Social justice is widely advanced as a central nursing value, and yet conceptual understandings of social justice remain inconsistent and vague. Further, despite persistently articulated commitments to upholding social justice, the profession of nursing has been implicated in perpetuating inequities in health and health care. In this context, it is essential to establish both conceptual clarity and tangible guidance for nurses in enacting practices to advance social justice—particularly through regulatory, education and accreditation documents that shape the nursing profession. This (...) Foucauldian discourse analysis examines how social justice is discursively positioned within nursing professional documents in Canada, and illustrates that social justice was largely discursively excluded from these texts. Where social justice discourses were invoked, we identified that four central discursive patterns obscured and de‐centred this nursing value: (i) Vague language undermined professional commitments to social justice; (ii) Constructions of knowledge and awareness de‐emphasized practice; (iii) Individualism discourses minimized institutional/professional responsibility; and (iv) Aspirational language obscured present action. Extending from this analysis, we contend that the nursing profession must re‐examine how social justice is understood and articulated, and call for a re‐conceptualization of social justice grounded in nursing practice toward remediating inequities in health and health care. (shrink)

Professional workplaces that embody an “ideal worker” image that is implicitly white and male set-up persistent biases against the competence and suitability for authority of those who are not white men, forcing them to work harder to prove their competence and fit in. The added labor of coping with these burdens is largely invisible to dominant actors in the workplace who do not experience them. To facilitate change by making such burdens visible for all, we present data from a (...) survey of 1,349 architects, including white, Asian, Black, Latinx, and mixed race/other underrepresented men and women, about their specific behavioral experiences of prove-it-again bias, tightrope bias, problems of fit, exclusion, emotion work, and interruptions. Across all measures, white men architects report significantly lower levels of these burdens than do women of any race and almost all non-white men. Consistent with status expectations and stereotype prototypicality theories, we find intersectional patterns in the relative burdens experienced by women and men of different racial groups. Gender differences in bias experiences are greatest among white, less among Asian, and least among Black architects. Women of color report the highest levels of bias overall. (shrink)

Historically, recordkeeping has been an essential task for health professionals. Today, this mandatory task increasingly takes place as digital documentation. This study critically examines problem constructions in practical documents on digital documentation strategies in Danish municipal healthcare and how these problem constructions imply particular solutions. A document analysis based on the approach presented in Bacchi's “What's the problem represented to be?” was applied. Forty practical documents in the form of guidelines, strategies, and quality control documents were included. (...) The analysis uncovered three problem representations: lack of coherence between health services in a complex healthcare system, lack of assessable data for management and political prioritization, and inefficiency in the healthcare system. The proposed solution is a digitalized and standardized practice that transforms recordkeeping in the municipalities. However, municipal healthcare is at risk of being fragmented due to digital documentation's focus on the organizational management of health with task‐oriented practices supplied by an anonymous health professional. We find that digital documentation functions as an organizational micromanagement approach that assigns the health professional a subject position as an employee acting according to the organization's framework rather than the profession's normative framework. (shrink)

Because of their responsibilities for providing high-quality care, at times when they are continuously confronted with inherent professional and ethical challenges, nurses should meet high ethical standards of practice and conduct. Contrary to other countries, where codes of ethics for nurses are formulated to support those standards and to guide nurses’ professional practice, Belgian nurses do not have a formal code of ethics. Nevertheless, professional ethics is recognized as an important aspect in legal and other professional (...) documents. The aim of this article is to illustrate that codes of ethics are not the only professional documents reflecting nurses’ values, norms and responsibilities. Other documents can also set out professional nursing ethics, and as such replace codes of ethics. (shrink)

This short perspective piece is about the documentation of clinical ethics consultation in Canada. It is written at a time when the Canadian Association of Practicing Health Care Ethicists (CAPHE) is endeavoring to develop standards of practice for clinical ethics in Canada. This brief commentary is informed by my experience working in clinical ethics in three different provinces, but it is primarily an attempt to draw attention to the normative questions: How much and what kinds of information should be included (...) in clinical ethics documentation? Where should ethics consultation reports be saved, and who should have access to them? These questions are, more fundamentally, about how we should balance concern for privacy, confidentiality, professional integrity, accountability and the promotion of trust. They are also about where clinical ethics fits within the broader Canadian health system. (shrink)

We are printing in its entirety the discussion document which sets out a code of professional conduct for nurses published by the Royal College of Nursing in November 1976 together with commentaries by the Assistant Secretary of the British Medical Association, a professor of nursing studies, student nurses and a lawyer. The image of the nurse is still that of one of Florence Nightingale's young ladies or of a member of a religious order who is wholly dedicated to caring (...) for the sick. Today, as this document and the comments upon it show, 'dedication' is still part of the motive which leads a man or woman to become a nurse but in addition, and this is where the public may be ignorant or choose to be ignorant, nursing offers a career where intellectual achievement and the satisfaction of a demanding job bring their proper financial reward and place in the professional community. We are grateful to the Royal College of Nursing for permission to publish this document. (shrink)

Health professionals communicate with each other about medication information using different forms of documentation. This article explores knowledge and power relations surrounding medication information exchanged through documentation among nurses, doctors and pharmacists. Ethnographic fieldwork was conducted in 2010 in two medical wards of a metropolitan hospital in Australia. Data collection methods included participant observations, field interviews, video‐recordings, document retrieval and video reflexive focus groups. A critical discourse analytic framework was used to guide data analysis. The written medication chart was the (...) main means of communicating medication decisions from doctors to nurses as compared to verbal communication. Nurses positioned themselves as auditors of the medication chart and scrutinised medical prescribing to maintain the discourse of patient safety. Pharmacists utilised the discourse of scientific judgement to guide their decision‐making on the necessity of verbal communication with nurses and doctors. Targeted interdisciplinary meetings involving nurses, doctors and pharmacists should be organised in ward settings to discuss the importance of having documented medication information conveyed verbally across different disciplines. Health professionals should be encouraged to proactively seek out each other to relay changes in medication regimens and treatment goals. (shrink)

El término competencias profesionales se define en la actualidad, como la posesión por parte del individuo de los conocimientos, destrezas y actitudes necesarias para realizar su actividad. El actual estudio tiene como objetivo profundizar en el análisis de la literatura sobre las competencias profesionales con un enfoque de formación y desarrollo de la expresión escrita en las universidades médicas. Con la revisión documental, se corroboró que en estas instituciones, el tratamiento de los contenidos de los programas de las asignaturas, no (...) garantizan el desarrollo de las competencias profesionales, atendiendo a que los currículos están diseñados por habilidades lo que trae como resultado que sus egresados no cuenten con el desarrollo adecuado de tales competencias, en particular las que garantizan la práctica afectiva de la expresión escrita. Professional competencies are currently defined as an individual's knowledge, skills and attitudes required to work in a specific profession. The current study aimed to further examine the literature related to professional skills with a focus on the development of writing in medical universities. Through document review, it was confirmed that in these institutions, the syllabi do not ensure the development of professional competencies since curricula are skills based. This in turn hinders the proper development of professional competencies, particularly those that guarantee strong writing practices. (shrink)

This contribution deals with the issue of the professional autonomy ofthe medical doctor. Worldwide, the physician's autonomy is guaranteedand limited, first of all, by Codes of Medical Ethics. InItaly, the latest version of the national Code of MedicalEthics (Code 1998) was published in 1998 by the Federation ofprovincial Medical Associations (FnomCeO). The Code 1998acknowledges the physician's autonomy regarding the scheduling, thechoice and application of diagnostic and therapeutic means, within theprinciples of professional responsibility. This responsibility has tomake reference to (...) the following fundamental ethical principles:(1) the protection of human life; (2) the protection of thephysical and psychological health of the human being; (3) therelief from pain; (4) the respect for the freedom and the dignityof the human person, without discrimination; (5) an up-to-datescientific qualification (Art. 5). The authors underline that autonomyis an anthropological – and consequently ethical –characteristic of the human person. Different positions on autonomy inbioethics (individualistic, evolutionistic, utilitarian andpersonalistic models) are explained. The relation between theprofessional autonomy of the physician and the autonomy of the patientand of colleagues is discussed. In fact, the medical doctor isobliged: (1) to respect the fundamental rights of the person,first of all his/her life; (2) to ensure the continuity of thecare, even if he can only relieve the patient's suffering; (3) tomaintain, except under certain circumstances, professional secrecy andconfidentiality regarding patients and their medical records. Moreover,the physician cannot deny the patient correct and appropriateinformation. He/she should not perform any diagnostic or therapeuticactivity without the informed consent of the patient and the medicaldoctor must give up medical treatment in case of documented refusal ofthe individual. Furthermore, the medical doctor has the right to raiseconscientious objections if he/she is requested to perform medicalactions that are contrary to his/her conscience or medical opinion,unless this attitude would seriously and immediately harm the patient.Regarding the relationships with colleagues, the physician is obliged tosolidarity, mutual respect, and care of sick colleagues. Finally, theauthors discuss the Italian legislation affecting the physician'sprofessional autonomy: (1) the SSN health care Acts; (2) theso-called Charter for Public Health Care Services; (3) the Acts onprivacy; (4) Good Clinical Practice. (shrink)

Name der Zeitschrift: Studies in Logic, Grammar and Rhetoric Jahrgang: 45 Heft: 1 Seiten: 51-67.

Background: A small minority of nurses are investigated when they fail to meet the required professional standards. Unprofessional conduct does not just affect the nurse but also patients, colleagues and managers. However, it has not been clearly defined. Objective: The objective was to identify unprofessional conduct by registered nurses by examining disciplinary decisions by a national regulator. Design: A retrospective document analysis. Data and research context: Disciplinary decisions delivered to 204 registered nurses by the Finnish national regulatory authority from (...) 2007 to 2016. The data were analysed with quantitative statistics. Ethical consideration: The study received permission from the Finnish National Supervisory Authority for Welfare and Health and used confidential documents that were supplied on the basis of complete anonymity and confidentiality. Findings: The mean age of the registered nurses who were disciplined was 44 years and 81% were female. Two-thirds had worked for their employer for 5 years or less, 53% had two or more employers and 18% had a criminal history. All the decisions included a primary reason for why the nurses were investigated, but there were also 479 coexisting reasons. In most cases, unprofessional conduct was connected to substance abuse (96%). In addition, stealing of medicine, a decreased ability to work and neglect of nursing guidelines were reported. Discussion: We found that the nurses were investigated for unprofessional conduct for complex combinations of primary and coexisting reasons. Our study highlighted that more attention needs to be paid to the key markers for unprofessional conduct. Conclusion: Unprofessional conduct is a complex phenomenon that is connected to nurses’ individual and working backgrounds and has an impact on their work performance. More research is needed to identify how nursing communities can detect, manage and limit the serious effects and consequences of unprofessional conduct. (shrink)

Background: Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses costing from $44,380 - $63,400 per nurse—an estimated $4.21 to $6.02 million financial loss annually for hospitals in the United States of America. Attrition of all nurses is costly. Most past research has focused on the new graduate nurse with little focus on the mid-career nurse. Attrition of mid-career nurses is a loss for the profession now and into the future. Research objective: The purpose of the study was (...) to explore relationships of professional values orientation, career development, job satisfaction, and intent to stay in recently hired mid-career and early-career nurses in a large hospital system. Research design: A descriptive correlational study of personal and professional factors on job satisfaction and retention was conducted. Participants and research context: A convenience sample of nurses from a mid-sized hospital in a metropolitan area in the Southwestern United States was recruited via in-house email. Sixty-seven nurses met the eligibility criteria and completed survey documents. Ethical considerations: Institutional Review Board approval was obtained from both the university and hospital system. Findings: Findings indicated a strong correlation between professional values and career development and that both job satisfaction and career development correlated positively with retention. Discussion: Newly hired mid-career nurses scored higher on job satisfaction and planned to remain in their jobs. This is important because their expertise and leadership are necessary to sustain the profession into the future. Conclusion: Nurse managers should be aware that when nurses perceive value conflicts, retention might be adversely affected. The practice environment stimulates nurses to consider whether to remain on the job or look for other opportunities. (shrink)

The practice of people mandated by the university to go to school in order to observe and evaluate the activity of trainees in pre-service teachers training remains poorly documented from the point of view of professional gestures (Jorro, 2016). This article focuses on the analysis of a feedback interview, which is a key moment in this practice, aiming at commenting, evaluating the performance of a trainee after the observation of their teaching. The originality of our analysis is that it (...) was carried out from several frames, in an effort to combine different perspectives on the same object. It is therefore a multifocal analysis (Altet, 2002). (shrink)

Scholarship on technological change in academe suggests that the adoption of instructional technologies will erode professional control. Researchers have documented the pervasiveness of new technologies, but neither demonstrate how technological change is experienced by faculty nor collect data that permit assessment of consequences for professional control. Drawing on a sample of interviews with forty-two professors at three research-intensive universities, this research makes two contributions to existing research. First, in contrast to existing depictions of technological change in higher education, (...) the findings reveals that academics perceive instructional technologies to have limited value in enhancing education and that technology use is rarely motivated by pedagogical innovation. Second, the study suggests that a relationship between technological change and “unbundling” of the academic role may be overstated. These data indicate that technological change threatens professional autonomy through exclusion from decision-making processes, increased workloads, and delimited teaching and research roles. (shrink)

Background: Nursing documentation is an essential aspect of ethical nursing care. Lack of awareness of ethical dilemmas in nursing documentation may increase the risk of patient harm. Considering this, ethical dilemmas within nursing documentation need to be explored. Aim: To explore ethical dilemmas in nurses’ conversations about nursing documentation. Research design, participants and context: The study used a qualitative design. Participants were registered nurses from a Patient Hotel at a Danish University Hospital. Data were collected in three focus groups with (...) a total of 12 participants. Data analysis consisted of qualitative content analysis inspired by Graneheim and Lundman. Ethical consideration: This study was conducted in accordance with the ethical principles of research and regulations in terms of confidentiality, anonymity and provision of informed consent. Findings: Ethical dilemmas were strongly present in nurses’ conversations about nursing documentation. These dilemmas were demonstrated in two themes: (1) a dilemma between respecting patients’ autonomy and not causing harm, which was visible in nurses’ navigation between written documentation and oral tradition, and (2) a dilemma concerning justice and fair distribution of goods, which was visible in nurses’ balancing between documenting deviations and proof of nursing practice. Discussion: Ethical dilemmas in nursing documentation regarding respecting patients’ autonomy and not causing harm accentuated discussions on professional responsibility and patient participation in clinical decisions. Dilemmas in justice and fair distribution of goods emphasised discussions on trust in relationships versus trust in electronic health records. Conclusion: Actual tendencies in the healthcare system may increase ethical dilemmas in nursing documentation. Sharing otherwise invisible and individual experiences of ethical dilemmas in nursing documentation among nurses, nurse leaders and decision-makers will enable addressing these in reflections and discussions as well as in considering adjustments of conditions for nursing documentation. (shrink)

This paper examines the potential limitations of professional wisdom alongside those of society more generally with respect to upholding the well-being of vulnerable and marginalized people. It presents the dangers, referring to four well-documented illustrations of professional failure, that services and service systems pose when both professionals and society at large do not demonstrate sufficient measures of positive values and ethics to ensure the protection of vulnerable people within care systems. While it argues that reform of service systems (...) and the repair of such breaches are always possible, even such system reform may fail if it is not ultimately guided by wisdom not only from professionals but society itself. Several recent international examples of this wisdom are noted. It sees such wisdom as being located in the inherited values and social ethics of a society and the power of these to guide human conduct in the face of the profound and ongoing limitations of human nature. (shrink)

This paper presents a narrative study on the professional identity development of a Chinese preservice EFL teacher, examining her experiences before, during, and after the teaching practicum. The data for this research were gathered through in-depth interviews, documents, and observations. By offering a comprehensive narrative of Yang’s practicum journey, this study sheds light on the evolving nature of professional identity among Chinese preservice EFL teachers. Through the framework of teacher socialization, the findings reveal distinct phases in Yang’s (...) professional identity. Yang’s stories highlight the dynamic and evolving process of professional identity development, characterized by continuous negotiation, adjustment, and reflection at each stage of the practicum. Additionally, this paper offers practical recommendations for educational institutions, placement schools, and preservice teachers. By integrating these findings, future teacher education programs can better prepare aspiring educators to navigate the complexities of professional identity development, thereby enhancing the effectiveness of EFL teacher training in China. (shrink)

Due to the rapid advance of the pandemic caused by COVID-19, several countries perceived that human and material resources would be insufficient to meet the demand of infected patients. The aim of this study is to analyze the knowledge of health professionals working in the pandemic about the application of ethical criteria in decision-making in situations of resource scarcity. This is a cross-sectional, descriptive, and quantitative survey study, conducted from June to December 2020, with health professionals working in the COVID-19 (...) pandemic in Brazil. We applied a questionnaire to assess the professionals’ knowledge about ethical criteria in decision-making in the allocation of scarce resources during the pandemic, containing 14 questions and possible score from 0 to 70, which was developed by researchers from documents and protocols validated by organizations from various countries, available in the first months of the pandemic, a sociodemographic characterization questionnaire and a self-assessment questionnaire regarding knowledge about bioethics. A total of 197 health professionals participated in the study, 37.6% of whom were nurses and 22.8% of whom were physicians, working in the Family Health Unit (28.4%) with a degree at the level of specialization (46.2%). Moreover, (9.5%) of nurses, (18.2%) of dental surgeons and (24.4%) of physicians reported that they have no prior knowledge about bioethics. Physicians and hospital workers scored higher on the knowledge assessment questionnaire. The mean score of the participants was 45.4 (SD = 7.2). Investments in training and professional education in the field of health focused on Bioethics are necessary, considering models and ethical theories that help professionals, managers and society to better position themselves in the face of pandemic contexts. (shrink)

BackgroundDecision-making in out-of-hospital cardiac arrest should ideally include clinical and ethical factors. Little is known about the extent of ethical considerations and their influence on prehospital resuscitation. We aimed to determine the transparency in medical records regarding decision-making in prehospital resuscitation with a specific focus on ethically relevant information and consideration in resuscitation providers’ documentation.MethodsThis was a Danish nationwide retrospective observational study of out-of-hospital cardiac arrests from 2016 through 2018. After an initial screening using broadly defined inclusion criteria, two experienced (...) philosophers performed a qualitative content analysis of the included medical records according to a preliminary codebook. We identified ethically relevant content in free-text fields and categorised the information according to Beauchamp and Childress’ four basic bioethical principles: autonomy, non-maleficence, beneficence, and justice. ResultsOf 16,495 medical records, we identified 759 (4.6%) with potentially relevant information; 710 records (4.3%) contained ethically relevant information, whereas 49 did not. In general, the documentation was vague and unclear. We identified four kinds of ethically relevant information: patients’ wishes and perspectives on life; relatives’ wishes and perspectives on patients’ life; healthcare professionals’ opinions and perspectives on resuscitation; and do-not-resuscitate orders. We identified some “best practice” examples that included all perspectives of decision-making. ConclusionsThere is sparse and unclear evidence on ethically relevant information in the medical records documenting resuscitation after out-of-hospital cardiac arrests. However, the “best practice” examples show that providing sufficient documentation of decision-making is, in fact, feasible. To ensure transparency surrounding prehospital decisions in cardiac arrests, we believe that it is necessary to ensure more systematic documentation of decision-making in prehospital resuscitation. (shrink)

There is an apparent contradiction between the widespread moves towards a uniform and instrumentalist standards‐based approach to teaching on the one hand and recent research‐based insights into the complexity of effective pedagogies. The former tendency reflects a politically driven agenda, the latter is more professionally driven. Tensions reflecting such a contradiction are evident in the debates over initial teacher education policy and practice in many parts of the world. This article examines aspects of ITE policy in two contiguous parts of (...) the United Kingdom, England and Scotland. The authors draw on a comparative study carried out during 2002–2004, particularly on an analysis of key contemporary policy documents, in order to consider some of the similarities and differences that are apparent in these two countries. It is argued that while features of national culture, tradition and institutional politics have a significant role to play in the detail of the approaches taken, there is nevertheless evidence of significant convergence between both countries in one aspect of the determination of initial teacher education, the definition of teaching through the prescription of standards, which set official parameters on professional knowledge required for entry into the profession. This, it is suggested, reflects trends associated with neoliberal ‘globalisation’. (shrink)

New testamentThe British Medical Association recently published guidance from its medical ethics committee on decision making concerning the withholding and withdrawing of life-prolonging medical treatment.1 It is a very thoughtful and thought-provoking document, the ramifications of which go far beyond the immediate situation it is addressing. The authors are clearly well aware of this. When considering a doctor's ethical response to “contemporaneous requests for life-prolonging treatment” made by competent patients, the committee observes:“Although patients' wishes should always be discussed with them, (...) the fact that a patient has requested a particular treatment does not mean that it must always be provided.”2They advance four propositions in support of this conclusion, namely: Health professionals are not obliged to provide any treatment which cannot produce the desired benefit”.3 There is no obligation to provide any treatment which is clearly contrary to an individual's health interests. A life-prolonging treatment may, for example, prolong life but result in severe pain or loss of function so that overall it produces severe harm to the patient”.4 Except in an emergency situation, doctors are not obliged to treat contrary to their conscience ”.4 Where resources are limited, it is inevitable that some patients will not receive all of the treatment they request even though such treatment could be potentially beneficial to them”.4Towards the end of their commentary on the last of these propositions, they observe:“Health professionals have an ethical duty to make the best use of the available resources and this means that hard decisions must be made. Whilst this is a much broader issue than can be discussed thoroughly in this document, it is clear that doctors are not obliged to comply with patients' requests for treatment when they …. (shrink)

A formal Ethics Consultation Service (ECS) can provide significant help to patients, families and hospital staff. As with any other form of clinical consultation, documentation of the process and the advice rendered is very important. Upon review of the published consult documentation practices of other ECSs, we judged that none of them were sufficiently detailed or structured to meet the needs and purposes of a clinical ethics consultation. Thus, we decided to share our method in order to advance the practice (...) of ethics consultation. Here, we describe a method of ECS documentation practice, including use of a formal consult report template, as well as a log for maintaining a chronological record of the consultations performed. These two documents facilitate order and organisation of the ECS. They also enable the ECS to keep an account of professional time and experience, enable quick consult trend assessments (by consult theme or ward, for example) and establish a potential registry of consults for future research study. This method of documentation, we believe, not only contributes significantly to the primary purpose of the consultation—namely, the evincing and sharing of ethical opinion about a case—but also enables consultants to improve their practice and to pursue research on clinical ethics consultation. (shrink)

A 47-year-old woman with a history of anxiety disorder is admitted to the hospital for shortness of breath. On the third day of hospitalization, she asks her physician for a copy of all documents pertaining to her care. What expectation should she have for full disclosure? Are there limits on her access to her medical records and do her physician's concerns about professional privilege matter?The virtues of transparency in medicine have been well described. As proponents of transparency, we (...) favor patient access to their medical records, but we are increasingly troubled by the ease and extent of disclosure in current practice as technology advances and... (shrink)

Health professionals increasingly face patients with complex health problems and this pressurizes them to cooperate. The authors have analyzed how the complexity of health care problems relates to two types of cooperation: consultation and multidisciplinary teamwork (MTW). Moreover, they have analyzed the impact of these two types of cooperation on perceived professional autonomy. Two teams were studied, one team dealing with geriatric patients and another treating oncology patients. The authors conducted semi-structured interviews, studied written documents, held informal discussions (...) and observed the teams at work. Consultation was most likely to take place when a patient had multiple problems. However, if these problems were interrelated, i.e. the solution for one problem interfered with solving another, then MTW was favored. The same was true when the available information was equivocal such that there were conflicting interpretations of a problem. How the professionals perceived the relationship between complexity and the need to cooperate depended on their expertise, their occupational background, and their work orientation. Consultation did not affect the professional autonomy of the health care professionals. MTW however did decrease the perceived level of professional autonomy. The extent to which this occurred seemed to depend on the quality of the interpersonal relations within the team. The findings can help in selecting the most appropriate and efficient type of cooperation based on the complexity of a patient’s problems. They can also help team leaders to stimulate reflection and feedback processes, and medical trainers to develop competencies among students related to such teamwork behaviors. (shrink)

In this paper, we argue that the professional engineering institutions ought to develop a Declaration of Climate Action. Climate change is a serious global problem, and the majority of greenhouse gas emissions come from industries that are enabled by engineers and represented by the engineering professional institutions. If the professional institutions take seriously the claim that a profession should be self-regulating, with codes of ethics that go beyond mere obedience to the law, and if they take their (...) own ethical codes seriously, recognising their responsibility to the public and to future generations, the professional institutions ought to develop a declaration for engineers, addressing climate change. Our argument here is largely inspired by the history of the Declaration of Helsinki. The Declaration of Helsinki was created by the medical profession for the profession, and it held physicians to a higher standard of ethical conduct than was found in the legal framework of individual countries. Although it was not originally a legal document, the influence of the Declaration can be seen in the fact that it is now enshrined in law in a number of different countries. Thus, we argue that the engineering profession could, and should, play a significant role in the abatement of climate change by making changes within the profession. If the engineering profession sets strict standards for professional engineers, with sanctions for those who refuse to comply, this could have a significant impact in relation to our efforts to develop a coordinated response to climate change. (shrink)

Caring for patients with anorexia nervosa (AN) is associated with high levels of moral distress among healthcare professionals. The main moral conflict has been posited to be between applying coercion to prevent serious complications such as premature death and accepting treatment refusals. However, empirical evidence on this topic is scarce. We identified all 19 documentations of ethics consultations (ECs) in the context of AN from one clinical ethics support service in Switzerland. These documentations were coded with a sequential deductive-inductive approach (...) and the code system was interpreted in a case-based manner. Here, we present findings on patient characteristics and ethical concerns. The ECs typically concerned an intensely pretreated, extremely underweight AN patient endangering herself by refusing the proposed treatment. In addition to the justifiability of coercion, frequent ethical concerns were whether further coerced treatment aimed at weight gain would be ineffective or even harmful, evidencing uncertainty about beneficence and non-maleficence and a conflict between these principles. Discussed options included harm reduction (e.g. psychotherapy without weight gain requirements) and palliation (e.g. initiating end-of-life care), the appropriateness of which were ethical concerns in themselves. Overall, nine different types of conflicts between or uncertainties regarding ethical principles were identified with a median of eight per case. Ethical concerns in caring for persons with AN are diverse and complex. To deal with uncertainty about and conflict between respect for autonomy, beneficence and non-maleficence, healthcare professionals consider non-curative approaches. However, currently, uncertainty around general justifiability, eligibility criteria, and concrete protocols hinders their adoption. (shrink)

Due to continual challenges in their external environment, corporations are facing an increased demand for public participation and stakeholder inclusion. As aresult, companies are seeking ways to improve communication with their stakeholders. The emergence of the Internet has provided new corporate channelsfor offering information to stakeholders. This paper suggests that the information contained in company web pages reflects strategic information about the company. In addition to offering information to the public, web pages signal which issues a company holds as strategically (...) important. The objective of this paper is to begin the process of examining how companies express their understanding of multiple stakeholder interests and their efforts to include stakeholders in their strategy documents. The theoretical premise of this paper draws from the strategic management and the stakeholder literatures. The empirical section examines the content of the web pages of two companies from the pulp and paper industry. Based on the results of meaning making analysis, we synthesize the content of the strategy documents with three dimensions: strategic actors, strategic activities, and strategic actions. (shrink)

It is unknown whether hospital-based medical professionals in Spain educate patients about advance directives. The objective of this research was to determine the frequency of hospital-based physicians’ and nurses’ engagement in AD discussions in the hospital and which patient populations merit such efforts. A short question-and-answer-based survey of physicians and nurses taking care of inpatients was conducted at a university hospital in Madrid, Spain. In total, 283 surveys were collected from medical professionals, of whom 71 per cent were female, with (...) an average age of thirty-four years. Eighty-four per cent had never educated patients about ADs because of lack of perceived responsibility, time, or general knowledge of ADs. Patient populations that warranted AD discussions included those with terminal illnesses, chronic diseases, and elderly patients. Regarding degree of AD understanding in medical professionals: 57 per cent of medical professionals claimed sufficient general knowledge of ADs, 19 per cent understood particulars regarding AD document creation, and 16 per cent were aware of AD regulatory policies. Engagement in AD discussions was considered important by 83 per cent of medical professionals, with 79 per cent interested in participating in such discussions themselves. The majority of hospital physicians and nurses do not educate their patients about ADs, despite acknowledging their importance. Patient populations of highest priority included those with terminal diseases or chronic illness or who are of advanced age. (shrink)

Due to continual challenges in their external environment, corporations are facing an increased demand for public participation and stakeholder inclusion. As aresult, companies are seeking ways to improve communication with their stakeholders. The emergence of the Internet has provided new corporate channelsfor offering information to stakeholders. This paper suggests that the information contained in company web pages reflects strategic information about the company. In addition to offering information to the public, web pages signal which issues a company holds as strategically (...) important. The objective of this paper is to begin the process of examining how companies express their understanding of multiple stakeholder interests and their efforts to include stakeholders in their strategy documents. The theoretical premise of this paper draws from the strategic management and the stakeholder literatures. The empirical section examines the content of the web pages of two companies from the pulp and paper industry. Based on the results of meaning making analysis, we synthesize the content of the strategy documents with three dimensions: strategic actors, strategic activities, and strategic actions. (shrink)

Accounting professionals play an important role in the generation and auditing of financial statements and, given their understanding of business processes, may be relied upon in the development of organizations’ ethical infrastructures (i.e., the formal aspects of an organization’s ethical environment that are explicitly under the control of the organization). Thus, understanding and improving the work environments of accounting professionals is crucial to improving organizational ethical culture and reducing fraud. In this study, we extend prior research that documents the (...) prevalence of ethical infrastructure programs by assessing how accounting professionals, a key employee group, perceive their organizations’ ethical infrastructures. In addition, we examine whether perceptions of the effectiveness of the ethical infrastructure and professional autonomy influence accountants’ ethical judgments. Based on the responses of 378 CPAs in the United States, we find the perceived state of the ethical infrastructure across accounting work environments—both public accounting firms and other organization types—is relatively strong. However, of the five ethical infrastructure components we examine (i.e., ethics code, ethics training, ethics-based punishments and incentives, ethics reporting system, and ethics review system), only 35% of respondents indicate that their organizations have more than three of these components. Importantly, we find that perceived ethical infrastructure effectiveness and professional autonomy influence both perceptions of the ethical culture and the ethical judgments of accounting professionals. We also contribute to practice by highlighting opportunities for improvement in ethics training formats, ethics-based incentives, and ethics review systems. (shrink)

In 1970 a coalition of student activists opposing the Vietnam War circulated documents revealing the involvement of several prominent social scientists in U.S. counterinsurgency activities in Thailand--activities that could cause harm to the people who were the subject of the scholars' research. The disclosure of these materials, which detailed meetings with the Agency for International Development and the Defense Department, prompted two members of the Ethics Committee of the American Anthropological Association to issue an unauthorized rebuke of the accused. (...) Over the next two years, the AAA agonized over the allegations and the appropriate response to them. Within an academic community already polarized by the war, political and professional acrimony reached unprecedented levels. Although the association ultimately passed a code of ethics, the key issues raised in the process were never fully resolved. Now back in print, Eric Wakin's Anthropology Goes to War is the first comprehensive study of what became known as the Thailand Controversy--and a timely reminder of a debate whose echoes may be heard in our own time. (shrink)

Background: Essential for the help relation, empathy is the ability to understand, share, and perceive the subjective experience of other human beings. Objective: The objective in this non-experimental, exploratory, and descriptive research was to verify, observe, and document empathy in nursing professionals. Research design: Non-experimental, exploratory, and descriptive research. Participants and research context: the study was conducted at two large hospitals, one public and the other private, across all shifts. The sample included 159 individuals. A questionnaire was used to identify (...) sociodemographic characteristics and the empathy inventory was applied. Ethical considerations: This study received approval from the Research Ethics Committee at the University of São Paulo at Ribeirão Preto College of Nursing, opinion 1348/2011, and authorization from the health institutions involved. Findings: The association tests demonstrated that professionals working in the night shift and in a work scale rotation scheme, older professionals, and professionals with longer professional experience are less empathetic. On the other hand, professionals working in the day shift and in a single shift are more empathetic. Other influential factors are the time on the job, education, and work shift. Conclusion: There is a lack of empathy studies in professional practice contexts, in human resource development programs, and throughout the professional education process. (shrink)

The systemic difficulties of health care in the USA have brought to light another issue in nurse—patient advocacy — those who require care yet have inadequate or non-existent access. Patient advocacy has focused on individual nurses who in turn advocate for individual patients, yet, while supporting individual patients is a worthy goal of patient advocacy, systemic problems cannot be adequately addressed in this way. The difficulties nurses face when advocating for patients is well documented in the nursing literature and I (...) argue that, through collective advocacy, professional nursing associations ought to extend the reach of individual nurses in order to address systemic problems in health care institutions and bureaucracies. (shrink)

The speed of technology integration among businesses has accelerated during the COVID-19 pandemic due to the work-from-home arrangements and safe distancing regulations, prompting businesses to automate operations and digitalize work environments. These impacts have disrupted work environments and operational processes, and a fresh set of competencies is required to stay competent in this new normal. Consequently, there is a need to develop a state-of-the-art competency framework for logistics professionals during these trying times. This study has adopted the Preferred Reporting Items (...) for Systematic Reviews and Meta-Analyses to review, identify, and update the emerging competencies required by logistics professionals. The relevant academic documents were narrowed down to 81 and were used to identify the emerging competencies relevant to Industry 4.0 and COVID-19. The competencies were subsequently categorized into four key domains i.e., business, logistics, digital, and personal competencies, with a total of 17 sub-domains. This state-of-the-art framework contributes to academic research by updating the existing competency frameworks. Future research can also build upon this holistic list of emerging competencies by utilizing it to reduce the competency gaps faced by those who are less technology savvy i.e., older logistics professionals. Additionally, future research can correlate the competency framework to organizational learning theories to improve the overall performance of logistics companies. (shrink)

Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the (...) contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

The Software Engineering Code of Ethics and Professional Practice, intended as a standard for teaching and practicing software engineering, documents the ethical and professional obligations of software engineers. The code should instruct practitioners about the standards society expects them to meet, about what their peers strive for, and about what to expect of one another. In addition, the code should also inform the public about the responsibilities that are important to the profession. Adopted in 2000 by the (...) IEEE Computer Society and the ACM--two leading international computing societies--the code of ethics is intended as a guide for members of the evolving software engineering profession. The code was developed by a multinational task force with additional input from other professionals from industry, government posts, military installations, and educational professions. (shrink)

Secondary use of clinical data in research or learning activities (SeConts) has the potential to improve patient care and biomedical knowledge. Given this potential, the ethical question arises whether physicians have a professional duty to support SeConts. To investigate this question, we analyze prominent international declarations on physicians’ professional ethics to determine whether they include duties that can be considered as good reasons for a physicians’ professional duty to support SeConts. Next, we examine these documents to (...) identify professional duties that might conflict with a potential duty of physicians to support SeConts. (shrink)

Background Nurses are challenged with many situations that require them to solve ethical dilemmas and make moral decisions based on professional values and a sense of accountability and responsibility. To support their decisions, it is important to know how they perceive and relate their ethical ideology, professional values, and clinical accountability in their workplace. Purpose The study’s aim was twofold: to investigate the ethical ideology and perceived importance of professional values and accountability among nurses. Further, explore the (...) relationship between each of ethical ideology and professional values with nurses’ work accountability. Methods A correlational study was conducted in an Egyptian hospital. All nurses were invited to participate = 192, and 150 nurses (78.3%) completed the study questionnaires. The Ethical Position Questionnaire, the Professional Values Scale, and the Clinical Vignettes Assessment for Clinical Accountability were proven to be reliable study measures. Ethical considerations Ethics Committee approval, written informed consent, data privacy and confidentiality, and participants’ right to voluntary participation and withdrawal were maintained. Results Nurses showed good ethical ideology (75 ± 6.2) and are more idealistic while maintaining professional values (108 ± 10.8). Most nurses believed they were accountable for documenting errors, completing incident reports, and calling physicians to discuss or manage the situations. Ethical ideology and the idealism subscale were positively correlated with overall nurses’ professional values (r = 0.321, p < 0.004, r =0.464, p 0.000), respectively. On the other hand, work accountability showed a partial correlation in some areas with ethical ideology and professional values. Discussion Professional values and nurses' accountability appear to be influenced by ethical positions and ideology. Conclusion Healthcare organizations should provide a supportive work environment to help nurses develop self-awareness, and knowledge of their ethical ideologies, which improve professional values and clinical accountability in their practice. Ethical ideology and professional values should be emphasized more in nursing curricula. (shrink)

Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the (...) contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

BackgroundThe relatively young and inexperienced healthcare professionals in Mongolia faced with an unprecedent service demand in response to the COVID-19 pandemic. Due to the small size of the healthcare workforce the Mongolian Health Ministry had no choice but to mandate continuous and long workhours from the healthcare workforce. Many of the healthcare professionals exhibited signs and symptoms of mental health disorders. This study aimed to discern the prevalence various mental health concerns, i.e., depression, anxiety and stress, insomnia, and to discern (...) the factors that increased susceptibility to mental health disorders among frontline healthcare professionals providing healthcare services for COVID-19 patients in Mongolia.MethodsA Cross-sectional research design was implemented. We collected data from 965 healthcare professional, randomly selected from 18 government hospitals, in four regions of Mongolia. Data were collected using the Depression Anxiety Stress-21, the General Self-Efficacy Scale, and the Insomnia Severity Index instruments. We constructed the scale of Pandemic Response Symptoms which captured stress, depression, and anxiety. Data were analyzed using descriptive statistics, Kruskal–Wallis statistical test and multinominal logistic regression analysis.ResultsPrevalence of depression, anxiety, and stress was documented among Mongolian healthcare professionals. Perception of self-efficacy reduced susceptibility to PaReSy either at mild/moderate or severe/extremely severe level. Within each stratum of insomnia, the risk of experiencing PaReSy increased almost linearly both in the category of mild/moderate PaReSy and in the category of severe/extremely severe PaReSy.ConclusionImproving self-efficacy and sleeping quality can assist healthcare workers to manage depression, anxiety, and stress. Findings provide important evidence to implement measures and strategies to assist healthcare professionals in low- and middle-income countries to constructively address their mental health concerns and needs. (shrink)

The present study used social learning theory and situated learning theory as a way to examine secondary social studies teacher participants' formal and informal professional learning. Existing literature is just beginning to attend to the potential of informal professional learning and to distinguish between formal and informal professional learning, so this exploratory study used observations of scheduled and spontaneous professional learning experiences, semi-structured interviews with 12 secondary social studies teachers, and relevant documents to consider the (...) following research question: In what ways do high school social studies teacher participants engage in formal and informal professional learning? Results indicate that while secondary social studies teachers engage in a variety of formal and informal professional learning experiences, their informal learning experiences are the most valuable and significant for their classroom practice. While informal professional learning is not a replacement for traditional formal professional learning, lessons learned here can inform ways to improve formal professional learning and to capitalize upon teachers’ existing informal professional learning experiences. This study provides insight into the ways in which social studies teachers support their growth outside of formal professional development. (shrink)

The first code of professional ethics must: (1)be a code of ethics; (2) apply to members of a profession; (3) apply to allmembers of that profession; and (4) apply only to members of that profession. The value of these criteria depends on how we define “code”, “ethics”, and “profession”, terms the literature on professions has defined in many ways. This paper applies one set of definitions of “code”, “ethics”, and “profession” to a part of what we now know of (...) the history of professions, there by illustrating how the choice of definition can alter substantially both our answer to the question of which came first and (more importantly) our understanding of professional codes (and the professions that adopt them). Because most who write on codes of professional ethics seem to take for granted that physicians produced the first professional code, whether the Hippocratic Oath, Percival’s Medical Ethics, the 1847 Code of Ethicsof the American Medical Association (AMA), or some other document, I focus my discussion on these codes. (shrink)

Background: Advocacy and activism are dynamic terms representing a spectrum of political action, aiming to achieve social or political change. The extent to which nursing advocacy and activism are legitimate nursing roles has been debated for around 50 years. Nursing regulatory documents, such as codes of conduct and professional standards, may provide direction to nurses on how they should act in the context of advocacy and activism. Aim: To explore what regulatory documents say about advocacy and activism, (...) either explicitly or implicitly, and how they shape advocacy and activism. Research design: We used a Reflexive Qualitative Document Analysis approach with a Critical Feminist lens to analyse contemporary nursing regulatory documents from the USA, UK and Australia. Ethical considerations: This article has no human participants, and informed consent was not required. Findings: We identified eight nursing regulatory documents from the American Nurses Association, Nursing and Midwifery Council and Nursing and Midwifery Board of Australia. We constructed two major themes that reveal how nursing advocacy and activism are conceived and shaped in regulatory documents. Theme 1, Ideological arena describes the gendered and neoliberal subtexts influencing advocacy and activism. Theme 2, A five-pointed star, describes the shape of advocacy and activism in the regulatory documents. Conclusions: Regulatory documents from the USA, UK and Australia support diplomatic nursing advocacy and activism for people, equity, ourselves (nurses), the profession and systems change. However, more oppositional and disruptive advocacy and activism are potentially constrained by gendered and neoliberal subtexts that depoliticise nurses’ roles. (shrink)

This paper reports findings from a study into national associations of accountants from the perspective of the model code of the International Federation of Accountants (IFAC), Code of Ethics for Professional Accountants. Using data collected from a survey document, the paper analyses the extent of the model code’s influence in an international process of harmonisation of ethical rules for accountants. Obstacles to the adoption of the model code are examined, as is the impact that government supervision of codes has (...) had on harmonisation efforts. Particular attention is paid to the relationship between professional independence and close family relationships and culture. Findings are also presented on other issues of code content, and the most appropriate body for interpreting national codes is identified. These items were included as matters of then current concern to the Ethics Committee of IFAC. (shrink)

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

Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association’s (APA’s) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present article analyzes the subject of psychologists taking a (...) public position on controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present article examines ethical issues that (a) should be taken into account before psychologists take a public position on a controversial issue and (b) are in conflict with APA’s Ethics Code or current research. (shrink)

The common law system is a legal system that values precedent, or previous court decisions, in the resolution of current cases. As the availability of legal documents in digital form has increased, it has become more difficult for legal professionals to manually identify relevant past cases due to the vast amount of data. Researchers have developed automated systems for determining the similarity between legal documents to address this issue. Our research explores various representations of a legal document and (...) discusses a novel paragraph filtering process to identify key paragraphs using legal citation information to remove unnecessary text paragraphs without disturbing the concept of the legal document. State-of-the-art techniques like TF-IDF, BERT, Legal Bert, Doc2Vec, and Legal-longformer are used for the performance analysis of the proposed approach with document comparison. It has been shown that a model trained on the proposed filtered paragraphs can achieve better results than a model trained on the complete text and can also shorten the document by over 40%. The proposed filtering strategy could be helpful for models like BERT, where the maximum token length is fixed. (shrink)

BackgroundScientific researchers are expected to follow the professional norms in their own domain. With a growing number of scientific publications retracted and research misconduct cases revealed in recent years, Chinese biomedical research integrity is questioned. As institutions educating and training future researchers, universities and the guidance they provide are important for the research quality and integrity of the country. Therefore, through a review of the guidance and policy documents on research integrity in Chinese universities, this work aims to (...) investigate how the professional norms are specified in these documents.MethodsAfter a stratified sampling, 53 universities were selected. Their guidance and policy documents on research integrity were collected via a web search of their official websites. The search was confirmed by these universities. Then the content of all the collected documents were analyzed using inductive content analysis.Results118 active university documents were collected and analyzed. Most of the Chinese universities we investigated had their own guidance or policy on research integrity. They listed principles or examples of desired and undesired academic practices, investigation procedures and punishments of academic misconduct, and put forward measures to promote research integrity. Differences on specific practices and principles were observed between university groups and with European university documents.ConclusionDespite the discrepancy they have, all these documents were designed to promote research integrity and cultivate a good research environment in Chinese biomedical domain. Nevertheless, there is still room for improvement, for example, through more consultation of international guidance. (shrink)

Chronic diseases are major causes of health inequalities. Community nurses can potentially make large contributions to chronic illness prevention and management in Israel but may be obstructed by professional dominance of physicians. However, insufficient research exists about community nursing in Israel, and how it may differ from other countries. This study aims to document chronic disease‐related community nursing roles in Israel, identify changes and trends in community nursing roles that may increase social justice, and understand how the roles and (...) trends in community health nursing in Israel may differ from developments in other countries. In‐depth interviews were performed with 55 Israeli health system professionals, and 692 nurse care‐givers were asked open‐ended questions. Interview answers were analyzed to find themes and trends. The study found that community nurse roles in Israel have expanded, especially for chronic disease control. Commonalities exist with countries such as the United States and the UK, albeit with important differences. However, continued conflicts with physicians exist, which can limit nurses' contributions to reducing health inequalities. Community nurses' importance is growing. Enabling them to overcome professional dominance and improve chronic disease control can help reduce health inequalities in Israel and elsewhere. (shrink)

In the face of criticisms that professional codes of ethics are not effective in promoting ethical behaviour, this article explores a methodology developed in a major Western Australian youth work agency for applying a Youth Work Code of Ethics in practical, real-time situations. The experience resulted in workers being conscious of the clause-by-clause content of the code across a range of situations, and being able to use it as a resource in their day-to-day work.