obstacles to effective knowledge acquisition. The model assists us to build a system aimed to aid managers and trainers to recognize the underlying causes, which supposedly interferes with employees' learning curve, both in the short run and in the long run. Finally, the research aims to identify and overcome the nature of constraints that employees face while being part of a learning organization. Because it demands proficient handling of new knowledge, and because knowledge organizations subsist on the expertise of the knowledge workers, it is much relevant for the organizations to understand the existing problems that the knowledge workers face so as to enable them to compete with others in the market for knowledge resources. The present paper addresses all these issues and advocates several solutions to identify and then overcome the constraints and barriers to effective learning under organizational cluster settings. (shrink)

Despite being the primary homeland of Quebec's Inuit people, Nunavik's health care is typically planned and provided by non-Inuit newcomers. This retrospective case study investigates the effects of ethical leadership on the Westernized local Nunavik health care system's cultural sensitivity to its disproportionately Inuit populations. An integrative framework is developed that considers the dimensions of ethical leadership and the omnibus and discrete dimensions of context. This study shows that some Nunavik health care managers seek to improve and adapt the system (...) to the needs of their Inuit populations, while others do not. Unfortunately, the context restricts the former managers' ability to act consistently with their moral responsibilities and beliefs. Specifically, the findings show various institutional barriers to providing respectful and sensitive health care to Inuit. This study contributes to the scientific literature on ethical leadership by proposing an integrative conceptual framework. This framework illustrates how ethical leadership is inseparable from organizational context, identifying 16 contextual factors influencing managers' ethical behavior. Finally, three practical recommendations are proposed to highlight the omnibus and discrete context elements. (shrink)

Medical informed consent stands as an ethical and legal requisite preceding any medical intervention. Hospitalized patients face functional health literacy (FHL) challenges when dealing with informed consent forms (ICFs). The legitimacy of ICFs and informed consent procedures in China remains substantially undisclosed. The study’s aim was to investigate if Chinese patients have adequate FHL to be truly informed before providing medical consent. In this cross-sectional, structured interview-based study, FHL was assessed within the context of the informed consent scenarios in two (...) teaching hospitals (a 1500-bed general tertiary hospital and a 700-bed cancer hospital) affiliated with Shantou University Medical College. Twenty-seven patients admitted across clinical departments, along with their relatives (n = 59), were enrolled in the study after obtaining informed consent. The participants underwent a three-step assessment with two selected ICFs —teach-back skills, perceived understanding (perception), and informed knowledge (cognizance), with each component carrying a maximum score of 10. Data were analyzed with SPSS (version 22.0) for descriptive and inferential statistics, with consideration of significant P values as < 0.05. The median age (IQR and range) of participants was 35.5 (28 – 49 and 13 – 74) years. Most participants had only high school education (24.4%, 21/86) or below high school education (47.7%, 41/86). The median score (IQR) of FHL assessments—teach-back, perception, and cognizance—was 4.0 (2.5, 5.8), 8.0 (6.8, 8.8), and 6.5 (5.5, 8.0) out of 10, respectively. A moderate correlation was observed between the scores of cognizance and teach-back (r = 0.359, P = 0.002) or perception (r = 0.437, P < 0.001). Multivariate linear regression analysis predicted being a patient and having lower education levels as independent risk factors of inadequate FHL (Ps = 0.001). Lack of patient-centeredness in ICFs, time constraints, and poor clinical communication were identified as barriers impeding informed consent. This study demonstrates inadequacy in personal FHL and impaired organizational HL, resulting in compromised informed consent in Chinese teaching hospitals. As a remedy, we propose improving the quality of ICFs and institutionally mandated outcome-focused training on informed consent for all concerned clinicians to enhance medical ethics, ensure quality health care, address patient values, and mitigate potential medical conflicts. (shrink)

Practice of knowledge management is often characterized by obstacles to creation, distribution, and transfer of knowledge from specific groups of settings. Obstacles or constraints to attempts to constitute knowledge as an organizational resource have been previously dealt within the context of organizational learning perspectives; however, there still remain barriers toward making learning available and all-pervasive throughout organizations. This is often as a result of two important factors: (i) bureaucratic and hierarchical forms of organization; and (ii) owing to the situated (...) and tacit character of knowledge. This paper is a result of theoretical exploration aimed at addressing these core issues, and proposes solutions to manage constraints and remove obstacles to knowledge management, as well as means to codify the tacit character of knowledge. The research offers a view that although it is reasonable to value knowledge in financial or economic terms, it is also important to consider the problems which make it difficult to extract and transfer knowledge within specific organizational settings. Addressing the issue of rising competitive pressure for innovation, this paper proposes several solutions to enable lateral flows of knowledge-sharing by overcoming the factors that affect acquisition of, and creation and distribution of knowledge across fluid social boundaries. (shrink)

By incorporating the conservation of resource theory, this study examines how high-performance work practices (HPWPs) affect the employee's in-role performance (EIRP) and employee's task performance (ETP) during the coronavirus disease 2019 (COVID-19) pandemic. Furthermore, this study investigates how organization-based self-esteem (OBSE) and positive psychological capital (PPC) affect the relationship between HPWPs and outcomes of employees such as EIRP and ETP. A quantitative technique based on the survey method was used to gather the primary data of the investigation. Two hundred and (...) eleven bank employees working in different banks of Punjab and Pakistan participated in the survey process. The PROCESS-macro was used to test the relationship among the study constructs. Our results supported all the study hypotheses, however positive psychological capital did not moderate the indirect effect of high performance work practices on employee's task performance via organization based self-esteem. This study is the earliest of its kind that focuses on HPWPs and outcomes of employees amid the COVID-19 pandemic in a developing country like Pakistan. The findings of this study provide practical implications in the post and continuing pandemic situation for organizations to human resource management to redesign workforce strategies to increase their contribution and responses to realize organizational priorities. Although researchers have explored the topic in different sectors, scant studies have investigated the potential impact, barriers, and enabling mechanisms that function as a catalyst in HPWPs during the pandemic situation. (shrink)

This paper explores the role of mentoring and networking in the career development of global female managers. The paper is based on data collected from interviews with 50 senior female managers. The voices of the female managers illustrate some of the difficulties associated with informal organisational processes, in particular mentoring and networking, which hinder their career development. The findings confirm that female managers can miss out on global appointments because they lack mentors, role models, sponsorship, or access to appropriate (...) networks – all of which are commonly available to their male counterparts. The interviewees suggest that men, as the dominant group, may want to maintain their dominance by excluding women from the informal interactions of mentoring and networking. The findings further suggest that if females had more access to networks and mentors they could be socialised in both the formal and informal norms of the organisation and gain career advantages from these. The managers reveal that they encounter additional barriers in ‹a man’s world’ and remind us that there is still much to be changed. (shrink)

A modern form of narrative, comic books, are used to communicate, discuss, and critique issues in business and society. A description of comic books as a legitimate medium is followed by a discussion of the pedagogical uses of comic books. The strengths of the pedagogy include crossing cultural barriers, understanding the complexity of individual decision-making and organizational influences, and the universality of dilemmas and values. We provide an initial source for educators on the topics, comic books, plotlines, and other (...) commentary for consideration of use in the classroom from high school to graduate business ethics courses. (shrink)

An important and supposedly impactful form of clinical ethics support is moral case deliberation. Empirical evidence, however, is limited with regard to its actual impact. With this literature review, we aim to investigate the empirical evidence of MCD, thereby a) informing the practice, and b) providing a focus for further research on and development of MCD in healthcare settings. A systematic literature search was conducted in the electronic databases PubMed, CINAHL and Web of Science. Both the data collection and the (...) qualitative data analysis followed a stepwise approach, including continuous peer review and careful documentation of our decisions. The qualitative analysis was supported by ATLAS.ti. Based on a qualitative analysis of 25 empirical papers, we identified four clusters of themes: 1) facilitators and barriers in the preparation and context of MCD, i.e., a safe and open atmosphere created by a facilitator, a concrete case, commitment of participants, a focus on the moral dimension, and a supportive organization; 2) changes that are brought about on a personal and inter-professional level, with regard to professional’s feelings of relief, relatedness and confidence; understanding of the perspectives of colleagues, one’s own perspective and the moral issue at stake; and awareness of the moral dimension of one’s work and awareness of the importance of reflection; 3) changes that are brought about in caring for patients and families; and 4) changes that are brought about on an organizational level. This review shows that MCD brings about changes in practice, mostly for the professional in inter-professional interactions. Most reported changes are considered positive, although challenges, frustrations and absence of change were also reported. Empirical evidence of a concrete impact on the quality of patient care is limited and is mostly based on self-reports. With patient-focused and methodologically sound qualitative research, the practice and the value of MCD in healthcare settings can be better understood, thus making a stronger case for this kind of ethics support. (shrink)

Utilizing social rhetorical criticism and social cultural texture, this exegetical analysis of John 4 examines the transformational interaction of Jesus and a Samaritan woman. Previous research focuses on the woman’s demographic profile without fully investigating the significance of relational demography in the context of first century Mediterranean culture. This analysis of the social cultural texture of John 4 presents a model for Christian leadership that crosses gender, race, and geographic barriers and capitalizes on the benefits of relational demography for (...) organizational success. (shrink)

Objective Futile treatment, which by definition cannot benefit a patient, is undesirable. This research investigated why doctors believe that treatment that they consider to be futile is sometimes provided at the end of a patient9s life. Design Semistructured in-depth interviews. Setting Three large tertiary public hospitals in Brisbane, Australia. Participants 96 doctors from emergency, intensive care, palliative care, oncology, renal medicine, internal medicine, respiratory medicine, surgery, cardiology, geriatric medicine and medical administration departments. Participants were recruited using purposive maximum variation sampling. (...) Results Doctors attributed the provision of futile treatment to a wide range of inter-related factors. One was the characteristics of treating doctors, including their orientation towards curative treatment, discomfort or inexperience with death and dying, concerns about legal risk and poor communication skills. Second, the attributes of the patient and family, including their requests or demands for further treatment, prognostic uncertainty and lack of information about patient wishes. Third, there were hospital factors including a high degree of specialisation, the availability of routine tests and interventions, and organisational barriers to diverting a patient from a curative to a palliative pathway. Doctors nominated family or patient request and doctors being locked into a curative role as the _main_ reasons for futile care. Conclusions Doctors believe that a range of factors contribute to the provision of futile treatment. A combination of strategies is necessary to reduce futile treatment, including better training for doctors who treat patients at the end of life, educating the community about the limits of medicine and the need to plan for death and dying, and structural reform at the hospital level. (shrink)

The impact of smaller firm size on corporate social responsibility (CSR) is ambiguous. Some contend that small businesses are socially responsible by nature, while others argue that a smaller firm size imposes barriers on small firms that constrain their ability to take responsible action. This paper critically analyses recent theoretical and empirical contributions on the size–social responsibility relationship among small businesses. More specifically, it reviews the impact of firm size on four antecedents of business behaviour: issue characteristics, personal characteristics, (...) organizational characteristics and context characteristics. It concludes that the small business context does impose barriers on social responsibility taking, but that the impact of the smaller firm size on social responsibility should be nuanced depending on a number of conditions. From a critical analysis of these conditions, opportunities for small businesses and their constituents to overcome the constraining barriers are suggested. (shrink)

Background In order to achieve the goals of the healthcare system, nursing managers are required to comply with ethical principles in decision-making. In complex and challenging healthcare settings, it is shown that the managers’ mere awareness of ethics does not suffice and managers need to be sensitive toward making ethical decisions. Aim To explore nursing managers and their sensitivity toward ethical decision-making by analyzing their related experiences. Method The current study has been conducted in Iran in 2017 through a qualitative (...) content analysis approach. Nineteen nurse managers were selected purposefully from different hospitals in Tehran. Data were collected using semi-structured, in-depth, face-to-face interviews, and after transcription, they were analyzed according to the Graneheim and Lundman method. Ethical considerations The research was approved by the ethics committee of Tarbiat Modares University, Tehran, Iran. Participants were informed about the purpose of the study and submitted written informed consents regarding their participation. The principle of autonomy, confidentiality, and anonymity was taken into account in data collection. Results Fifteen subcategories, three categories (assertiveness, commitment, and insight), and one theme of excellent decision-making were the results of data analysis. Discussion Findings showed that nursing managers’ sensitivity to ethical decision-making allows them to make the best decision by insight, commitment, and assertiveness. Making a morally excellent decision ensures that ethical principles are followed in the healthcare system. Conclusion Considering that most managers are committed to making ethical decisions, it is required to develop the scope of their insights even further using a professional management and ethical principles training program. Also, by addressing some of the ethical barriers at personal and organizational levels, the assertiveness in managers can be improved, which in turn can facilitate their ethical decision-making. (shrink)

Background: Moral courage is one of the most fundamental virtues in the nursing profession, however, little attention has been paid to it. As a result, no exact and clear definition of moral courage has ever been accessible. Objective: This study is carried out for the purposes of defining and clarifying its concept in the nursing profession. Methods: This study used a hybrid model of concept analysis comprising three phases, namely, a theoretical phase, field work phase, and a final analysis phase. (...) To find relevant literature, electronic search of valid databases was utilized using keywords related to the concept of courage. Field work data were collected over an 11 months’ time period from 2013 to 2014. In the field work phase, in-depth interviews were performed with 10 nurses. The conventional content analysis was used in two theoretical and field work phases using Graneheim and Lundman stages, and the results were combined in the final analysis phase. Ethical consideration: Permission for this study was obtained from the ethics committee of Tehran University of Medical Sciences. Oral and written informed consent was received from the participants. Results: From the sum of 750 gained titles in theoretical phase, 26 texts were analyzed. The analysis resulted in 494 codes in text analysis and 226 codes in interview analysis. The literature review in the theoretical phase revealed two features of inherent–transcendental characteristics, two of which possessed a difficult nature. Working in the field phase added moral self-actualization characteristic, rationalism, spiritual beliefs, and scientific–professional qualifications to the feature of the concept. Conclusion: Moral courage is a pure and prominent characteristic of human beings. The antecedents of moral courage include model orientation, model acceptance, rationalism, individual excellence, acquiring academic and professional qualification, spiritual beliefs, organizational support, organizational repression, and internal and external personal barriers. Professional excellence resulting from moral courage can be crystallized in the form of provision of professional care, creating peace of mind, and the nurse’s decision making and proper functioning. (shrink)

For over half a century there have been concerns about increases in the occurrence of academic misconduct by higher education students and this is now claimed to have reached crisis proportions (e.g. Mostrous & Kenber, 2016a ). This study explores the extent to which multi-national faculty judge the effectiveness of higher education institutions in dealing with such misconduct. A survey of multi-national higher education faculty was conducted to explore the perceived barriers to the implementation of academic integrity processes. It (...) asked faculty how likely some hypothetical scenarios of failures of such processes were to occur in the real world of higher education institutions. 63% of our participants perceived there to be institutional and/or faculty barriers to effectively dealing with academic misconduct. Mostly, they blamed the higher education model for this which, in the interests of mass education, has come to prioritise the need for institutions to focus more on their quantity of output as corporate business enterprises than on the integrity of their output as educators. In discussing participants’ comments, about the relationship of faculty to their employing institutions, Schein and Scheins’ ( 2016 ) theory of three levels of organisational culture was used. Participants’ comments suggested that, at the deepest level of organisational culture i.e. basic underlying taken-for-granted assumptions about beliefs and values, inadequate integrity measures have tended to become normalised. Despite the often considerable, efforts of the institutions, organisational barriers were noted which mitigate against faculty behaving professionally i.e. from doing a ‘good job’ in respect of student academic misconduct. Some blame was also placed on faculty. We argue that apparent institutional inability to effectively manage the integrity process, has potentially significant consequences for wider society. We discuss ways in which this situation might be improved including a recommendation that governments regulate this aspect of the corporate social responsibility of higher education institutions as they do other aspects, requiring that it be managed effectively. (shrink)

This paper depicts a case study of an organizational strategy for the promotion of ethical practice when introducing a new, high-risk, ethically-charged medical practice like Medical Assistance in Dying (MAiD). We describe the development of an interprofessional program that enables the delivery of high-quality, whole-person MAiD care that is values-based and sustainable. A “care ecology” strategy recognizes the interconnected web of relationships and structures necessary to support a quality experience of MAiD for patients, families, and clinicians. This program exemplifies a (...) care ecology approach that addresses common barriers to entry to MAiD practice, and also meets the needs of a variety of stakeholders through the creation of patient and family resources, team supports, standards of practice, professional development opportunities, organizational infrastructure, and community partnerships. We also describe how a thriving care ecology evolves to remain resilient, and to enable integration as the needs of the organization, team and program change over time. The design and development of this program may be adapted to other jurisdictions and organizations where MAiD is introduced, or where new patient populations become eligible for MAiD. This care ecology model may also be applicable to the creation of sustainable programs that provide other morally controversial or novel clinical services. (shrink)

The current crisis has come at a cost not only for big business but also for business schools. Business schools have been deemed largely responsible for developing and teaching socially dysfunctional curricula that, if anything, has served to promote and accelerate the kind of ruthless behavior and lack of self-restraint and social irresponsibility among top executives that have been seen as causing the crisis. As a result, many calls have been made for business schools to accept their responsibilities as social (...) institutions and to work toward becoming more socially embedded and better attuned to public interests. In this paper, however, we point to some of the barriers there may be in the way of business schools developing into responsible organizational citizens proper. We argue that there are lines of resistance against responsibilization operating at epistemological, institutional, and organization levels and that we need to take account of barriers on all these levels in order to properly capture the challenges that are involved in making the modern business school amenable to demands for more social responsibility. In terms of working toward overcoming such barriers, we discuss how business education can become more socially embedded via the inclusion of ethical reflection and critical thinking. (shrink)

Corporate entrepreneurs -- described in the academic literature as those managers or employees who do not follow the status quo of their co-workers -- are depicted as visionaries who dream of taking the company in new directions. As a result, though, in overcoming internal obstacles to reaching their professional goals they can often walk a fine line between clever resourcefulness and outright rule breaking. A framework is presented as a guideline for middle managers and organizations seeking to impede unethical behaviors (...) in the pursuit of entrepreneurial activity. This paper examines the barriers middle managers face in trying to be entrepreneurial in less supportive environments, the ethical consequences that can result, and a suggested assessment and training program for averting such dilemmas. We advise companies that embrace corporate entrepreneurship: (1) establish the needed flexibility, innovation, and employee initiative and risk-taking; (2) remove the barriers that the entrepreneurial middle manager may face to more closely align personal and organizational initiatives and reduce the need to behave unethically; and (3) include an ethical component to corporate training which will provide guidelines for instituting compliance and values components into the state-of-the-art corporate entrepreneurship programs. (shrink)

A modern form of narrative, comic books are used to communicate, discuss, and critique issues in business ethics and social issues in management. A description of comic books as a legitimate medium is followed by a discussion of the pedagogical uses of comic books and assessment techniques. The strengths of the pedagogy include crossing cultural barriers, understanding the complexity of individual decision-making and organizational influences, and the universality of dilemmas and values. We provide an initial source for educators on (...) the topics, comic books, plotlines, and other commentary for consideration of use in the classroom from high school to graduate business ethics and social issues in management courses. (shrink)

In this article, the author addresses two feminist issues: first, how to conceptualize intersectionality, the mutual reproduction of class, gender, and racial relations of inequality, and second, how to identify barriers to creating equality in work organizations. She develops one answer to both issues, suggesting the idea of “inequality regimes” as an analytic approach to understanding the creation of inequalities in work organizations. Inequality regimes are the interlocked practices and processes that result in continuing inequalities in all work organizations. (...) Work organizations are critical locations for the investigation of the continuous creation of complex inequalities because much societal inequality originates in such organizations. Work organizations are also the target for many attempts to alter patterns of inequality: The study of change efforts and the oppositions they engender are often opportunities to observe frequently invisible aspects of the reproduction of inequalities. The concept of inequality regimes may be useful in analyzing organizational change projects to better understand why these projects so often fail and why they succeed when this occurs. (shrink)

This article explores the critical role of emotions and bodies in the individual dynamics of engagement as well as the construction of collective identities and action in women’s groups in the 1970s in France. Much literature on emotion work in feminist organizations has tended to discuss emotions stemming from women’s dominant socialization processes as, above all, alienating, thereby as barriers to their activism. The Movement for the liberty of abortion and birth control offers essential insights into how gendered dispositions (...) can be primary determinants of feminist collective identity formation, and even spur innovative protest practices. With their specific organizational settings and action, some ‘dissident MLACs’ in Aix-en-Provence, Lille, Lyon and Paris – those which continued to practice abortion despite its legalization and in defiance of the 1975 law which forbade them to do so – mobilized reciprocal emotions and bodily experiences to sustain engagement and serve a political project. Drawing on a wide array of biographical interviews and archival sources centred on abortion practices, the article examines the distinctive emotion culture these groups constructed. Its anchoring in bodies, commitment to emotions like tenderness and compassion, but also domestic and relational skills consecrated a gendered repertoire of action which therefore notably appealed to women whose social properties did not predispose them to collective action. (shrink)

We highlight exclusionary practices in management research, and demonstrate through example how a more inclusive management literature can address the unique contexts of persons with disabilities, a group that is disadvantaged in society, globally. Drawing from social psychology, disability, self-employment, entrepreneurship, and vocational rehabilitation literatures, we develop and test a holistic model that demonstrates how persons with disabilities might attain meaningful work and improved self-image via self-employment, thus accessing some of the economic and social-psychological benefits often unavailable to them due (...) to organizational-employment barriers. Our longitudinal study provides evidence of the self-image value of ‘doing’ in self-employment, highlighting the potential to reduce stigma and improve generalized self-efficacy and self-esteem. Implications for self-image theory, entrepreneurship training and development, and public policy related to persons with disabilities are discussed. (shrink)

Corporate social responsibility has been linked with numerous organizational advantages, including recruitment, retention, productivity, and morale, which relate specifically to employees. However, despite specific benefits of CSR relating to employees and their importance as a stakeholder group, it is noteworthy that a lack of attention has been paid to the individual level of analysis with CSR primarily being studied at the organizational level. Both research and practice of CSR have largely treated the individual organization as a “black box,” failing to (...) account for individual differences amongst employees and the resulting variations in antecedents to CSR engagement or disengagement. This is further exacerbated by the tendency in stakeholder theory to homogenize priorities within a single stakeholder group. In response, utilizing case study data drawn from three multinational tourism and hospitality organizations, combined with extensive interview data collected from CSR leaders, industry professionals, engaged, and disengaged employees, this exploratory research produces a finer-grained understanding of employees as a stakeholder group, identifying a number of opportunities and barriers for individual employee engagement in CSR interventions. This research proposes that employees are situated along a spectrum of engagement from actively engaged to actively disengaged. While there are some common drivers of engagement across the entire spectrum of employees, differences also exist depending on the degree to which employees, rather than senior management, support corporate responsibility within their organizations. Key antecedents to CSR engagement that vary depending on employees’ existing level of broader engagement include organizational culture, CSR intervention design, employee CSR perceptions, and the observed benefits of participation. (shrink)

Corporate sustainability is an important strategy and value orientation for marketing, but scarce research addresses the organizational drivers and barriers to including it in companies’ marketing strategies and processes. The purpose of this study is to determine levels of commitment to corporate sustainability in marketing, processes associated with sustainability marketing commitment, drivers of sustainability marketing at the functional level of marketing, and its organizational context. Using survey data from 269 managers in marketing, covering a broad range of industries in (...) Sweden and Denmark, we took a structural modelling approach to examine construct relationships, mediation, and moderation effects. Overall, the findings show that marketing capabilities associated with the innovation of new products, services, and business models constitute a strong driver to leverage sustainability marketing commitment. In conjunction with insights into processes related to the enactment of sustainability marketing, this result indicates that companies’ marketing departments have a propensity to drive corporate sustainability. The study provides substance to the idea of aligning substantive marketing capabilities closer to dynamic capabilities. Accordingly, the study reveals that reliance on market orientation alone does not lead to greater sustainability commitment. (shrink)

Although justice is a central principle in clinical ethics, work that centers social justice is often marginalized in clinical ethics. In addition to institutional barriers that may be preventing clinical ethicists from becoming the activists that Meyers argues we should be, we must also recognize the barriers embedded in the field of clinical ethics itself. As clinical ethicists, we have an opportunity to support anti‐racism work in particular by altering our own organizational structures to be more inclusive and (...) reflective of the Black, Indigenous, and other communities of color we serve, enhancing clinical ethics education and training by making critical theories foundational, and decolonizing our clinical ethics consultation tools and practices. (shrink)

Perioperative nurses assist in organ procurement surgery; however, there is a dearth of information of how they encounter making conscientious objection requests or refusals to participate in organ procurement surgery. Organ procurement surgical procedures can present to the operating room ad hoc and can catch a nurse who may not desire to participate by surprise with little opportunity to refuse as a result of staffing, skill mix or organizational work demands. This paper that stems from a larger doctoral research study (...) exploring the experiences of perioperative nurses participating in multi‐organ procurement surgery used a grounded theory method to develop a substantive theory of the nurses’ experiences. This current paper aimed to highlight the experiences of perioperative nurses when confronted with expressing a conscientious objection towards their participation in these procedures. A number of organizational and cultural barriers within the healthcare organization were seen to hamper their ability in expressing a conscience‐based refusal, which lead to their reluctant participation. Perioperative nurses must feel safe to express a conscientious objection towards these types of surgical procedures and feel supported in doing so by their respective hospital organizations and not be forced to participate unwillingly. (shrink)