Ethical Standards for a Post-COVID-19 World

The cataclysmic events of 2020 created an urgent need for mental health counseling to help individuals, families, and communities deal with grief, loss, and trauma. The sheer magnitude of the challenges has highlighted the necessity for collective interventions, as the need for help far surpasses what can be met through traditional individual or family counseling. Clinical mental health counselors must be prepared to respond to the new challenges in creative, culturally responsive, and ethical ways. The authors discuss the limitations of the prevailing codes of ethics, which are grounded in principle ethics, and propose that virtue ethics and relational ethics perspectives can be incorporated into ethical reasoning to make the process more responsive to collective interventions. A case scenario is presented and analyzed to illustrate this broader and more inclusive approach to ethical decision-making in a situation that calls for a collective intervention.

The LORD will Exalt the Power of his Anointed

To conclude, the limits of Kantian retribution for ethics are reviewed and the diversity of approaches to ethical reasoning that may be applied to divine violence in the book of Samuel are emphasised. Three ethical, literary, and political considerations of this study are highlighted. Firstly, the study is organised around instances of subjective violence, but attention to systemic, objective violence has raised alternative evaluations of the ethics of the violence. Secondly, different kinds of emotions/cognitions of God are correlated with the formulations of divine violence. For each emotion/cognition resulting in violence, a corresponding example is given where the same emotion/cognition results in blessing. The contiguity of different formulations of divine violence in 2 Sam 24 suggests a coherence to God’s characterisation despite the diverse traditions, not a ‘light’ and a ‘dark’ side to God. Finally, the political visions of divine violence in the book of Samuel are oriented towards an ideology of the Davidic kings. Although human monarchic sovereignty is expansive, it is also limited by divine violence.

The Ethical Dilemma of Safety Versus Self-Determination in Long-Term Care Community Residents During COVID-19

The pandemic profoundly affected the care of older adults in long term care communities (LTCC) across the world. More than one third of pandemic deaths were linked to nursing homes. Most nations and states had strict guidelines on visitation, with many, especially in the United States, totally prohibiting visitation for over an entire year. Well-intentioned measures to protect through isolation caused a profound ethical tension between safety and self-determination. The aim of the project was to examine this dilemma using a case study and the Madison Collaborative Ethical Reasoning in Action Framework. Eight key questions of fairness, outcomes, rights, responsibilities, character, liberty, empathy, and authority were applied in the context of federal and state mandates in the US and Australia. Results highlighted issues of ageism, paternalism vs empathy, regulatory vs family authority, a focus on short-term outcomes while forfeiting long-term outcomes, community responsibilities to the resident trumped individual resident rights, the potential loss of community character in lieu of basic care provision, a loss of personal freedoms, and the emphasis of physical well-being over holistic well-being. The results of this analysis can inform future policy and provide lessons learned for the future.

Ethics of care and moral resilience in health care practice: A scoping review

Background Ethics of care provides a framework for health care professionals to manage ethical dilemmas and moral resilience may mitigate stress associated with the process and outcomes of ethical reasoning. This review addresses the empirical study of ethics of care and moral resilience, published in the health care literature, and identifies potential research gaps. Methods and procedure Arksey O’Malley's framework was adopted to conduct this scoping review. A literature search was conducted across six databases: CINAHL Plus with full text, PubMed, PsycINFO, EMBASE, Scopus and MEDLINE. We collected and synthesised information on the nature of studies including study design, methods and key findings. Results While there is an abundance of literature describing the potential strengths of an ethics of care approach to ethical reasoning and growing interest in the role of moral resilience in protecting against moral distress, both concepts have received little empirical attention. A total of six relevant publications were selected for review. No studies explored the relationship between ethics of care and moral resilience. However, studies focused upon ethics of care approach as a facilitator of patient-practitioner professional relationships and effective ethical decision making in health care practice. Current evidence explores key characteristics consistent with moral resilience in health care professionals. Conclusion This review identified a dearth of research in ethics of care and moral resilience in healthcare practice. Further empirical investigation may provide a deeper understanding of the translation of ethics of care and moral resilience to health care practice to facilitate workplace culture.

Ethical Leadership and Deviant Workplace Behaviour: The Role Ethical Reasoning, LMX, Distributive Justice, and Psychological Safety and Attachment in a Moderated Mediation Framework

The article aims to analyse and explain the relationship between ethical leadership, organisational deviance. We proposed a theoretical framework arguing a mediatory role of situational factors including psychological safety, psychological attachment, distributive justice, and Leader-Member Exchange (LMX). We also argue that utilitarian based ethical reasoning make employees more responsive towards the ethical decision by the leadership making them less deviant. Empirical validity was established by conducting a survey using a close-ended questionnaire. Data was collected from 254employees and analysed using confirmatory factor analysis and structured equation modelling. The measurement and structure model were assessed using AVE (average variance extracted), Composite Reliability (CR), Cronbach’s alpha, discriminant validity through the Fornell-Larcker Criterion, and Collinearity methods in PLS-SEM. The results suggested a significant and positive effect of ethical leadership on Leader-member-exchange, psychological attachment, distributive justice, and psychological safety. Moreover, apart from distributive justice, all other factors seem to decrease Organisational Deviance, however, their effect remained insignificant. Surprisingly, ethical leadership (EL) seems to be directly instigating Organisational Deviance (OD), as well as through the mediation of distributive justice. However, EL seems to significantly reduce deviance through including Utilitarianism ethical reasoning amongst its followers, as EL seems to positively affect utilitarianism, which in turn negatively affects deviance. Utilitarianism also seems to complement EL in reducing OD directly as the result showed significant and negative complementarities amongst EL and Utilitarianism in explaining OD. The results imply that EL and OD nexus is more affected by ethical reasoning rather than situational factors.

An Ethnographic study of unhealthy alcohol use in a Danish Emergency Department

Background Emergency Departments (EDs) are important arenas for the detection of unhealthy substance use. Screening, Brief Intervention, and Referral to Treatment (SBIRT) for unhealthy alcohol use has been used in some ED settings with funding support from external sources. However, widespread sustained implementation is uncommon, and research aimed at understanding culture as a determinant for implementation is lacking. This study aims to explore cultural practices concerning the handling of patients with unhealthy alcohol use admitted to an ED. Methods An ethnographic study was conducted in an ED in the Capital Region of Denmark. The data consists of participant observations of Health Care Professionals (HCPs) and semi-structured interviews with nurses. Data was collected from July 2018 to February 2020. A cultural analysis was performed by using Qualitative Content Analysis as an analytic tool. Results 150 h of observation and 11 interviews were conducted. Three themes emerged from the analysis: (1) Setting the scene describes how subthemes “flow,” “risky environment,” and “physical spaces and artefacts” are a part of the contextual environment of an ED, and their implications for patients with unhealthy alcohol use, such as placement in certain rooms; (2) The encounter presents how patients’ and HCPs’ encounters unfold in everyday practice. Subtheme “Professional differences” showcases how nurses and doctors address patients’ alcohol habits differently, and how they do not necessarily act on the information provided, due to several factors. These factors are shown in remaining sub-themes “gut-feeling vs. clinical parameters,” “ethical reasoning,” and “from compliance to zero-tolerance”; and (3) Collective repertoires shows how language shapes the perception of patients with unhealthy alcohol use, which may cause stigma and stereotyping. Subthemes are “occupiers” and “alcoholic or party animal?”. Conclusions Unhealthy alcohol use in the ED is entangled in complex cultural networks. Patients with severe and easily recognizable unhealthy alcohol use—characterized by an alcohol diagnosis in the electronic medical record, intoxication, or unwanted behavior—shape the general approach and attitude to unhealthy alcohol use. Consequently, from a prevention perspective, this means that patients with less apparent unhealthy alcohol use tend to be overlooked or neglected, which calls for a systematic screening approach.

Antecedents of Deviant Behavior: Psychological and Non-Psychological Factors and Ethical Justifications

An integrative model of ethical justifications in organizations is proposed. The model recognizes the roles of psychological and non-psychological factors on the link between ethical theories and the ethical reasoning and, consequently, on the way operators justify themselves when accused of being against (or not favoring) the good of the company. This study wants to contribute to highlighting the benefits of the prevention of deviant behavior through a more profound comprehension of its antecedents. The analysis confirms the complexity of human beings, and the need for an integrated approach that leads to clarity and coherence among tools (e.g. mission, code of ethics, incentive system), people and among both people and tools. A central role is played by the dissemination of a culture that considers the firm as a real entity, with its own interest, that is separated from that of its stakeholders and which brings the purpose of the common good.