scholarly journals COVD-08. THE DIVIDED PRINCIPLE OF JUSTICE: ETHICAL DECISION-MAKING IN CANCER CARE DURING THE COVID-19 PANDEMIC

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii22-ii22
Author(s):  
Connor Brenna ◽  
Sunit Das
Keyword(s):  
Cancer Care ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Resource Limitation ◽  
Prima Facie ◽  
Common Language ◽  
Ethical Considerations ◽  
Principle Of Justice ◽  
Principles Of Justice ◽  
Formal Recognition

Abstract The four-principle approach to medical ethics, balancing prima facie obligations to beneficence, nonmaleficence, autonomy, and justice, has supplied a common language for the application of ethical analysis to medical practice for the last four decades. The frayed edges of this edifice are made visible, however, by the ongoing COVID-19 pandemic (and other historical circumstances of severe resource limitation in the healthcare system). We interrogate ethical considerations involved in the state of medical care during the COVID-19 pandemic, as demonstrated by reconsiderations of cancer care, in which the pillar of justice is exposed as internally divided. Specifically, we identify both patient-oriented and system-oriented principles of justice constituting a broader collective, unique among the classical four principles. This leads us to suggest a formal recognition of justice as a divided category, and a reclassification of the term into two subcategories which serve fundamentally different interests. The result is a more cohesive four principle approach in which all principles favour the deontological relationships fostered between patients and providers, which exists in constant balance with the utilitarian interests of the broader medical system.

Supporting Ethical Decision Making – A Tool for Ethical Reflection on Care Technologies

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 84-85
Author(s):  
Katrin Grüber ◽  
◽  
Elena Loevskaya ◽  
◽  
Keyword(s):  
Ethical Decision ◽  
Nursing Practice ◽  
Ethical Decision Making ◽  
Digital Technologies ◽  
Ethical Reflection ◽  
Ethical Considerations ◽  
Care Facilities ◽  
Home Context ◽  
Low Threshold ◽  
Care Innovation

"The tool FreTiP (Fragen zur ethischen Reflexion von digitalen Technologien in der Pflegepraxis – questions on ethical reflection of digital technologies in nursing practice) was developed in 2020 by the Institute Mensch, Ethik und Wissenschaft (IMEW) as part of ELSI research in the PPZ-Berlin project. Our aim was to develop an instrument that stimulates and supports ethical reflection processes in the application of digital care innovation technologies in practice. Ethical considerations are part of everyday (nursing) life, are closely interwoven with other aspects and are therefore difficult to recognise as such. The starting thesis of our work was that actors in care act on the basis of value concepts that they are more or less aware of. An ethics that is consciously integrated into everyday care takes into account all aspects that are relevant for an action or decision. In this respect, it is important to look at ethics in context and not to understand “ethics” as something isolated, coming from outside. Based on this, the development of the instrument should not consist of “breaking down” ethical concepts and theories to practice, but of ethically locating, structuring and making applicable the experiences, questions and needs of the actors working in nursing practice. Thus, FreTiP is not only to be considered practice-oriented, but also to a certain extent practice-based. The instrument was designed to be suitable for everyday care in clinics, care facilities and in the home context. FreTiP was developed as a low-threshold instrument that can be used flexibly and that takes into account the perspective of patients as well as carers. The development of the instrument was preceded by a triangulated study that included a literature review, interviews and (non-)participatory observations. In the paper, experiences with the ethical reflection tool FreTiP will be presented. "

scholarly journals Navigating conflict between research ethics and online platform terms and conditions: a reflective account

2021 ◽  
pp. 174701612110455
Author(s):  
Shi Min Chua
Keyword(s):  
Ethical Decision ◽  
Ethical Decision Making ◽  
Careful Consideration ◽  
Online Discussions ◽  
Ethical Considerations ◽  
Private Company ◽  
Online Platform ◽  
Learning Platform ◽  
Internet Users ◽  
Online Spaces

Internet users’ comments in online spaces have attracted researchers’ attention in recent years. Although this data is typically publicly available, its use requires careful consideration so as to not cause harm to the users, while complying with the terms and conditions (Ts & Cs) of the online spaces. However, the Ts & Cs and researchers’ ethical considerations may sometimes be in conflict. I faced such a conflict when I conducted discourse analysis of online discussions that were sourced from a public online learning platform owned by a private company. In this article, I reflect on how I navigated the Ts & Cs and copyright law, taking users’ likely expectations into consideration when deciding whether to seek informed consent and anonymize content. I employed an ‘attribution with anonymization’ method to acknowledge users for their comments while safeguarding their confidentiality. Given the variety of online spaces and research methods, ethical decision-making must be a contextualized process that requires researchers to consider the nature of the online platform and the potential experience of the users, rather than simply following guidelines or Ts & Cs.

Ethics and Evaluative Consultations with Children in Small to Mid-Sized Australian Non-Government Organisations

2017 ◽  
Vol 17 (1) ◽  
pp. 4-11 ◽  
Author(s):  
Leanne Kelly
Keyword(s):  
Decision Making ◽  
Empirical Research ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Program Improvement ◽  
Ethical Guidelines ◽  
Ethical Considerations ◽  
Decision Making Processes ◽  
Children’S Voices

The value of listening to children's voices is well acknowledged. The vast body of literature surrounding this topic discusses children's voices in pedagogy, theory, methodology, and through empirical research. While some of this literature has focused on ethical considerations surrounding evaluative consultations with children in applied practice settings, there is a shortage of literature specifically relevant to small and medium-sized nongovernment organisations (NGOs). These organisations typically conduct consultations on a smaller scale and with fewer resources than their larger counterparts. This paper refers to Australian ethical guidelines using a practice example from a mid-sized NGO to examine ethics in child consultation from a practice-based program improvement perspective. The paper examines whether consultations with children always require formal ethics approval and discusses terminology and considerations surrounding ethical decision making processes.

Ethical Decision-Making Made Easier: The Use of Decision Trees in Case Management

1999 ◽  
Vol 1 (3) ◽  
pp. 163-169 ◽  
Author(s):  
Heidi Storl ◽  
Brenda DuBois ◽  
Julie Seline
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethics Committee ◽  
Case Managers ◽  
Ethical Considerations ◽  
The Face ◽  
Effective Decision ◽  
Central Apparatus ◽  
Effective Decision Making

Case managers have never before faced the multitude of difficult ethical dilemmas that now confront them daily. Legal, medical, social, and ethical considerations often fly in the face of previously reliable intuitions. The importance and urgency of facing these dilemmas head-on has resulted in clear calls for action. What are the appropriate legal, ethical, and professional parameters for effective decision making? Are normatively sensitive, but also practically sensible protocols possible? In an effort to address these concerns, Alternatives for the Older Adult, Inc., Rock Island, Illinois established an ethics committee to look into possible means of resolving or dissolving commonly occurring dilemmas. As a result of year-long deliberations, the committee formulated a decision-making strategy whose central apparatus is the decision tree—a flowchart of reasonable decisions and their consequent implications. In this article, we explore the development of this approach as well as the theory that underlies it.

scholarly journals Multicultural ethics in rehabilitation services

2021 ◽  
pp. 1-10
Author(s):  
Tammy Jorgensen Smith
Keyword(s):  
Ethical Decision ◽  
Ethical Decision Making ◽  
Multicultural Competency ◽  
Diagnostic Tools ◽  
Rehabilitation Services ◽  
Diverse Population ◽  
Ethical Considerations ◽  
Major Objective ◽  
Rehabilitation Professionals ◽  
Multiculturally Diverse

BACKGROUND: Rehabilitation professionals are required to be competent in serving multiculturally diverse individuals in a manner that promotes empowerment and full engagement. Multicultural competency is critical for accurate clinical assessment and diagnosis and for effectively serving a diverse population of clients. OBJECTIVE: The major objective of this paper is to promote multicultural competency and sensitivity by increasing knowledge and awareness of ethical considerations for multicultural populations in rehabilitation settings. CONCLUSION: Diagnostic tools and ethical decision-making models that integrate multicultural considerations are discussed, and recommendations for building multicultural competency are provided.

Navigating the “Passaggio” Between Voice Therapy and a Singing Lesson: Ethical Considerations for the Speech-Language Pathologist

2020 ◽  
Vol 5 (3) ◽  
pp. 658-661
Author(s):  
Katherine McConville
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Code Of Ethics ◽  
Voice Therapy ◽  
Speech Language Pathology ◽  
Ethical Considerations ◽  
Therapeutic Purpose ◽  
Speech Language Pathologist ◽  
Language Pathology

Purpose The purpose of this article is to discuss factors that guide ethical decision making in determining what constitutes medically necessary voice therapy that involves or targets singing, which is distinct from a singing lesson. Method Different treatment tasks and scenarios are identified, and their rationales are compared with deference to precedent literature and relevant portions of the American Speech-Language-Hearing Association Code of Ethics. These materials are referenced in an effort to define the boundaries between voice therapy involving singing technique and a singing lesson. Results Suggestions regarding goal writing and documentation to highlight apparent boundaries are made. Conclusions In the care of injured voices, both precedent and ethical principles support speech-language pathology treatment that targets singing. However, it is incumbent upon the treating speech-language pathologist to determine when they are venturing into tasks that no longer serve a therapeutic purpose and to refer the patient for voice lessons as appropriate.

scholarly journals Equipping African Medical Students with Ethical Decision-Making Skills: a Case-Based Method from Burundi

2018 ◽  
Vol 5 (3) ◽  
pp. 23-28
Author(s):  
Eric McLaughlin ◽  
Alyssa Pfister
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Resource Limitation ◽  
African Culture ◽  
East African ◽  
Decision Making Capacity ◽  
Case Discussions

In addition to medical ethical issues faced in every context globally, many African contexts have the challenge of additional ethical scenarios particular to African culture, resource limitation, and more varied levels of professional expertise.  In an effort to equip medical trainees with the knowledge and skills to confront these situations well and from a particularly Christian vantage point, we developed a bioethics module for medical students in Burundi, which begins with a didactic ethics lecture and spends most of the time on student-led, facilitated case discussions.  The cases were designed to highlight problems specifically created by the particularities of our rural, East African, under-resourced context.  Five rounds of implementing this module have shown a positive and interactive reception, with students critically thinking about the problems, engaging in personal application, and being willing to disagree with each other.  Evaluation after each module has resulted in some cases being discarded and others modified.  Facilitation of case discussions has been especially aided by structuring cases that specifically force the making of a difficult ethical decision, soliciting an articulation of any disagreements existing within the presenting group, and exploring permutations of each case in order to see if that changes opinions and to clarify the underlying ethical principles at play.  In our setting, the creation of bioethical case scenarios that are specifically applicable to the context of our East African learners has been helpful in making a module with useful content in growing the ethical decision-making capacity of the participants.

scholarly journals A qualitative examination of graduating nurses’ response to the Covid-19 pandemic

2021 ◽  
pp. 096973302199977
Author(s):  
Rachelle J Lancaster ◽  
Catherine Schmitt ◽  
Melanie Debish
Keyword(s):  
Ethical Decision ◽  
Ethical Decision Making ◽  
Research Question ◽  
Familial Risk ◽  
Moral Dilemmas ◽  
Ethical Considerations ◽  
Self Assessment ◽  
New Nurses ◽  
Institutional Review ◽  
Qualitative Descriptive

Background: Currently, graduating nurses face pandemic-related uncertainty including gaps in risk perception, unexpected Covid-19 moral dilemmas, and distress surrounding personal health risk. Research question/aim/objectives/Method: The purpose of this basic qualitative descriptive study is to describe the willingness of graduating nurses to provide care during the Covid-19 pandemic. Participants and research context: One week prior to graduation, students were required to submit a written assignment describing willingness to practice in light of the ongoing pandemic. Ethical considerations: This study was approved by an Institutional Review Board. Findings/results: Eighty-four ( n = 84) assignments were used for analysis. Of these, 82% (n = 69) of the graduating nurses describe a willingness to voluntarily care for Covid-19 patients. After summarizing narrative responses, two themes emerged including self-assessment of personal and familial risk and conflicting obligations. Discussion: The assessment of risk to self and family are key in determining whether graduating nurses will care for Covid-19 patients. Conflicting obligations may contribute to stress and uncertainty potentially leading to early burnout. Conclusion: Findings from this study can inform academicians of the need to adequality prepare graduating nurses for Covid-19-associated risks and ethical decision making. Organizations should alter residencies and orientation to support the needs of new nurses.

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