Paediatric Residents and Fellows Ethics (PERFEct) survey: perceptions of European trainees regarding ethical dilemmas

With an increasingly complex healthcare environment, ethics is becoming a more critical part of medical education. We aimed to explore European paediatric trainees’ experiences of facing ethical dilemmas and their medical ethics education whilst assessing their perceptions of ethical dilemmas in current and future practice. The Young Sections of the European Academy of Paediatrics and European Society of Paediatric and Neonatal Intensive Care developed an explorative online survey covering demographics, ethical dilemmas faced and ethics training. The survey was made available in nine languages from November 2019 to January 2020 via newsletters and social media. Participants (n = 253) from 22 countries, predominantly female (82%) and residents (70%), with a median age of 29-years, completed the survey. The majority (58%) faced ethical dilemmas monthly or more frequently. Most ethics training was received by ethics lectures in medical school (81%) and on the job (60%). A disagreement between the healthcare team and patient/family was the most frequently faced moral dilemma (45%); the second was withholding/withdrawing life-prolonging measures (33%). The latter was considered the most challenging dilemma to resolve (50%). Respondents reported that ethical issues are not sufficiently addressed during their training and wished for more case-based teaching. Many have been personally affected by moral dilemmas, especially regarding withholding/withdrawing life-prolonging measures, and often felt inadequately supported.Conclusion: Paediatric trainees face many moral issues in daily practice and consider that training about managing current and future ethical dilemmas should be improved, such as by the provision of a core European paediatric ethics curriculum. What is Known:• Paediatric services are becoming more complex with an increase in ethical dilemmas asking for rigorous training in ethics.• Ethics training is often lacking or covered poorly in both pre- and postgraduate medical education curricula.• Existing ethics training for European paediatric trainees is haphazard and lacks standardisation. What is New:• The PaEdiatric Residents and Fellows Ethics (PERFEct) survey provides insight into the European paediatric trainees’ views regarding ethical dilemmas in their current and future practice.• European paediatric trainees report a lack of ethics training during paediatric residency and fellowship.• This study provides content suggestions for standardised medical ethics training for paediatric trainees in Europe.

Virtue Ethics and the Social Responsibilities of Researchers*

Traditional ethics training for scientists and engineers stresses the basic ethical obligations of conducting research with honesty and integrity. But as the products of science and engineering research impact society in increasingly profound ways, major ethical issues closely connected to science and technology research are not captured, or even approached, by such training. As the powers conferred on us by science and technology research grow, and their impacts on society become increasingly conspicuous, it is past time that ethics training for scientists and engineers evolve to embrace the social responsibilities related to research. Following on experiences developing and deploying an advanced social-responsibilities-of-research program for doctoral STEM students at the University of Notre Dame, this chapter argues that the virtue ethics tradition provides essential conceptual resources both to frame and then to provide training in the social responsibilities of research.

A Longitudinal Study of the Effects of Academy Socialization on Police Integrity

The objective of this study was to examine changes in American recruits’ perceptions of the seriousness of behaviors related to police integrity from the beginning to the end of their academy training. Using a sample of 655 recruits from multiple academies in the United States, multilevel growth models were used. The results showed that the recruits rated scales related to misconduct, code of silence, and a noble cause less seriously at the end than at the beginning of their training. The results also showed that ethics training mitigated the effects of socialization, while organizational injustice intensified the effects of socialization. Female recruits rated the behaviors more seriously at the beginning and the end of training compared to male recruits. The results confirm the role of the academy in socializing officers into the negative aspects of the traditional police culture and highlight important avenues for police reform.