This book delves deeply into modern surrogacy arrangements, responding to both practical and ethical critiques by offering a radically new model for surrogate motherhood. Current practice distinguishes between two models of surrogacy – the altruistic model and the commercial model, both of which present social, ethical, and conceptual challenges. This book proposes a novel arrangement for surrogate motherhood – the professional model. Inspired by professions, such as nursing, teaching, and social work, the professional (...) class='Hi'>model acknowledges the caring motives that surrogate mothers have while at the same time compensating them for their work. Walker and Van Zyl adopt an evidence-based approach to explain that the professional model enables trust between intended parents and surrogates, provides professional support at every stage of the relationship, affords legal protections against exploitation and commodification, and recognizes the rights and interests of all parties, including the intended baby. The model applies to both transnational and domestic surrogacy and will be of great interest to policy makers, social researchers, bioethicists, legal scholars, fertility professionals, clinicians, and graduate students in psychology, philosophy, medicine and ethics. (shrink)

The task of teaching students how to think well rests formally with schools and the classroom teachers who work within them. The education system has a responsibility to fulfil the need for relevance in the school curriculum. A corollary is that the teaching profession, through collective efforts, needs to transform the ways in which curriculum and teaching are conceived. This is not to say that teachers cannot or should not work with existing curriculum, but rather that we need to reconceptualise (...) the ways in which we approach curriculum, teaching and learning. Professional development for teachers to teach philosophically needs to move away from an in-service model that relies on ‘skilling-up’ to one of an ‘apprenticeship’ in self-correction which allows teachers to help themselves. Teachers, as professionals, need to keep abreast of new ideas and insights; to extend their professional development to joining professional associations, attending and presenting at conferences, undertaking further study, and engaging in ‘collaborative negotiation’ with universities, consultants, teacher educators, professional bodies, and in-service providers in the development of deliberative and reflective capabilities, pedagogical practices, and classroom materials as ways of assessing their own philosophical progress. (shrink)

The impact of labor quality on project effectiveness is crucial, influenced by factors like leadership style, motivation, and work-life balance. Companies must consider the commitment model of professional construction workers to enhance project performance, especially in resource-scarce regions like East Kalimantan. Researchers aimed to identify this commitment model's role in East Kalimantan's projects. Using a mixed method with 250 respondents, including various stakeholders, the study found that authentic leadership positively affects worker commitment and project outcomes (accepted hypotheses (...) H1, H2, H5, H7), while other hypotheses were rejected (H3, H4, H6). Data were collected via questionnaires and interviews, analyzed using SEM SmartPLS for quantitative data and qualitative methods for interview data. (shrink)

Introduction The starting point is that ethical competence is the basis for ethical healthcare practices and quality of care. Simultaneously, there is a need for research and development from a holistic multi-professional perspective. Aim The aim is to create a proposed model for multi-professional ethical competence grounded in clarified meanings and dimensions of ethical competence studied from a multi-professional healthcare perspective. The research questions are, what is ethical competence from a multi-professional healthcare perspective and what (...) strengthens a multi-professional ethical healthcare practice? Research design The research has a qualitative approach and hermeneutic application research design. Two groups with six participants from clinical practice and two scientific researchers in each group met four times for dialogue. Thematic analysis was used as an analysis method. Ethical considerations The research is approved by the Declaration of Helsinki, the General Data Protection Regulations, and ethical permission was asked from the Norwegian Centre for Research Data (NSD). Results The proposed model for multi-professional ethical competence encompasses a three-dimensional ethical value base that is underpinned by: Ethical attitude – a personal desire to do good; Ethical basis – the best for the patient as a common goal and Ethical culture – common goals and values in the organization. Multi-professional ethical competence is strengthened by: Reflection – to see with new wondering eyes; Time for talk – interdisciplinary teamwork and Leadership – an ethical role model and support. Discussion Ethical competence has a strong link to the core of caring ethics and a deeper personal value base and attitude. Ethical competence involves the whole culture and is seen as a shared value base and a responsibility to do the best for the patient as a multi-professional team and organization. Ethical competence becomes active in healthcare practice by opening up for meaningful multi-professional talks and reflections. (shrink)

This paper articulates an Aristotelian theory of professional virtue and provides an application of that theory to the subject of engineering ethics. The leading idea is that Aristotle’s analysis of the definitive function of human beings, and of the virtues humans require to fulfill that function, can serve as a model for an analysis of the definitive function or social role of a profession and thus of the virtues professionals must exhibit to fulfill that role. Special attention is (...) given to a virtue of professional self-awareness, an analogue to Aristotle’s phronesis or practical wisdom. In the course of laying out my account I argue that the virtuous professional is the successful professional, just as the virtuous life is the happy life for Aristotle. I close by suggesting that a virtue ethics approach toward professional ethics can enrich the pedagogy of professional ethics courses and help foster a sense of pride and responsibility in young professionals. (shrink)

Background: Some patients are stigmatised as difficult patients by healthcare professionals. This phenomenon has great many negative consequences. The behaviours of healthcare professionals towards difficult patients are important. Objective: To explore the behaviours of all healthcare professionals towards difficult patients. Research Design: This study was based on a cross-sectional research design using structural equation modelling. Participants and Research Context: Two hundred and fifty-four healthcare professionals were involved in the study in Turkey. ‘Participant Information Form’ and the ‘Healthcare Professionals Behaviour Assessment (...) Questionnaire For Difficult Patient’ were used to collect data from participants. Ethical Consideration: Ethical approval was obtained from Gazi University Ethics Committee for the study. Informed consent of the participants in the study was taken and the confidentiality of the participants was ensured. Findings: It was explored that the behaviours of healthcare professionals towards difficult patients were categorised into ethical, supportive and negative. The highest mean score was supportive behaviour and the least mean score was negative. According to structural equation modelling, the most important predictor of difficult encounters was an ethical dimension. One-unit increase in ethical behaviour contributed to 0.92 unit increase in positive patient behaviour. Discussion: Patients generally are perceived as ‘difficult patient’ by the healthcare professionals, so the patients’ treatment and care services are affected negatively due to healthcare professionals’ negative beliefs and attitudes. The healthcare professionals should behave supportively towards difficult patients. Conclusion: Healthcare professionals should be aware of management strategies in dealing with difficult encounters. The behaviours of healthcare professionals should be improved in a positive way and awareness of ethical dimension of difficult encounters should be increased. (shrink)

In the article I prove the separateness of professional medical ethics in three ways: 1. By showing differences between the normative rank of responsibilities within general and professional ethics. 2. By justifying affiliation of professional medical ethics within the appropriation model which is a type of applied ethics characterized by its unique properties. 3. By justifying historical professionalism as the ethics that is proper for the medical profession; for this kind of ethical internalism the content of (...) professional ethics is the sole work of medical professional organizations as well as individual doctors. In the final part of the article I reconstruct the actual and postulated relations between professional ethics and professionalism as well as between academic bioethics and public bioethics. The aim of this reconstruction is to indicate the optimal from the perspective of ethical education place of professional ethics within the ethics education system for professionalists. (shrink)

The complexities of professional ethics are best understood and interpreted within their sociohistorical context. This paper focuses on the experience of 20 rural psychologists from across Canada, a context rife with demographic and practice characteristics that may instigate ethical issues. Employing hermeneutic phenomenology, these qualitative research results are indicative of professional struggles that impacted the participants’ experience of professional ethics and raised key questions about policy and practise. Concerns regarding competition highlight potential professional vulnerability, beget the (...) idea of fostering general psychological practice, and question the role of professional bodies in addressing rural shortages. Dependency on government funding models and decisions highlights the benefits and medical cost-offset effect of psychological services’ role in funded medical care. The controversial prescriptive authority debate for psychologists raises myriad concerns that are particularly salient to rural practitioners. These include changes to training and practice, with risks of psychopharmacology gaining prominence over behavioural health interventions. National inconsistencies in level of registration add to the growing shortage of practitioners. Finally, the results illuminate the need for advocacy to move beyond the literature and into public policy to increase public awareness, decrease the stigma of mental illness, and develop rural Canadian psychology. Although limited to this study, these results allowed for a fuller and more robust understanding of rural practice in consideration of professional ethics, which may inform policy, science, or ethical clinical practice. (shrink)

Health disparities in primary care remain a continual challenge for both practitioners and patients alike. Integrating mental health services into routine patient care has been one approach to address such issues, including access to care, stigma of health-care providers, and facilitating underserved patients’ needs. This article addresses examples of training programs that have included mental health learners and licensed providers into family medicine residency training clinics. Descriptions of these models at two Midwestern Family Medicine residency clinics in the United States (...) are highlighted. Examples of cross-training both medical residents and mental health students are described, detailing specific areas where this integration improves mental health and medical outcomes in patients. Challenges to effective integration are discussed, including larger system buy-in, medical providers’ knowledge of mental health treatment, and the skills for clinical providers to possess in order to present mental health options to patients. Patients who traditionally experience multiple barriers to mental health treatment now have increased access to comprehensive care. As a result of more primary care clinics ascribing to an integrated care model of practice, providers may benefit from not only increased coordination of patient services but also utilizing behavioral health professionals to address health barriers in patients’ lives. (shrink)

Ten years ago there was little talk about adding “professionalism” to the medical curriculum. Educators seemed to believe that professionalism was like the studs of a building—the occupants assume them to be present, supporting and defining the space in which they live or work, but no one talks much about them. Similarly, educators assumed that professional values would just “happen,” as trainees spent years working with mentors and role models, as had presumably been the case in the past. To (...) continue the metaphor, when educators did discuss ethics and values, they tended to focus more on external building codes than on the nature of construction materials. Building codes are designed to ensure the public's safety by establishing procedures and standards. Likewise, the “new” bioethics of autonomy and informed consent that entered the medical curriculum in the 1970s and 1980s was oriented primarily toward protecting human rights by codification. In fact, educators explicitly warned students against acting on their personal or professional values in a misguided way—that is, in the absence of adequate ethical constraints, a type of behavior that came to be labeled, pejoratively, as paternalism. (shrink)

Background Professional values are important in promoting healthy work environments, patient satisfaction, and quality of care. Magnet® hospitals are recognized for excellence in nursing care and as such, understanding the relationship between nurses' values and Magnet status is essential as healthcare organizations seek to improve patient outcomes. Research question/aim/objectives The research question is: are there differences in individual values, professional values, and nursing care quality for nurses and nurse managers practicing in Magnet, Magnet journey, and non-Magnet direct patient (...) care settings? Research Design This descriptive cross-sectional study is guided and informed by the conceptual framework of the Professional Values Model including individual values, professional values, and nursing care quality. Participants and research context Convenience sampling of registered nurses and nurse managers, responsible for direct patient care, was utilized in a non-profit healthcare system in the Midwest region of the United States. Ethical Considerations Institutional review board approval was obtained. Participants were informed about the right to self-determine participation and assurance of anonymity. Findings 827 (n = 827) nurses and nurse managers responded to the survey. Significant differences were identified in individual values sub-scale: self-enhancement ( p = 0.38), professional values ( p = 0.037), practice environment: participation in hospital affairs ( p = 0.00), foundations for quality care ( p = 0.016), and resources adequacy ( p = 0.012) and in nurse sensitive HCAHPS questions: nurses explained things understandably ( p = 0.00), got help as soon as wanted ( p = 0.00), and treated with courtesy and respect ( p = 0.00). Discussion/Conclusions Findings indicate that fostering individual and professional values may impact nursing practice, regardless of Magnet designation. Promoting professional values may contribute to improved work environments, enhancing patient satisfaction. Study results offer valuable insights for organizations striving to enhance nursing values, impacting quality of care provided to patients. MeSH Terms Cross-Sectional Studies, Respect, Ethics Committees, Patient Satisfaction, Nurse Administrators, and Personal Satisfaction. (shrink)

Background Developing a framework that illustrates causal relationships and an in-depth comprehension of contextual elements is essential for steering the development of ethical interventions to enhance nurses’ ethical decision-making. Research aim To examine the relationship between cultural competence, professional nursing values, and moral sensitivities of surgical nurses with a mediation analysis and structural equation model. Research design This study is descriptive and correlational. Participants and research context: This study was conducted with a total of 201 surgical nurses from (...) two university hospitals in Konya, Türkiye. Data were gathered face-to-face between June and October 2023 with the Moral Sensitivity Questionnaire (MSQ), Nurses Professional Values Scale-Revised (NPVS-R), and Nurse Cultural Competence Scale (NCCS). Ethical considerations Ethical approval from Necmettin Erbakan University Ethics Committee was obtained (Number: 2023/419). Results In this study, the mean scores for the surgical nurses were as follows: 89.3 ± 19.33 on the MSQ, 113.1 ± 20.74 on the NPVS-R, and 72.06 ± 18.61 on the NCCS. Nurses’ cultural competence level significantly affected their professional nursing values (β = 0.192; p =.007; R2 = 0.04), and their professional nursing values, in turn, had a significant effect on their moral sensitivities (β = −0.363; p <.001; R2 = 0.16). However, it was determined that the direct effect of nurses’ cultural competence level on their moral sensitivity was not statistically significant. In contrast, the indirect effect of nurses’ cultural competence level on their moral sensitivity, mediated by their professional nursing values was seen to be statistically significant (B = −0.070; p =.008). Conclusions This study showed that there is a significant positive relationship between the professional nursing values and cultural competence levels of surgical nurses and that as professional nursing values increase, their moral sensitivity also rises. Sensitivity with higher professional nursing values. Additionally, it was found that nurses’ professional values served as a mediating factor between their levels of cultural competence and moral sensitivity. Therefore, it is crucial to enhance the cultural competence, professional nursing values, and moral sensitivity of nursing students and registered surgical nurses and to improve their reasoning and decision-making skills in ethical dilemmas. (shrink)

Conscientious objections (CO) can be disruptive in a variety of ways and may disadvantage patients and colleagues who must step-in to assume care. Nevertheless, nurses have a right and responsibility to object to participation in interventions that would seriously harm their sense of integrity. This is an ethical problem of balancing risks and responsibilities related to patient care. Here we explore the problem and propose a nonlinear framework for exploring the authenticity of a claim of CO from the perspective of (...) the nurse and of those who must evaluate such claims. We synthesized the framework using Rest’s Four Component Model of moral reasoning along with tenets of the International Council of Nursing’s (ICN) Code of Ethics for Nurses and insights from relevant ethics and nursing ethics literature. The resulting framework facilitates evaluating potential consequences of a given CO for all involved. We propose that the framework can also serve as an aid for nurse educators as they prepare students for practice. Gaining clarity about the sense in which the concept of conscience provides a defensible foundation for objecting to legally, or otherwise ethically, permissible actions, in any given case is critical to arriving at an ethical and reasonable plan of action. (shrink)

During an Australian qualitative and empirical study looking at lesbian, gay, bisexual, and transgender client's experiences of counseling, and counselor's experiences of working with minority clients, a large body of unsolicited data emerged related to experiences of religious-based homophobia. Analysis of the data suggests that a lifelong process of posttraumatic recovery for many lesbian, gay, bisexual, and transgender people follows prior experiences of religious-based homophobia. This paper discusses the sociological debate related to how counselors find themselves at the crossroad between (...) a healthy lifestyle model of homosexuality based in well established contemporary professional ethics versus long standing religious-based attitudes and constraints toward homosexuality. This intersection of conflicting beliefs generates a controversial social and political environment in which counselors must make a basic decision to either support minority clients according to ethical guidelines or to side with socially conservative constructs that, rightly or wrongly, rely largely on Western religious traditions. (shrink)

Renewed Accountability for Access and Excellence provides a forum for contributing scholars and practitioners to advance the discussion of Tenuto’s democratic professional practice in education by sharing additional insights, perspectives, and implications for both policy and practice. Consistent with the model itself, this collective work is intended to encourage meaningful conversations and critical thinking about inclusionary practices, equitable access, excellence, and renewed accountability for teaching and leading.

This chapter discusses a form of pedagogy of reflection suggested to be defined as the dialogical-reflective professional-development school (DRPDS)
a framework that develops and empowers students by engaging them in a process of continual improvement, responding to diverse situations, providing stimuli for learning, and giving anchors for mediation. The pedagogy of reflection relates to dialogue not only from a theoretical historical context but also by way of example
that is, it offers empowering dialogues within the traditional teacher-training (...) framework. This chapter outlines the importance of the pedagogy of reflection in the multicultural educational space of the preservice education field in Israel, analyzing the first university PDS model. The pedagogy of reflection in the context of the educational dialogue of educators is outlined as a tool for student empowerment, achieved through a community of learners who dedicate space to the development of their whole personality within the profession, taking a moral stance toward the educational discourse, minimizing judgmentalism and prejudice, creating national/gender equality with the goal of examining the fundamental question of educational performance, and reinforcing their sense of organizational belonging within the system. In these contexts, the chapter is based on the elements of dialogical philosophy exemplified in the thought of Burbules, Nelson, Isaacs, Bohm, and Heckmann and the reflective basis of educational and organizational performance exemplified in the writings of van Manen. The chapter also presents two examples from a project in which teaching units based on dialogue and reflection were developed within a dialogic community that represents in its very being collective empowerment, the possibility of coping with problems that are too large for an individual to solve on his/her own, and an alternative to sealed and alienated organizations. (shrink)

Conflicts of interest, stemming from relationships between health professionals and the pharmaceutical industry, remain a highly divisive and inflammatory issue in healthcare. Given that most jurisdictions rely on industry to self-regulate with respect to its interactions with health professionals, it is surprising that little research has explored industry leaders’ understandings of conflicts of interest. Drawing from in-depth interviews with ten pharmaceutical industry leaders based in Australia, we explore the normalized and structural management of conflicts of interest within pharmaceutical companies. We (...) contrast this with participants’ unanimous belief that the antidote to conflicts of interest with health professionals were “informed consumers.” It is, thus, unlikely that a self-regulatory approach will be successful in ensuring ethical interactions with health professionals. However, the pharmaceutical industry’s routine and accepted practices for disclosing and managing employees’ conflicts of interest could, paradoxically, serve as an excellent model for healthcare. (shrink)

In spite of numerous studies of program outcomes finding little or no positive effect on violent behavior, the Duluth model remains the most common program type of interventions with perpetrators of domestic violence. In addition, Duluth model programs often ignore serious mental health and substance abuse issues present in perpetrators. These and other issues of possible threat to mental health professional ethics are reviewed in light of the court-mandated, compulsory nature of most Duluth model programs and (...) client and victim expectations for program efficacy. (shrink)

When (if ever) may a professional deceive a client for the client's own good? Under what conditions (if any) is whistle-blowing morally required? These are just some of the questions that scholars as diverse as Michael D. Bayles, Thomas Nagel, Sissela Bok, Jessica Mitford, and Peter A. French confront in this stimulating anthology. Organized around philosophical issues such as the moral foundations of professional ethics, models of the professional-client relationship, deception, informed consent, privacy and confidentiality, professional (...) dissent, and professional virtue, the volume illuminates the complex ethical issues that arise in journalism, law, health care, counselling, education, engineering, business, politics, and social science research. A variety of pedagogical aids--including clear introductions to and study questions for each set of readings, concrete cases designed to focus discussion, and an appendix on preparing cases and position papers--makes the text invaluable for both students and teachers of professional ethics. (shrink)

Norms and values set in professional ethics are viewed here as fundamentals of professional activity. Professional culture is a culture of thinking, acting and communicating. It arises from a specific professional work, its subject, methodology, and stylistic originality that allow to build ideal models of professional acting. Professional ethics lies at the intersection of the individual personal sphere, socially important results of professional activity and human values.

With technological possibilities in healthcare steadily increasing, more tools for digital cognitive rehabilitation become available. Acceptance of such technological advances is crucial for successful implementation. Therefore, we examined technology acceptance specifically for this form of rehabilitation in a sample of healthcare providers involved in cognitive rehabilitation. An adjusted version of the Technology Acceptance Model questionnaire was used, including the subscales for perceived usefulness, perceived ease of use, subjective norm, and intention to use, which all contribute to actual use of (...) a specific technology. Results indicate a generally favorable attitude toward the use of digital cognitive rehabilitation and positive responses toward the TAM constructs. Only for subjective norm, a neutral mean response was found, indicating that this could pose a potential obstacle toward implementation. Potential differences between subgroups of different age, gender, and professional background were assessed. Age and gender did not affect the attitude toward digital cognitive rehabilitation. Occupational therapists showed lower scores than healthcare psychologists and physiatrists with regard to perceived usefulness, possibly linked to a difference in operational and managerial tasks. The findings of his study stimulate further implementation of digital cognitive rehabilitation, where the role of subjective norms should be specifically considered. (shrink)

Clinicians and administrators have a professional obligation to contribute (OTC) to improvement of healthcare quality. At the same time, participation in embedded research poses risks to healthcare institutions. Disclosure of an institution’s sensitive information could endanger relationships with patients and undermine its reputation. The existing ethical framework (EF) for learning healthcare systems (LHSs) does not address the conflict between the OTC and institutional interests. Ethical guidance and policy regulation are needed to create a safe environment for embedded research. In (...) this article we analyse the EF for LHSs and the concept of professionalism. We suggest that the EF should be supplemented with an obligation to protect provider’s legitimate interests. We define legitimate interests as those that enable providers to discharge their primary duties. We argue that both the OTC and the obligation to protect legitimate interests are grounded in the concept of medical professionalism and can be understood as a matter of contract between a democratic society and medical professionals. The proposed supplemented EF can be implemented into a regulatory system in three different ways: theself-regulating: where providers decide themselves how to balance the ethical claims, the centralised: where a governmental institution decides the right balance between providers’ interests and interests of a health system; and themediating: where medical professionals, the state and patients negotiate their interests. Our article contributes to the discussion on ethical relevance of providers’ interests and the regulatory model for weighing opposite interests in LHSs. (shrink)

Author applies four models of professional ethics of politicians (Aristotle’s virtuous citizen, Machiavelli’s prince, Erasmus’ man of values and Weber’s responsible politician) to politics and politicians in Slovakia since the first half of the 20th century to the present. According to author, there is possible to identify Milan Hodža with Weber’s model, Alexander Dubek with Aristotle’s one, Vladimír Meiar and Robert Fico are identified with Machiavelli’s model and Iveta Radiová with Erasmus’ model of professional ethics (...) of politician in Slovakia. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.2 (2004) 165-173 [Access article in PDF] Professional Judgment, Critical Realism, Real People, and, Yes, Two Wrongs Can Make a Right! K.W.M. Fulford Anthony Colombo Keywords values, values-based practice, models of disorder, concept of mental illness, user-centred practice, patient-centred practice, multidisciplinary teamwork We are grateful to our four commentators for putting much-needed conceptual air and space around the models project. Published originally as an (...) empirical study of the different implicit models of disorder, held by users of services, carers, nurses, psychiatrists, and social workers (Colombo et al. 2003), our paper outlined the philosophical roots of the models project in linguistic analytic philosophy of the "Oxford school" (Fulford and Colombo 2004). Our four commentators provide extra dimensions of understanding, respectively from professional education (Williams 2004), sociology (Bendelow 2004), Heideggerian phenomenology (Heginbotham 2004), and mental health policy and practice (Williamson 2004).Since the original study, the models project has been taken forward as a key contribution to a range of philosophy-into-practice initiatives called, collectively, Values-Based Practice. In this brief response, we outline the key features of Values-Based Practice and indicate how these connect with some of the many thoughtful points about models made by our commentators. Values-Based Practice Values-Based Practice, then, is the theory and skills-base for effective health care decision making where different, and hence potentially conflicting, values are in play (Fulford 2004). Premised on the democratic meta-value of equal respect for all voices, Values-Based Practice relies, much as a political democracy relies, on good process rather than preset outcomes for its practical effectiveness. The ten pointers to good process in Values-Based Practice are summarized in Figure 1. We return to the implications of these for the work on models below.Relying on good process may be thought to be a recipe more for relativism and indecision in clinical decision making than for practical effectiveness. To the contrary, however, the 'values democracy' of Values-Based Practice, again like a political democracy, carries a number of clear and coherent implications for policy and practice in health care. [End Page 165] Click for larger viewFigure 1 10 Pointers to Good Process in VBP [End Page 166]Examples of the implications of Values-Based Practice for policy and practice are given in the Values Framework shown in Figure 2. This is a policy framework for the development of Values-Based Practice in mental health produced by a project group in the National Institute for Mental Health in England (NIMHE), the section of the UK's National Health Service (NHS) responsible for implementing government policy on mental health as embodied in the National Service Framework for Mental Health (Department of Health 1999) and subsequent policies. The framework gives three key principles of Values-Based Practice (the three Rs of recognition, raising awareness, and respect) and then summarizes some of the specific implications of the approach. Racism, for example, is incompatible with Values-Based Practice because racism is by definition intolerant of diversity. Again, we indicate some of the policy implications of Values-Based Practice for the points about models made by our commentators below.Training for mental health practitioners in Values-Based Practice will be rolled out from April 2005, through both voluntary and statutory bodies, in each of the eight regions of the National Health Service of England and Wales. This roll out will be supported by training methods developed and piloted in a unique joint venture between Warwick University's Department of Philosophy and Medical School, and an in-service training provider, the Sainsbury Centre for Mental Health (Fulford, Williamson, and Woodbridge 2002; Woodbridge and Fulford 2003). These training methods are the basis of a detailed workbook for Values-Based Practice (Woodbridge and Fulford 2004). The workbook will be launched in July 2004 at a conference in London by the Minister of State with responsibility for mental health, Rosie Winterton. Professional Training and Professional Judgment The models project has been central to the development of... (shrink)

This study investigates the association between work-family conflict and organizational citizenship behavior and examines the mediated role of subjective happiness between and the moderated part of family support. A moderated mediation model is established based on the Conservation of Resources theory. We collected data from 386 employees of nine companies in China. This study shows that the work-family conflict of female professional employees is negatively correlated with organizational citizenship behavior, and that the relationship is mediated by subjective well-being. (...) Furthermore, female professional employees’ family support moderates the effects of work-family conflict on subjective happiness and organizational citizenship behavior, with the relationship weaker when family support is higher. This study enriches the literature on work-family conflict by using family support as a mediating mechanism for work-family conflict. It enhanced our understanding of the influencing mechanisms of organizational citizenship behavior by constructing a more detailed model. (shrink)

A career in academics entails far beyond teaching. Being an academician is a very good job. The freedom to think creatively and learn is priceless. In addition, an academician working towards a PhD goes through intellectually stimulating experience to be shared. Having a PhD is a must to all academics since the PhD experience is about much more than learning to do deep work in some technical area of expertise and being constructively critical. The key is to figure out ways (...) of moving between the different facets of the job without becoming too crazy. In another aspect, an academician is most likely to encounter his role model in teaching, research and professional service environments which are the platforms in pursuit towards excellence. In fact, these are the three main areas within which a faculty member must demonstrate excellence and achievement in order to be promoted: research, teaching and professional service. Indeed, there may be an array of promotion tracks to fit such different career paths; these tracks may have different requirements for promotion. It is critically important that the junior faculty member be familiar with the requirements of their particular track early in the course of their career. He should find out the relevant requirements and expectations for promotion and be thinking about these matters from an early point in his career, rather than near the end when the promotion clock is ticking. This paper also focuses on the significance of getting a PhD, sharing good lessons and experiences during doctorate training, and giving practical job strategy description and academic solutions for a career roadmap towards excellence. The paper is written from the perspective of the authors, the former who has survived the fast track promotion process from a lecturer to a full professor at quite an early age of 39 years old and the latter having promoted to senior lecturer within five years of tenure. In the earlier section of this paper, it attempts to answer the questions: What is academic excellence and what defines "success" in academic excellence? What is required for promotion? The questions of where young and new academicians are heading to and how do they get there are also highlighted by laying out a general career roadmap academic excellence plan and importantly, present strategies to deal with the potential pitfalls and avoid some of the bumps in the road towards striving for academic excellence. (shrink)

Motor skills of professional musicians can be regarded as a model to investigate human skill acquisition after prolonged practice. Although rhythmic tapping skills of musicians such as drummers and pianists were investigated previously, the tapping performance of hand percussionists is still largely unknown. In this study, we investigated the tapping performance of professional and amateur darbuka players. Three tapping tasks were performed: single-, double-, and triple-finger tapping tasks. The participants were asked to tap as fast as possible (...) for 12 s in the single-finger tapping task while they tapped as fast and alternate/even as possible in the double- and triple-finger tapping tasks. The tapping speed and variability of inter-tap interval and tapping amplitude were assessed for each task. In the single-finger and triple-finger tapping tasks, there was no significant difference in the tapping speed between the professional and amateur darbuka players. In the double-finger tapping task, the tapping speed was significantly faster in the professional players than the amateur players. Interestingly, the professional players showed faster tapping speed in both familiar and unfamiliar patterns of finger coordination. The tapping speed of the double-finger tapping task was significantly correlated with the duration and the age of commencement of darbuka training. The professional players also showed less variability of ITI and tapping amplitude compared to the amateur players. These results suggest that prolonged practice of the hand percussion increases the performance stability and coordination speed of both familiar and unfamiliar patterns. (shrink)

This study investigates the role of language in cross‐sector collaboration between mental health hospitals and municipalities, focusing on the challenges of maintaining continuity of care and integrating patient‐centered approaches. Using Fairclough's framework for critical discourse analysis, we examined focus group interviews with 21 healthcare professionals, including nurses, social workers, and psychiatrists, to identify key themes and patterns in how cross‐sector collaboration is discussed. The analysis revealed a dominant medicalized discourse in hospital settings, which often emphasized structured care processes like treatment (...) plans and medication management, overshadowing more flexible, patient‐centered approaches common in community‐based services. Power dynamics were evident, with hospital professionals frequently positioned as active agents, while patients and community‐based workers were portrayed in more passive roles. Although efforts to involve patients in decision‐making were noted, these were often controlled by professionals, reflecting a mediated approach to patient empowerment. The findings highlight the cultural and structural divides between hospital and community services and suggest the need for improved communication strategies, integrated care pathways, and a shift toward more inclusive, patient‐centered care models. Addressing these discursive barriers is crucial for achieving more effective, integrated, and patient‐centered care, ultimately improving outcomes for patients. (shrink)

In this paper, I examine the development and application of codes of ethics for alternative dispute resolution practitioners, specifically mediators. I discuss thecommon vocabulary that one linds in model codes of conduct, and address the various dilemmas that arise for the "ethical" practitioner who wishes to model their practices on the standards found in such codes. I assert that some of the most intriguing and trenchant work on ethical dilemmas for mediators concerns the tension between accountability to participants, (...) and aspirations to ensure just outcomes. The latter invokes norms pertaining to social justice in society at large. I suggest that it can be helplul to conceive of such dilemmas in terms of a contrast between obligations a rising from the "role" of an ADR prolessional and the "policy" dimensions of evaluating the impacts of the work of ADR professionals on society at large. (shrink)

본 논문의 목적은 현재의 인공지능(artificial intelligence, 이하 AI) 윤리 논의에서 결여되어 있는 AI 개발자 윤리의 중요성과 필요성을 부각하고, AI 개발자 윤리로 덕성(virtue)기반의 모델이 적합함을 보여 이를 제안하는 것이다. AI는 고정된 과학기술이 아니라 발전노정에 있는 동적이라는 특성과 인간과의 상호작용에서 AI를 만든 인간의 삶에 지대한 영향을 끼치는 재귀적 특성이 있는 과학기술이다. 이러한 AI의 특성으로 인해, AI가 초래할 리스크에 대응하려는 AI 윤리는 발전 과정에 따라 제시되어야 한다는 점에서 체계적이고, 실천을 도모하는 동기부여의 구조를 가져야 한다는 점에서 기존 도덕의 형식적 특징인 1인칭, 2인칭, 3인칭 관점이 (...) 통합될 필요가 있다. 그런데 최근에 활발하게 제시된 많은 AI윤리 지침에 대한 메타 분석에 따르면, 현재의 지침으로서의 AI 윤리 논의들은 1인칭 관점의 동기부여가 없는 3인칭 관점에만 한정되어 실질적인 ‘윤리 실현’(ethics realizing)을 도모하기에 취약하다. AI 윤리 지침 자체가 추상적이고 모호할 뿐만 아니라, AI를 개발하는 사람들에게 아무런 영향력을 행사하지 못하는 ‘윤리 세탁’(ethics washing)에 불과하기 때문이다. 이러한 한계를 보완하기 위해서는 AI 개발자들이 AI 윤리를 내면화하여 규범적으로 실천하게 할 수 있게 하는 AI 개발자 윤리가 필요한데, 본 논문은 덕성 기반의 AI 개발자 윤리가 이러한 목적을 위해 효과적이라고 주장한다. 덕성 기반의 AI 개발자 모델은, 과학적 덕성 모델(scientific virtue model)이 그랬던 것처럼 AI 개발의 목적이 무엇인지, AI개발자들의 전문직 덕성(vocational virtue)이 무엇인지, 그리고 이러한 덕성을 함양하기 위한 효과적인 교육 방법은 무엇인지 등의 이론 연구와 AI 개발자들과의 소통을 토대로 하는 경험 연구의 결합을 통해 실천적 차원의 모델로 구체화될 수 있다. 본 논문에서 이론적으로 제안하는 덕성 기반의 AI 개발자 윤리가 추후 한국 사회의 경험 연구를 통해 실천적 차원의 모델로 구체화되어 AI가 초래하는 윤리적 문제들에 효과적으로 대응하면서 AI의 혜택이 풍성히 향유되는데 기여하기를 기대한다. (shrink)

Background Professional ethics is the regulation and discipline of nurses’ daily nursing work. Nurses often encounter various ethical challenges and problems in their clinical work, but there are few studies on nurses' adherence to professional ethics. Research Aim An analysis of nursing adherence to nursing ethics from the perspective of clinical nurses in the Chinese public health system. Research Design This study adopts the grounded theory approach proposed by Strauss and Corbin. Participants and research context Between July 2021 (...) and January 2022, Clinical nurses were recruited for online video interviews using purposive and theoretical sampling methods in seven hospitals in Beijing, Tianjin, Shanxi, Henan, Guangdong, and Fujian, China. Data analysis was conducted using Strauss and Corbin’s coding approach. Ethical considerations This study was approved by the Ethics Committee of Sanming First Hospital (MingYiLun 71/2021) Findings A total of 27 participants were included. A theoretical model of nursing staff adherence to professional ethics was constructed. The main core was adherence to professional ethics and the other cores were (1) causal conditions: professional ethics code, individual conscience; (2) intervening conditions: personal growth, social support system, matching career compensation, prediction of adverse consequences; (3) action strategies: sticking to professional values, self-regulation, flexible response, post-event improvement; and (4) outcomes: self-harmony, reduced medical disputes. Conclusions This study provides an interpretive understanding of why clinical nurses adhere to professional ethics in China and describes the challenges and issues posed by nurses’ use of strategies to cope with ethical adversity. The findings can be used to develop future complex studies. (shrink)

The rapid expansion of competence‐based education through the work of the National Council for Vocational Qualifications has now, thanks to generous public funding and official endorsement by the Department for Education, penetrated the theory and practice of professional studies in teacher education at both school and post‐school levels. The NCVQ model of CBE is criticised and alternatives described. The current NCVQ approach is neither the only nor necessarily the most appropriate model of occupational development on offer. Models (...) of professionalism based on the concept of ‘expertise’ are recommended as the ones most likely to produce the reflective practitioners required to enhance the status and quality of teaching in schools and colleges. (shrink)

Perhaps the most difficult part of the famous inscription from Heraclea is the opening section of the extant text, where from a given form of procedure it is required to determine the subject matter. A solution of this puzzling problem, which I proposed some months ago, has recently been made the subject of an interesting article in this journal by Dr. E. G. Hardy. Mr. Hardy has long been engaged in this field, and has rendered much useful service. In this (...) article, however, he seems to be interested in my views chiefly in their relation to his own theory. This is apparent in his agreements with me. For example, one aim of my study was to identify the professiones of Cicero's letters ad Att. xiii. 33, 1, and ad Fam. xvi. 23, 1, with those provided for in the first section of the inscription. It appeared that the returns mentioned by Cicero were registrations of property, that they were to be made yearly, and that they had their prototype in the annual property census of Egypt. It also seemed clear that Caesar's recensus populi of 46 was modelled on the Egyptian kατ' oίkíαm άπoγραφήiKíαν. With these preliminary conclusions Mr. Hardy is not unwilling to agree. He even goes so far as to say that I have made a good case for ‘a new system of professiones somehow relating to property and introduced in 46.’ He thinks too that the settlement of the frumentations as a part of a more comprehensive legislative scheme would be most appropriate. So far so good, but when it comes to the vital point of admitting a connection between these matters and vv. 1–19 of the Tablet he draws back as if from some fatal step. (shrink)

Background Moral courage is the ability to defend and practice ethical and moral action when faced with a challenge, even if it means rejecting pressure to act otherwise. However, moral courage remains an unexplored concept among middle eastern nurses. Aim This study investigated the mediating role of moral courage in the relationship between burnout, professional competence, and compassion fatigue among Saudi Arabian nurses. Research design Correlational, cross-sectional design following the STROBE guidelines. Participants and research context Convenience sampling was used (...) to recruit nurses ( n = 684) for four government hospitals in Saudi Arabia. Four validated self-report questionnaires (Nurses’ Moral Courage Scale, Nurse Professional Competence Scale-Short Form, Maslach Burnout Inventory, and Nurses Compassion Fatigue Inventory) were used to collect data between May to September 2022. Spearman rho and structural equation modeling analyses were employed to analyze the data. Ethical considerations The ethics review committee of a government university in Ha’il region, Saudi Arabia, approval this study (Protocol no.: H-2021-012; Approved: 08/022,021). Participants were fully explained the study aims, and consent was voluntarily secured. Results The emerging model showed that burnout had a direct and positive influence on compassion fatigue, while professional competence had a direct, negative effect on compassion fatigue. Moral courage had a small and direct but negative influence on compassion fatigue. Mediation analyses also indicated that moral courage significantly mediated the indirect effects of burnout and professional competence on compassion fatigue. Conclusion Moral courage can be a crucial aspect in preserving the psychological and mental health of nurses, particularly under stressful conditions. Therefore, it is advantageous from an organizational and leadership standpoint to implement measures such as programs and interventions to foster moral courage among nurses. (shrink)

Jones, Kate The shortage of registered nurses in Australia necessitates that management move their attention towards those organisational dynamics, which improve the retention of nurses, reducing the potential for high turnover from hospital to hospital. Organisational culture should be considered in the favor of nurses, considering that the model of acute care service provision used by hospitals expects registered nurses to be the professional body entrusted to provide around the clock and continuous patient care.

The psychological factors influencing a return to sport has gained increased research attention. In the current investigation, we explored professional basketball players’ perceptions of the psychological factors facilitating a return to performance equal to or exceeding previous performance standards. We also sought to describe athletes’ experiences – both positive and negative – of returning to sport following injury recovery. Ten Italian professional male basketball players (age range 22-36 years), were retrospectively interviewed in relation to three time-periods: (1) from (...) the commencement of rehabilitation to their first official competition, (2) the first official competition, and (3) the six-months following the initial competition. Hierarchical content analysis of the data revealed numerous themes across the three time periods. In regards to Period 1, participants indicated that social support, investment in rehabilitation and training programs, coping skills and motivation were fundamental in reaching pre-injury performance levels. During their first official game (i.e. Period 2), athletes reported that realistic performance expectations, focusing on the performance, positive emotions, motivation, arousal and social support facilitated their return to sport. Athletes however, also described a predominance of factors that hindered their return to pre- injury levels (i.e., low confidence in personal abilities, decrements in skill execution and dysfunctional physical sensations). Moreover, participants typically described a substandard level of performance during their first competition back following injury. In recounting experiences during the six months following their first official game, basketballers reported improvements in skill execution and highlighted the importance of coping skills, motivation and social support. The process of restoring self-confidence in one’s ability to successfully perform was perceived as crucial in enabling participants to move beyond a mere return to sport to a return to high performance ─ that is, to reach a level of proficiency equal to or exceeding previous performance standards. Findings support the relevance of cognitive, emotional and behavioral responses highlighted in the Integrated Model and suggest the importance of addressing psychological factors throughout the return-to-sport process. Finally, results from the present study hold a number of practical implications for athletes’ aiming to achieve a return to pre-injury levels. (shrink)

In our ‘The Professional Virtue of Civility and the Responsibilities of Medical Educators and Academic Leaders’,1 we provided an historically based conceptual account of the professional virtue of civility and the role of leaders of academic health centres in creating and sustaining an organisational culture of professionalism that promotes civility among healthcare professionals and between medical educators and learners. We emphasised that any adequate understanding of the virtues, including professional virtues, has cognitive, affective, behavioural and social components. (...) Some of the commentators expand on these components in important ways. Xuhao et al emphasises the importance of role models, especially in the hierarchical context of medical education.2 The hierarchy of faculty in the senior position and junior doctors and other learners below them has characterised medical education for centuries. Xuhao et al rightly call for academic leaders to shape this hierarchy in a morally responsible way, by becoming ‘exemplary role models’.2 Berry, a clinician manager, in critiquing our account, calls for an increased appreciation for the psychological and environmental factors that might explain why uncivil behaviour occurs.3 …. (shrink)

Russian-speaking homecare workers deploy two divergent discursive practices—professionalism and sainthood—in understanding carework. These two meaning-making systems have consequences for how this work is performed and experienced by workers. Surprisingly, the division is not based on gender. Instead, immigration laws filter Jewish and Orthodox Christian immigrants from the former Soviet Union into two separate sets of resettlement institutions. The characteristics of these separate institutional settings shape the discursive tools available to these two groups, leading Jewish refugees to deploy professionalism while Orthodox (...) Christian immigrants deploy sainthood. These discursive practices affect gendered identities, allowing workers in some cases to renegotiate hegemonic notions of masculinity and create new models of “feminine” caregiving. (shrink)

The ability to group perceptual objects into functionally relevant categories is vital to our comprehension of the world. Such categorisation aids in how we search for objects in familiar scenes and how we identify an object and its likely uses despite never having seen that specific object before. The systems that mediate this process are only now coming to be understood through considerable research efforts combining neurological, psychological and behavioural studies. What is much less well understood are the differences between (...) the categories, how they are formed and how they are used by experts and non-experts in a complex task that can take decades to master. In a quite different direction to previous studies, this work infers the different categorical structures that might be used by amateurs and professionals in the oriental game of Go. This is achieved by using a newly developed combination of artificial neural networks (Self-organising Maps) and perceptual inference to show that categories of strategic scenes can be learned while playing games using a model of ‘conditional perceptual learning’. Applying this technique to two databases of games, one of amateurs and one of professionals, shows that a structural hierarchy of scene information develops that can be readily incorporated into traditional psychological models of decisions and readily implemented in computational systems. The results are discussed in terms of the heuristics and biases literature, emphasising where the significant similarities and differences lie between this work and previous work. (shrink)

In his paper ‘The truth behind conscientious objection’ Nir Ben-Moshe develops a new approach aimed at justifying conscientious objection (CO) without relying on respect of moral integrity of the conscientious objector or tolerance towards her moral views.1 According to Ben-Moshe, the problem with justifications of CO based on moral integrity and tolerance is that ‘truth of conscience’s claims is irrelevant to their justification’. He argues, to the contrary, that whether the claims of the conscientious objector are true or false makes (...) a difference in assessing whether their objection is justifiable or not. He goes on explaining that someone’s CO can be justified if it can be proved that ‘conscience can express true moral claims’. Ben-Moshe then proceeds to explain how one can determine true moral claims. He develops an account of conscience that is modelled on that of Adam Smith. In particular, he uses the idea of the ‘impartial spectator’ to show how a true claim of conscience can emerge after careful thinking from the point of view of an impartial perspective. So, if the healthcare practitioner wants to object to a certain medical procedure after considering the issue at hand from the moral standpoint of such impartial spectator, then her claims of conscience are true (or …. (shrink)

This article outlines and develops the concept of ‘ethics work’ in social work practice. It takes as its starting point a situated account of ethics as embedded in everyday practice: ‘everyday ethics’. This is contrasted with ‘textbook ethics’, which focuses on outlining general ethical principles, presenting ethical dilemmas and offering normative ethical frameworks (including decision-making models). ‘Ethics work’ is a more descriptive account of ethics that refers to the effort people put into seeing ethically salient aspects of situations, developing themselves (...) as good practitioners, working out the right course of action and justifying who they are and what they have done. After identifying seven features of ethics work, including work on framing, roles, emotion, identity, reason, relationships and performance, each element is illustrated with reference to two case examples from social work practice. It is argued that the concept of ethics work, with its focus on the practitioners as moral agents in context, is an important antidote to the rules-based managerialism of much contemporary practice. (shrink)

This study examines the tensions between the western concept of professional independence and accountants’ commitment to significant others under the care perspective of guanxi. The principle of professional independence is founded on arm’s-length transactions to avoid undue influence on professional and ethical judgement. However, in the relational society of China, social interactions based on Confucianism elicit a duty of care and concern towards significant others in important relationships. For a professional accountant, the commitment to persons with (...) whom they have guanxi is potentially at odds with their commitment to professional independence. Data collected from interviews with Chinese accounting professionals, accounting academics and expatriate accountants working in China provide insight on how Chinese accounting professionals discharge their obligations under guanxi. Notions of guanxi and the rules of exchange identified in Hwang’s (Knowledge and action: A social psychological interpretation of Chinese cultural traditions, Sin-Li, Taipei, 1995) model of “Confucian ethics for ordinary people” provide the lens to explain the ethical dilemmas facing Chinese accountants. The findings suggest that accounting professionals prioritise the interests of their superiors and clients over the users of financial reports. Despite accountants’ moral obligation to protect the public interest, personal and professional obligations in China struggle to extend beyond client or employer interests mostly because of the absence of a formal relationship or connection with the public. This contrasts sharply with the notion of professional independence practised in western societies, where accounting professionals must be independent of their clients and superiors and commit to a duty to protect the public interest. The outcome of this study demonstrates the impediments to transplanting western concepts to different cultures. (shrink)

Background: Empathy and moral courage are important virtues in nursing and nursing ethics. Hence, it is of great importance that nursing students and nurses develop their ability to empathize and their willingness to demonstrate moral courage. Research aim: The aim of this article is to explore third-year undergraduate nursing students’ perceptions and experiences in developing empathy and moral courage. Research design: This study employed a longitudinal qualitative design based on individual interviews. Participants and research context: Seven undergraduate nursing students were (...) interviewed during or immediately following their final clinical placement. Ethical considerations: The Norwegian Social Science Data Services (NSD) approved the study. Participants were informed that their participation was voluntary and were assured confidentiality. They were informed that they could withdraw from the study at any time, without providing reasons. Findings: Affective empathy seemed to be strong among third-year undergraduate nursing students. However, they tried to handle the situations in a ‘professional’ way, and to balance their emotions. At the same time, they expressed how difficult it can be to show moral courage when confronted with poor patient care. In addition, they spoke about a lack of role models during clinical practice and supervision. Conclusions: Undergraduate nursing students are in a vulnerable position throughout their journey to become professional and to develop empathy and moral courage. The professional socialisation and forming of professional empathy and moral courage among nursing students, may be seen as a complex interaction of formal and hidden curriculum, where role models play an important role. We argue that the main theme ‘Vulnerable students – a journey towards professional empathy and moral courage’ may cover the longitudinal project as a whole. This vulnerability is something both teachers and supervisors should be aware of when following up with students in their clinical placements. (shrink)

This book will help professions and professionals to identify their contribution to society and to understand the argument in which they must engage if they are to justify their conduct. Because of their specialized expertise and power, the task is both difficult and pressing. The work is divided into two parts. Part 1 discusses the concepts 'ethics' and 'professional conduct', indicating their dimensions and contested nature. In each case, following examination and analysis of relevant literature, a conceptual framework or (...) model is proposed for locating instances of, in turn, ethics and professional conduct. In Part 2, the model of ethical choice is used to discuss the ethical justification of professional conduct in the various forms, locations, and stages provided by its social setting. In this way, it provides grounding arguments for relevant action by professionals and others dealing with professionals. The book concludes with a proposal for a national standing commission on the professions. (shrink)

This study examines the effects of ethical pressure on management accountants' perceptions of organizational-professional conflict, and related work outcomes. It was hypothesized that organizational pressure to engage in unethical behavior would increase perceived organizational-professional conflict, and that this perceived conflict would reduce organizational commitment and job satisfaction, and increase the likelihood of employee turnover. A survey was mailed to a random sample of Certified Management Accountants to assess perceptions of the relevant variables. The results of a structural equations (...) model indicated that, as hypothesized, ethical pressure was associated with higher levels of perceived organizational-professional conflict. Also as hypothesized, higher levels of conflict were associated with lower levels of organizational commitment and job satisfaction. Finally, lower levels of commitment and satisfaction were associated with higher turnover intentions. (shrink)

The role and ethics of professionals in business and economics have been questioned, especially after the financial crisis of 2008. Some suggest a reorientation using concepts such as craftsmanship. In this article, I will explore professional practices within the context of behavioural theory and business ethics. I suggest that scholars of behavioural theory need a strategy to deal with normative questions to meet their ambition of practical relevance. Evidence-based management (EBMgt), a recent behavioural approach, may assist business ethics scholars (...) in understanding how professionals infer ‘evidence’ to make decisions. For a professional, ethical issues are an integral part of decision-making at critical moments. As reflective practitioners, they develop insights related to ethical concerns when collecting and assessing evidence within decision-making processes. (shrink)

Objective Moral distress is a complex phenomenon experienced by healthcare professionals. This study examined the relationships between key dimensions of Organizational Culture in Healthcare (OCHC)—perceived psychological safety, ethical climate, patient safety—and healthcare professionals’ perception of moral distress.Design Cross-sectional surveySetting Pediatric and adult critical care medicine, and adult hospital medicine healthcare professionals in the United States.Participants Physicians (n = 260), nurses (n = 256), and advanced practice providers (n = 110) participated in the study.Main outcome measures Three dimensions of OCHC were (...) measured using validated questionnaires: Olson’s Hospital Ethical Climate Survey, Agency for Healthcare Research and Quality’s Patient Safety Culture Survey, and Edmondson’s Team Psychological Safety Survey. The perception of moral distress was measured using the Moral Distress Amidst a Pandemic Survey. The hypothesized relationships between various dimensions were tested with structural equation modeling (SEM).Results Adequate model fit was achieved in the SEM: a root-mean-square error of approximation =0.072 (90% CI 0.069 to 0.075), standardized root mean square residual = 0.056, and comparative fit index =0.926. Perceived psychological safety (β= −0.357, p <.001) and patient safety culture (β = −0.428, p<.001) were negatively related to moral distress experience. There was no significant association between ethical climate and moral distress (β = 0.106, p = 0.319). Ethical Climate, however, was highly correlated with Patient Safety Culture (factor correlation= 0.82).Conclusions We used structural equation model to test a theoretical model of multi-dimensional organizational culture and healthcare climate (OCHC) and moral distress.Significant associations were found, supporting mitigating strategies to optimize psychological safety and patient safety culture to address moral distress among healthcare professionals. Future initiatives and studies should account for key dimensions of OCHC with multi-pronged targets to preserve the moral well-being of individuals, teams, and organizations. (shrink)

The study used a thematic analysis to examine student and faculty responses to two qualitative questions focused on their perceptions of the consequence of incivility and solutions that would embed civility expectations as a key element to professional role socialization in higher education. Participants included students and faculty across multiple academic programs and respondent subgroups at a regional university in the southern United States. A new adapted conceptual model using Clark’s in _Nursing Education Perspectives_, _28_(2), 93–97 ( 2007, (...) revised 2020) Conceptual Model for Fostering Civility in Nursing Education and Daniel Goleman’s in _Emotional intelligence: Why it can matter more than IQ_. Bantam Books ( 1995 ) Emotional Intelligence domains was used as the framework for this study to give meaning and context to its findings. For this group of respondents, the study found that seventy percent of faculty and students agree that incivility has the largest impact on the emotional intelligence domain of self-management, which includes negative emotional outcomes, loss of respect, negative professional and student outcomes, poor academic outcomes, attrition, and less success. Leadership in higher education will strengthen their institutions by using a relational approach centered on communication skill-building to ensure that faculty have been socialized to the importance of civil professional behavior and that stakeholders collectively explore and agree on the meaning and organizational integration of civility. (shrink)

Teaching ethics to professionals pursuing a university degree programme requires a method that engages them with the realities and problematic nature of their workplace environment. In this paper we examine some of the history of Professional Ethics from a philosophical and political standpoint. Unfortunately this analysis appears to produce more questions than answers with the terms professional and expert seemingly poorly defined. In order to demonstrate some of the generic problems likely to be encountered by anyone teaching (...) class='Hi'>Professional Ethics we make use of our case study. Whilst this is concerned largely with what can be termed Business and Computing Ethics, the case study does highlight problems that occur across the curricula. We look at the concerns and problems surrounding the teaching of issues such as Integration into the Curricula, Codes of Ethics, Ethical Decision Making and Ethical Standards. We stress the value in universities moving away from traditional methods, based purely in direct value, of decision making to an alternative ethical evaluative framework based on Social, Economic, Environmental and Rights information. This model should be introduced early in the student calendar and used as a vehicle for discussion of later issues such as Whistleblowing. (shrink)