scholarly journals Being torn by inevitable moral dilemma: experiences of ICU nurses

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Neda Asadi ◽  
Zahra Royani ◽  
Mahbubeh Maazallahi ◽  
Fatemeh Salmani
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Moral Dilemma ◽  
Healthcare Team ◽  
Ethical Challenges ◽  
Main Category ◽  
Internal Conflicts ◽  
Ethical Decisions ◽  
Ethical Conflicts

Abstract Background Ethical decision-making of nurses could affect patients’ recovery and also decrease medical costs. To make ethical decisions, ICU nurses experience complicated ethical conflicts. Considering the multi-dimensional process of ethical decision-making, the present study was conducted to describe the experiences of ICU nurses regarding ethical decision making. Method The present research is a qualitative study with conventional content analysis approach that was done in 2020. Fourteen ICU nurses were interviewed using a semi-structured in-depth interview method. The interviews were recorded, transcribed verbatim, and analyzed using Granheim and Landman approach. Results Being torn by inevitable moral dilemma was defined as the main category which contained the categories of conflict with professional self, feeling squeezed between self-authority and demands of others, and Surrounded by organizational limitations. Conclusions Results of the present study showed that moral dilemma is a situation in which the nurses are forced to choose between two options based on their equipment and facilities. In these situations, the nurses would hesitate between their internal conflicts and confusion between choosing their own benefits and patients’ benefits. To prevent ethical challenges in decision making, it is necessary to educate healthcare team about ethical dilemmas and empower the personnel for encountering ethical challenges.

scholarly journals A Deeper Look at Autonomous Vehicle Ethics: An Integrative Ethical Decision-Making Framework to Explain Moral Pluralism

2021 ◽  
Vol 8 ◽  
Author(s):  
Jimin Rhim ◽  
Ji-Hyun Lee ◽  
Mo Chen ◽  
Angelica Lim
Keyword(s):  
Decision Making ◽  
Moral Reasoning ◽  
Moral Philosophy ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Autonomous Vehicle ◽  
Moral Dilemma ◽  
Individual Factors ◽  
Ethical Decisions ◽  
Ethical Behavioral Intentions

The autonomous vehicle (AV) is one of the first commercialized AI-embedded robots to make autonomous decisions. Despite technological advancements, unavoidable AV accidents that result in life-and-death consequences cannot be completely eliminated. The emerging social concern of how an AV should make ethical decisions during unavoidable accidents is referred to as the moral dilemma of AV, which has promoted heated discussions among various stakeholders. However, there are research gaps in explainable AV ethical decision-making processes that predict how AVs’ moral behaviors are made that are acceptable from the AV users’ perspectives. This study addresses the key question: What factors affect ethical behavioral intentions in the AV moral dilemma? To answer this question, this study draws theories from multidisciplinary research fields to propose the “Integrative ethical decision-making framework for the AV moral dilemma.” The framework includes four interdependent ethical decision-making stages: AV moral dilemma issue framing, intuitive moral reasoning, rational moral reasoning, and ethical behavioral intention making. Further, the framework includes variables (e.g., perceived moral intensity, individual factors, and personal moral philosophies) that influence the ethical decision-making process. For instance, the framework explains that AV users from Eastern cultures will tend to endorse a situationist ethics position (high idealism and high relativism), which views that ethical decisions are relative to context, compared to AV users from Western cultures. This proposition is derived from the link between individual factors and personal moral philosophy. Moreover, the framework proposes a dual-process theory, which explains that both intuitive and rational moral reasoning are integral processes of ethical decision-making during the AV moral dilemma. Further, this framework describes that ethical behavioral intentions that lead to decisions in the AV moral dilemma are not fixed, but are based on how an individual perceives the seriousness of the situation, which is shaped by their personal moral philosophy. This framework provides a step-by-step explanation of how pluralistic ethical decision-making occurs, reducing the abstractness of AV moral reasoning processes.

Nurses' tension-based ethical decision making in rural acute care settings

2020 ◽  
Vol 27 (4) ◽  
pp. 1032-1043
Author(s):  
Manal M Alzghoul ◽  
Kristen Jones-Bonofiglio
Keyword(s):  
Decision Making ◽  
Registered Nurses ◽  
Acute Care ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Acute Care Hospitals ◽  
Ethical Challenges ◽  
Northern Ontario ◽  
Ethical Conflicts ◽  
Acute Care Settings

Background Nurses in acute care are frequently involved in ethical decision making and experience a higher prevalence of ethical conflicts and dilemmas. Nurses in underresourced rural acute care settings also are likely to face unique ethical challenges. However, rarely have the particular contexts of these experiences in rural acute care settings been researched. A culture of silence and fear in small towns has made exploring these issues difficult. Objectives To explore registered nurses’ experiences of ethical issues and ethical decision making in rural acute care hospitals in northern Ontario, Canada. Research design Guided by an interpretive descriptive approach, data were collected by two nurse researchers using in-depth, individual, and semistructured telephone interviews. Data were managed with NVivo v.11 and analyzed using inductive, comparative, thematic analyses. Participants and research context The participants were eight registered nurses working in two acute care hospitals in northern Ontario. Ethical considerations Ethical protocols were followed in accordance with ethics approval from the researchers’ university and the hospitals. Findings Results identified four themes that culminated in the development of a quadruple helix ethical decision-making framework of power, trust, care, and fear. Discussion and conclusion The participants described complex ethical conflicts and dilemmas in acute care settings that were influenced by the context of working and living in small rural communities in northern Ontario. Nurses described navigating ethics in practice using a tension-based approach to ethical decision making, needing to carry these issues silently and often having no resolution to ethical challenges. These findings have important implications for nursing education, research, and practice. Nurses need safe spaces, formal ethics support, and improved access to resources. Additional ethics education and training specific to the unique contexts of rural settings are needed.

Ethical decision-making based on field assessment: The experiences of prehospital personnel

2017 ◽  
Vol 26 (4) ◽  
pp. 1075-1086 ◽  
Author(s):  
Mohammad Torabi ◽  
Fariba Borhani ◽  
Abbas Abbaszadeh ◽  
Foroozan Atashzadeh-Shoorideh
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Structured Interviews ◽  
Ethical Decisions ◽  
Emergency Personnel ◽  
Field Assessment ◽  
Ethical Conflicts ◽  
Prehospital Emergency ◽  
Insufficient Time

Introduction: Due to the stressful nature of prehospital emergency providers’ duties, as well as difficulties such as distance to information resources and insufficient time to analyze situations, ethical decision-making in prehospital services is a daily challenge. Objectives: This study aimed to describe the experiences of Iranian prehospital emergency personnel in the field of ethical decision-making. Methods: The data were collected by semi-structured interviews (n = 15) in Iran and analyzed using the content analysis approach. Ethical considerations: This study was conducted in accordance with the principles of research ethics and national rules and regulations relating to informed consent and confidentiality. Results: The results obtained were categorized into three main categories that included “assessment of the scene atmosphere, assessment of patients’ condition and their family, and predicting outcomes of decision-making.” The central category was “field assessment,” which demonstrated the strategy of ethical decision-making by prehospital providers when facing ethical conflicts. Conclusion: Although findings showed that the majority of prehospital providers make ethical decisions based on the patients’ benefit, they also consider consequences of their decisions in dealing with personal and professional threats. This article identifies and describes a number of ethical values of prehospital providers and discusses how the values may be considered by paramedics when facing ethical conflicts.

Military health outreach on Exercise ASKARI SERPENT: a discussion of clinical and ethical challenges

2018 ◽  
Vol 165 (5) ◽  
pp. 346-350 ◽  
Author(s):  
Luke John Turner ◽  
D Wilkins ◽  
J I J A Woodhouse
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Challenges ◽  
Military Health ◽  
Post Hoc Analysis ◽  
Rural Kenya ◽  
Four Quadrant ◽  
Post Hoc ◽  
Universal Nature

Exercise ASKARI SERPENT (Ex AS) is an annual British Army medical exercise that sees the deployment of a medical regiment to rural Kenya. The exercise involves the delivery of health outreach clinics and health education to the civilian population alongside Kenyan governmental and non-governmental organisations. This article includes a post hoc analysis of the ethical and clinical challenges that clinicians faced during Ex AS, applying a four-quadrant approach to ethical decision-making. This article intends to stimulate further debate and discussion on how to best prepare clinicians for clinical challenges and ethical decision-making on future exercises and operations. We conclude that our experiences on Ex AS can provide an insight on how to develop predeployment training for clinicians. Furthermore, the universal nature of the challenges faced on Ex AS can be applied to training for future contingency operations.

Simulating Complexity-Based Ethics for Crucial Decision Making in Counter Terrorism

2008 ◽  
pp. 3250-3268
Author(s):  
Cecilia Andrews ◽  
Edward Lewis
Keyword(s):  
Decision Making ◽  
Power Systems ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Counter Terrorism ◽  
Ideal State ◽  
Ethical Decisions ◽  
Systems Planning ◽  
Planning Approach ◽  
Tools And Techniques

“Counter-terrorism refers to the practices, tactics and strategies that governments, militaries and other groups adopt in order to fight terrorism.” Counter Terrorism (CT) is a complex system driven by political, stress and time pressures that contribute to the enormous difficulty that involved people face in making sustainable ethical decisions. This chapter proposes a systems planning approach for enhancing the sustainability of crucial ethical decisions in CT. First, we describe the need for enhancing crucial ethical decision-making using some recent cases. Next, we evaluate the relevance and utility of a systems planning approach in providing such enhancements for CT. We develop the “ideal state” for tools and techniques to be used for crucial ethical decision-making in CT. We propose the POWER systems planning framework as a model for advancing towards this ideal state Finally, we consider how games and simulation could be used to envision and inform, aid synthesis of and support evaluation of decision-making through the POWER model.

Ethical Decision-Making in Schools

2020 ◽  
Author(s):  
Özgür Önen ◽  
Burcu Tibet
Keyword(s):  
Decision Making ◽  
Intensity Factor ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Theoretical Models ◽  
Intimate Relationship ◽  
Moral Intensity ◽  
Educational Organizations ◽  
Factors Affecting ◽  
Ethical Decisions

How many times do people encounter an ethical dilemma within a day? Many of them, probably, say more than one. Frequently encountering ethically questionable situations which have heavy costs to both business and educational organizations is very common. It is crucial to understand how teachers, for example, make decisions when they are faced with ethically questionable situations, such as intimate relationship offers or dishonest grading desires. Indeed, every individual involved with schools—not only teachers, but principals, students, and even parents—are faced with ethically questionable situations, forcing them to choose between right and wrong, possibly benefiting themselves or the ones they are close to and/or harming innocent others. So, increasing knowledge on how individuals make judgments and act when they are confronted a dilemma is important. Which factors affects ethical decisions? Do people simply choose the options granting their positions or beneficial for them in some way? A review of theoretical models of ethical decision-making revealed that existing models need to be modified in order to cover some ignored aspects. Additionally, there seems to be a need to add new constructs to the moral intensity factor: ease of the act and magnitude of the gain are possible issue contingents to be considered. Furthermore, empirical findings, in general, present contradictory results on proposed factors affecting ethical decision-making. However, some factors, such as moral intensity and reward–sanction systems, were found to consistently affect decisions on ethically questionable issues. There are, nonetheless, many finer points to be understood regarding what exactly is happening when people face dilemmas. This suggests new studies need to be conducted.

scholarly journals How do clinical psychologists make ethical decisions? A systematic review of empirical research

2020 ◽  
Vol 15 (4) ◽  
pp. 213-224
Author(s):  
Becky Grace ◽  
Tony Wainwright ◽  
Wendy Solomons ◽  
Jenna Camden ◽  
Helen Ellis-Caird
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Empirical Research ◽  
Clinical Psychology ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Theoretical Models ◽  
Future Research ◽  
Original Research ◽  
Ethical Decisions

Given the nature of the discipline, it might be assumed that clinical psychology is an ethical profession, within which effective ethical decision-making is integral. How then, does this ethical decision-making occur? This paper describes a systematic review of empirical research addressing this question. The paucity of evidence related to this question meant that the scope was broadened to include other professions who deliver talking therapies. This review could support reflective practice about what may be taken into account when making ethical decisions and highlight areas for future research. Using academic search databases, original research articles were identified from peer-reviewed journals. Articles using qualitative ( n = 3), quantitative ( n = 8) and mixed methods ( n = 2) were included. Two theoretical models of aspects of ethical decision-making were identified. Areas of agreement and debate are described in relation to factors linked to the professional, which impacted ethical decision-making. Factors relating to ethical dilemmas, which impacted ethical decision-making, are discussed. Articles were appraised by two independent raters, using quality assessment criteria, which suggested areas of methodological strengths and weaknesses. Comparison and synthesis of results revealed that the research did not generally pertain to current clinical practice of talking therapies or the particular socio-political context of the UK healthcare system. There was limited research into ethical decision-making amongst specific professions, including clinical psychology. Generalisability was limited due to methodological issues, indicating avenues for future research.

Ethical Issues for Neonatal Nurses

1998 ◽  
Vol 5 (3) ◽  
pp. 206-217 ◽  
Author(s):  
Kaye Spence
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Ethical Decision ◽  
Clinical Decision Making ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Response Rate ◽  
Clinical Decision ◽  
Neonatal Nurses ◽  
Ethical Decisions

This article examines the involvement of neonatal nurses in ethical issues, achieved through a survey of Australian neonatal nurses. The aim was to discover if nurses were involved in ethical decisions, to examine various categories of neonates and the concerns that nurses felt about them, and to determine the extent to which nurses saw themselves as advocates. A response rate of 65% was achieved from nurses in two states who worked in intensive care and special care nurseries. The findings show that nurses were more likely to be involved in clinical decision making than in ethical decision making, showed the greatest concern for infants who had an uncertain prognosis, and saw themselves as advocates for their patients. The issues surrounding these findings are examined.

Ethical Decisions and Gender Differences of European Hospitality Students

2007 ◽  
Vol 7 (3-4) ◽  
pp. 230-241 ◽  
Author(s):  
LaChelle R. Wilborn ◽  
Robert A. Brymer ◽  
Ray Schmidgall
Keyword(s):  
Gender Differences ◽  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Business Management ◽  
Decision Making Process ◽  
Ethical Behaviour ◽  
Hospitality Students ◽  
Ethical Decisions ◽  
And Gender

The purpose of this paper is to assess the sources influencing an ethical decision-making process of European hospitality students. Ten scenarios were used (1) to indicate whether the action posed was ‘ethical’, ‘unethical’, or ‘not a question of ethics’ and (2) to indicate what they would do if they were in this situation. We found that of the nearly 400 European hospitality students, 54 per cent females and 46 per cent males, both genders indicated that parents, close friends, and business management courses influenced their ethical beliefs the most. Additionally, we found that responses were significantly different for only one of the ten scenarios with regards to gender. The action responses to the proposed scenarios were, however, statistically significant for five scenarios; four of these five were business scenarios. Female European hospitality students were more likely to engage in ethical behaviour and are generally less tolerant of questionable practices than their male peers.

scholarly journals Understanding The Factors Underlying Ethical Organizations: Enabling Continuous Ethical Improvement

2011 ◽  
Vol 15 (3) ◽  
pp. 1 ◽  
Author(s):  
Vicky Arnold ◽  
James C. Lampe ◽  
Steve G. Sutton
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Academic Research ◽  
Corporate Ethics ◽  
Major Focus ◽  
Curriculum Revision ◽  
The Past ◽  
Ethical Decisions ◽  
Lower Stage

<span>Over the past decade, issues surrounding corporate ethics and the ethical decision making of individuals in business have been a major focus in the popular press, academic research and curriculum revision efforts in business schools. One of the quandaries faced throughout these efforts is how to enable an individual to make ethical decisions In this paper, a model is proposed that focuses on organizational culture as the means by which to provide an environment that fosters ethical decision making by the organizations members. A four-stage model for understanding the current ethical state of organizations is formulated. Subsequently, the focus shifts to the underlying factors and situations that may intentionally or unintentionally exist and that may cause an organization to progress to a higher stage or regress to a lower stage.</span>

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