This article reviews suggestions for how ethical tools are to be evaluated and argues that the concept of ethical soundness as presented by Kaiser et al. is unhelpful. Instead, it suggests that the quality of an ethical tool is determined by how well it achieves its assigned purpose. Those are different for different tools, and the article suggests a categorization of such tools into three groups. For all ethical tools, it identifies comprehensiveness and user-friendliness as crucial. For tools that (...) have reaching a decision in a democratic context as a main purpose, it identifies transparency, guiding users toward a decision and justification of the decision-supporting mechanism. For tools that aim to engage the public, it identifies procedural fairness as essential. It also notes that the scope of use for ethical tools is limited to the same moral community, and that this feature is frequently overlooked. (shrink)

This special issue of the Journal of Agricultural and Environmental Ethics presents so-called ethical tools that are developed to support systematic public deliberations about the ethical aspects of agricultural biotechnologies. This paper firstly clarifies the intended connotations of the term “ethical tools” and argues that such tools can support liberal democracies to cope with the issues that are raised by the application of genetic modification and other modern biotechnologies in agriculture and food production. The paper secondly characterizes the societal (...) discussion on agricultural biotechnology and defends the thesis that normative perspectives fuel this discussion, so one cannot come to grips with this discussion if one neglects these perspectives. The paper thirdly agrues that no such thing exists as “one” societal debate in which these issues should be discussed. There are several interwined debates, and different actors participate in different discourses. Some practical instruments are necessary in order to include the right issues in these debates. These instruments will be coined as “ethical tools,” since they are practical instruments that can be used (tools) in order to support debates and deliberative structures for a systematic engagement with ethical issues (hence, ethical tools). Finally, the paper clarifies the ethics of these ethical tools and presents the tools as discussed in the remainder of this special issue: 1) tools to include ethical issues in public consulation and involvement; 2) tools to support systematic reflection upon ethical issues in decision-making; and 3) tools to support explicit communication about values in the food chain. (shrink)

This article is a response to the letter from the Department of Health that was published in the previous edition of the Research Ethics Review upon the matter of the legal duty of the research ethics committees. It also deals briefly with the article published in the current edition of Research Ethics Review by Colin Parker on what appears to be the same topic.

In this paper, the author shows how research ethics committees must deal with illegality in the research protocol. He defines their legal duty by reference to the 2001 Clinical Trials Directive, and especially in the key areas of insurance, indemnity and no-fault compensation. The author is critical of the current GAfREC and recent guidelines issued by the Royal College of Physicians. He concludes that new rules are needed to replace the 2001 edition of GAfREC.

Frameworks for responsible data stewardship, such as that proposed by McCoy et al. (2023), are intended to encourage and provide guidelines for data processors to engage in responsible data process...

In this paper the author argues that the Academy of Medical Sciences's ‘Review of the regulation and governance of medical research’ has produced a set of muddled recommendations that could increase complexity and uncertainty in research governance rather than reduce it. Issues discussed in the paper include the additional legal burden placed upon the newly proposed Health Research Agency by the plan for a National Research Governance Service and its system of centralized permissions, the consequences that this may have for (...) the research ethics committees in the discharge of their legal duty, and the unanswered questions surrounding the TGN1412 incident. (shrink)

This article is a response to the public consultation on the draft Code of Practice issued by the Human Tissue Authority on the import and export of human bodies, body parts and tissue. The question is whether the Draft Code and the Human Tissue Act go far enough to prevent the unethical acquisition and movement of human tissue. I conclude that the answer to this question is ‘no’ and go on to demonstrate how the identified deficiencies can be remedied.

In this article, the author contends that the current indemnity provided to REC members is unfair and is so badly drafted that it cannot be described as an indemnity at all. He contends that the Appointing Authorities should give guidance to clarify the scope of the indemnity or replace it. The author discusses potential legal claims by REC members against their Appointing Authority if this is not provided. The legal liability of REC members for negligence and other claims is also (...) discussed. The author provides a solution in a simpler form of indemnity framed by reference to actual claims that can be made against a REC member. (shrink)

In the past, several researchers in the field of physiotherapy have asserted that physiotherapy clinicians rarely use ethical knowledge to solve ethical issues raised by their practice. Does this assertion still hold true? Do the theoretical frameworks used by researchers and clinicians allow them to analyze thoroughly the ethical issues they encounter in their everyday practice? In our quest for answers, we conducted a literature review and analyzed the ethical theoretical frameworks used by physiotherapy researchers and clinicians to discuss the (...) ethical issues raised by private physiotherapy practice. Our final analysis corpus consisted of thirty-nine texts. Our main finding is that researchers and clinicians in physiotherapy rarely use ethical knowledge to analyze the ethical issues raised in their practice and that gaps exist in the theoretical frameworks currently used to analyze these issues. Consequently, we developed, for ethical analysis, a four-part prism which we have called the Quadripartite Ethical Tool (QET). This tool can be incorporated into existing theoretical frameworks to enable professionals to integrate ethical knowledge into their ethical analyses. The innovative particularity of the QET is that it encompasses three ethical theories (utilitarism, deontologism, and virtue ethics) and axiological ontology (professional values) and also draws on both deductive and inductive approaches. It is our hope that this new tool will help researchers and clinicians integrate ethical knowledge into their analysis of ethical issues and contribute to fostering ethical analyses that are grounded in relevant philosophical and axiological foundations. (shrink)

The proposed adoption of International Financial Reporting Standards (IFRS) in the United States has ignited a debate as to whether the principles‐based nature of these standards better serves the interests of investors. While it is argued that these principled‐based standards will encourage more transparent financial reporting than the current rules‐based U.S. standards, critics argue that IFRS will invite more aggressive financial reporting through the liberal exercising of professional judgment. This empirical study aims to understand what individual and organizational factors may (...) affect aggressiveness when making accounting judgments. In particular, we examine the influence that prior ethics training, codes of ethics and an individual's predominant moral reasoning schema have on adherence to company policy in an accounting‐related (depreciation) judgment. Results of the study show that respondents with prior ethics training are more likely to adhere to company accounting policy than those who have not had formal ethics education. Respondents presented with a company ethics code also were less aggressive in their accounting judgments than those who were not presented with a code prior to reading the scenario. Finally, decision aggressiveness was moderated by individuals who used conventional moral reasoning schemas. (shrink)

Volume 19, Issue 6, June 2019, Page 62-64.

The debate about the ethical implications of Artificial Intelligence dates from the 1960s :741–742, 1960; Wiener in Cybernetics: or control and communication in the animal and the machine, MIT Press, New York, 1961). However, in recent years symbolic AI has been complemented and sometimes replaced by Neural Networks and Machine Learning techniques. This has vastly increased its potential utility and impact on society, with the consequence that the ethical debate has gone mainstream. Such a debate has primarily focused on principles—the (...) ‘what’ of AI ethics —rather than on practices, the ‘how.’ Awareness of the potential issues is increasing at a fast rate, but the AI community’s ability to take action to mitigate the associated risks is still at its infancy. Our intention in presenting this research is to contribute to closing the gap between principles and practices by constructing a typology that may help practically-minded developers apply ethics at each stage of the Machine Learning development pipeline, and to signal to researchers where further work is needed. The focus is exclusively on Machine Learning, but it is hoped that the results of this research may be easily applicable to other branches of AI. The article outlines the research method for creating this typology, the initial findings, and provides a summary of future research needs. (shrink)

Dealing with situations where parents’ views about treatment for their child are strongly opposed to doctors’ views is one major area of ethical challenge in paediatric health care. The traditional approach focuses on the child’s best interests, but this is problematic for a number of reasons. The Harm Principle test is regarded by many ethicists as more appropriate than the best interests test. Despite this, use of the best interests test for intervening in parental decisions is still very common in (...) clinical settings and can lead to confusion. In this paper, I propose the Zone of Parental Discretion as a means of putting into practice the key ideas of the Harm Principle, in a clear, step-by-step process. The Zone of Parental Discretion provides a tool for ethical deliberation by clinicians and ethicists about all situations in which parents and doctors disagree about treatment of a child, whether parents are refusing medically recommended treatment, or requesting non-recommended treatment. (shrink)

Although ethics consultation is offered as a clinical service in most hospitals in the United States, few valid and practical tools are available to evaluate, ensure, and improve ethics consultation quality. The quality of ethics consultation is important because poor quality ethics consultation can result in ethically inappropriate outcomes for patients, other stakeholders, or the health care system. To promote accountability for the quality of ethics consultation, we developed the Ethics Consultation Quality Assessment (...) class='Hi'>Tool. ECQAT enables raters to assess the quality of ethics consultations based on the written record. Through rigorous development and preliminary testing, we identified key elements of a quality ethics consultation, established scoring criteria, developed training guidelines, and designed a holistic assessment process. This article describes the development of the ECQAT,.. (shrink)

A novel Protocol Ethics Tool Kit (‘Ethics Tool Kit’) has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women9s Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol (...) to improve the consistency and transparency between clinical trial protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval. (shrink)

This article introduces _the Ethics Laboratory_ as an inter-sectorial and cross-disciplinary dialogical forum which can be viewed as an educational tool for moral learning. _The Ethics Laboratory_ represents a platform for the informal, collaborative investigation, in strict confidentiality, of ethical questions that have social consequences and/or legal concerns and bridges boundaries between research communities, institutions and patients. Its methodological structure proposes an experimental, open-ended way of unpacking implied assumptions, underlying values, comparable notions and observations from different professional (...) fields. In connection with a large social science project on precision medicine, we conducted four Ethics Laboratories followed by eight interviews with a selected number of participants. Through these interviews we learnt how this exploratory dialogical forum heighten moral awareness on issues that are shared among stakeholders who work to implement precision medicine in Denmark. Though the framework was developed specifically to foster ethical reflection within precision medicine, its dialogical structure lends itself to other professional areas and can easily be adopted and carried out. (shrink)

Courses on ethics and technology have become compulsory for many students at the three Dutch technical universities during the past few years. During this time, teachers have faced a number of didactic problems, which are partly due to a growing number of students. In order to deal with these challenges, teachers in ethics at the three technical universities in the Netherlands — in Delft, Eindhoven and Twente — have developed a web-based computer program called Agora (see www.ethicsandtechnology.com). This (...) program enables students to exercise their ethical understanding and skills extensively. The program makes it possible for students to participate actively in moral reflection and reasoning, and to develop the moral competencies that are needed in their later professional practice. The developers of the program have tried to avoid two traps. Firstly, they rejected, from the outset, a cookbook style of dealing with ethical problems that applied ethics is often taken to be and, secondly, they wanted to design a flexible program that respects the student’s as well as the teacher’s creativity, and that tries to engage students in moral reflection. Agora meets these requirements. The program offers possibilities that extend beyond the requirements that are usually accepted for case-exercises in applied ethics, and that have been realised in several other computer models for teaching ethics. In this article, we describe the main considerations in the development of Agora and the features of the resulting program. (shrink)

In this article, we discuss ethical issues related to using and disclosing artificial intelligence (AI) tools, such as ChatGPT and other systems based on large language models (LLMs), to write or edit scholarly manuscripts. Some journals, such as Science, have banned the use of LLMs because of the ethical problems they raise concerning responsible authorship. We argue that this is not a reasonable response to the moral conundrums created by the use of LLMs because bans are unenforceable and would encourage (...) undisclosed use of LLMs. Furthermore, LLMs can be useful in writing, reviewing and editing text, and promote equity in science. Others have argued that LLMs should be mentioned in the acknowledgments since they do not meet all the authorship criteria. We argue that naming LLMs as authors or mentioning them in the acknowledgments are both inappropriate forms of recognition because LLMs do not have free will and therefore cannot be held morally or legally responsible for what they do. Tools in general, and software in particular, are usually cited in-text, followed by being mentioned in the references. We provide suggestions to improve APA Style for referencing ChatGPT to specifically indicate the contributor who used LLMs (because interactions are stored on personal user accounts), the used version and model (because the same version could use different language models and generate dissimilar responses, e.g., ChatGPT May 12 Version GPT3.5 or GPT4), and the time of usage (because LLMs evolve fast and generate dissimilar responses over time). We recommend that researchers who use LLMs: (1) disclose their use in the introduction or methods section to transparently describe details such as used prompts and note which parts of the text are affected, (2) use in-text citations and references (to recognize their used applications and improve findability and indexing), and (3) record and submit their relevant interactions with LLMs as supplementary material or appendices. (shrink)

Military employees face all sorts of moral dilemmas in their work. The way they resolve these dilemmas—how they decide to act based on their moral deliberations—can have a substantial impact both on society and on their personal lives. Hence, it makes sense to support military employees in dealing with these dilemmas. Military organizations already support their personnel by adopting compliance‐based approaches that focus, for instance, on enforcing moral rules. At the same time, however, they struggle to develop value‐based approaches that (...) could foster moral learning by improving employees' understanding of personal values, others' values, and their responsibility for others. Consequently, military employees are not adequately supported in their ethical decision‐making when confronted with complex situations. To address this issue, drawing on a design research approach, we develop and evaluate the use of a value‐based reflection tool to support military employees with their moral decision‐making. The design and evaluation of the value‐based reflection tool were informed by five semistructured interviews, notes on 45 joint reflection meetings with trainers, and evaluation notes of 755 participants. Our findings suggest the value‐based reflection tool is a promising way to foster actors' moral competence in organizational settings by triggering the social mechanisms of reflection, empathy, and psychological safety. This study is the first to illustrate that value‐based ethics support can complement compliance‐based ethics support in a military organization. Furthermore, it demonstrates design research's potential to develop actionable knowledge for ethics support practices in organizations. (shrink)

Two articles by Lewis Feuer caught my attention in the '40s when 1 was wondering, asa student physicist, about the relations of physics to philosophy and to the world in turmoil. One was his essay on 'The Development of Logical Empiricism' (1941), and the other his critical review of Philipp Frank's biography of Einstein, 'Philosophy and the Theory of Relativity' (1947). How extraordinary it was to find so intelligent, independent, critical, and humane a mind; and furthermore he went further, as (...) I soon realized when I looked for his name on other publications. I recall arguing with myself over his exploration of 'Indeterminacy and Economic Development' (1948), and even more when I read his 'Dialectical Materialism and Soviet Science' (1949). More papers, and then the fascinating, sometimes irritating, always insightful, books. His monograph on Psychoanalysis and Ethics 1955, the beautiful sociological and humanist study of Spinoza and the Rise of Liberalism (1958), his essays on 'The Social Roots of Einstein's Theory of Relativity' (1971) together with the book on Einstein and the Genera tions of Science (1974), the splendid reader from the works of Marx and Engels, Basic Writings on Politics and Philosophy (1959) which was a major text of the '60s, the stimulating essays on the social formation which seems to have been required for a modern scientific movement to develop, set forth most convincingly in The Scientific Intellectual (1963). (shrink)

An ethical matrix is a method—or tool—for carrying out an ethical assessment of technology and policy options. This paper describes the ethical matrix method and applies it to the example of GM rape seed. It is argued that added public legitimacy is achieved when the matrix method is used in a participatory process.

As organization development (OD) increasingly is being viewed globally as the major approach to organization change, a parallel interest in and need for attention to ethical issues has emerged in the field. In spite of the importance of ethical issues in OD, little attention has been focused on the ethical dilemmas that arise in OD practice, especially specific ethical dilemmas that may appear at each stage of the process. In addition, there is little discussion in the literature about how to (...) deal effectively with ethical dilemmas in OD and how to make an ethical decision by utilizing appropriate tools. Thus, in this paper, potential ethical dilemmas that may occur in each stage of the OD process are identified and presented. Recommendations and implications are discussed. (shrink)

Courses on ethics and technology have become compulsory for many students at the three Dutch technical universities during the past few years. During this time, teachers have faced a number of didactic problems, which are partly due to a growing number of students. In order to deal with these challenges, teachers in ethics at the three technical universities in the Netherlands — in Delft, Eindhoven and Twente — have developed a web-based computer program called Agora (see www.ethicsandtechnology.com). This (...) program enables students to exercise their ethical understanding and skills extensively. The program makes it possible for students to participate actively in moral reflection and reasoning, and to develop the moral competencies that are needed in their later professional practice. The developers of the program have tried to avoid two traps. Firstly, they rejected, from the outset, a cookbook style of dealing with ethical problems that applied ethics is often taken to be and, secondly, they wanted to design a flexible program that respects the student’s as well as the teacher’s creativity, and that tries to engage students in moral reflection. Agora meets these requirements. The program offers possibilities that extend beyond the requirements that are usually accepted for case-exercises in applied ethics, and that have been realised in several other computer models for teaching ethics. In this article, we describe the main considerations in the development of Agora and the features of the resulting program. (shrink)

This book develops an intellectual framework for analyzing ethical dilemmas that is both grounded in theory and versatile enough to deal rigorously with real-world issues. It sees ethics as a necessary foundation for the social infrastructure that makes modern life possible, much as engineering is a foundation for physical infrastructure. It is not wedded to any particular ethical philosophy but draws from several traditions to construct a unified and principled approach to ethical reasoning. Rather than follow the common academic (...) practice of seeking a reflective equilibrium of moral intuitions and principles, it builds on a few bedrock principles of rational thought that serve as criteria for valid argumentation. It develops the ideas from the ground up, without presupposing any background in ethics or philosophy. Epistemologically, the book views ethics as parallel to mathematics, in that it relies on generally accepted proof techniques to establish results. Whereas mathematics rests on such proof paradigms as mathematical induction and proof by contradiction, ethics can be seen as relying on proof by applying consistency tests, such as generalizability and respect for autonomy. Utilitarianism also plays a key role, but it is reconceived as a deontological criterion. This approach obviously requires that these criteria be formulated more rigorously than is normally the case. To accomplish this, the book begins with the classical idea that an action is distinguishable from mere behavior by virtue of its having a coherent rationale, where coherence requires passing certain consistency tests such as generalizability. An action is therefore inseparable from its rationale, and generalizability is defined in terms of consistency with the rationale. A utilitarian criterion receives a similar treatment with respect to a means-end rationale. Respect for autonomy is grounded in a carefully developed action theory that takes into account such concepts as joint autonomy, implied consent, and the permissibility of interference with unethical behavior. It provides an account of responsibility that is both practical and theoretically satisfying, and it yields a novel solution of the much-discussed trolley car dilemmas. The book is written for a general audience and strives to be as readable and engaging as possible, while maintaining rigor. It begins by dispelling a raft of misconceptions that trivialize ethics and block its development as an essential tool of modern life, such as the notion that ethics is just a matter of opinion without rational foundation. After presenting the ethical principles just described, along with many examples, it provides several chapters that analyze real-life dilemmas, many obtained from the author's students and professional workshop participants. One cannot understand physics or chemistry without seeing how their principles are applied to real problems, and the same is true of ethics. These chapters demonstrate that a unified normative theory can deal with a wide range of real cases while achieving a reasonable level of objectivity and rigor. (shrink)

Although moral case deliberation (MCD) is evaluated positively as a form of clinical ethics support (CES), it has limitations. To address these limitations our research objective was to develop a thematic CES tool. In order to assess the philosophical characteristics of a CES tool based on MCDs, we drew on hermeneutic ethics and pragmatism. We distinguished four core characteristics of a CES tool: (a) focusing on an actual situation that is experienced as morally challenging by (...) the user; (b) stimulating moral inquiry into the moral concepts, questions and routines in the lived experience of the CES tool user; (c) stimulating moral learning by exploring other perspectives; and (d) incorporating contextual details. We provide an example of a CES tool developed for moral dilemmas over client autonomy. Our article ends with some reflections on the normativity of the CES tool, other application areas and the importance of evaluation studies of CES tools. (shrink)

This article outlines the potential for Research Higher Degree supervisors at universities and similar institutions to use ethical review as a constructive, dynamic tool in guiding RHD students in the timely completion of effective, innovative research projects. Ethical review involves a bureaucratized process for checking that researchers apply risk management strategies when dealing with human participants. Ethical review can also be a powerful instrument for RHD supervisors in the creative arts if they use it to lead students through processes (...) of imagining, articulating, and improving their methodologies and relationships with research participants. Proposed strategies involve adaptation of theories of visualization and imagination from several disciplines—imagined interaction from the social sciences and psychology, dramatic rehearsal from political science, and creative visualization from the health professions, sports coaching and many other personal–professional development contexts. By using creativity and imagination, supervisors can use ethical review to help students to ‘walk through’ the potential, progressive phases of proposed research in order to refine or redesign both ‘big picture’ strategies and specific steps taken to reach research goals. This can stimulate students to unearth possibilities that improve the quality and quantity of knowledge that their research generates and to avoid or manage problems that might disrupt their research. (shrink)

How the diversity of membership of research ethics committees is arrived at has, to date, largely been fairly arbitrary. However, a tool to help determine one's moral preference is now available and it is introduced here as, arguably, having the potential to assist with ensuring a more meaningful diversity amongst an ethics committee's membership. The tool is seen to be easily applied – but, it is argued, may be conceived on at least two false premises. Firstly, (...) despite different theories of ethics, none can be proved to give the ‘right’ answer other than in its own terms. Secondly, if there is an ethical hierarchy, as the model suggests, then ethical diversity must become redundant for the possibility of achieving ethical excellence. (shrink)

Interruptions are often inevitable and occur many times in daily life (Ratwani & Trafton, 2010). Interruptions at work can disrupt progress on tasks and result in costly mistakes (Brumby, Cox, Back...

Background: Although ethics consultation has been introduced to clinical practice for many years, the results of empirical studies to evaluate the effectiveness of ethics consultation are still controversial. The design of randomised controlled trials is considered the best research design to evaluate the effect of a clinical practice on the outcomes of interests. In order to understand the effects of ethics consultation, we conducted this search for studies with the design of randomised controlled trials to evaluate (...) class='Hi'>ethics consultation.Objective: To provide an integrated review of studies with the design of randomised controlled trials to evaluate the effectiveness of ethics consultation.Methods: PubMed was used to search for studies using the randomised controlled trial design to evaluate the effectiveness of ethics consultation. The search term used was “ethics consultation”. The selection criterion was limited to “randomised controlled trial”.Results: Four articles that met both search criteria were retrieved. One of these articles reported a study that did not actually use the design of a randomised controlled trial and is excluded from the following discussion.Conclusions: To apply randomised controlled trials to evaluate the effectiveness of ethics consultation is extremely difficult as long as two issues are not resolved: the standardisation of ethics consultation and a placebo for ethics consultation to eliminate the placebo effect. Thus, the results generated by the design of randomised controlled trials are always problematic. Furthermore, as long as the two issues exist, the results generated by the design of quantitative research methods always pose problems. (shrink)

The American Society for Bioethics and Humanities has created a quality attestation process for clinical ethics consultants; the pilot phase of reviewing portfolios has begun. One aspect of the QA process which is particularly challenging is assessing the interpersonal skills of individual clinical ethics consultants. We propose that using case simulation to evaluate clinical ethics consultants is an approach that can meet this need provided clear standards for assessment are identified. To this end, we developed the Assessing (...) Clinical Ethics Skills tool, which identifies and specifies specific behaviors that a clinical ethics consultant should demonstrate in an ethics case simulation. The aim is for the clinical ethics consultant or student to use a videotaped case simulation, along with the ACES tool scored by a trained rater, to demonstrate their competence as part of their QA portfolio. The development and piloting of the tool is described. (shrink)

Contemporary engineering education recognises the need for engineering ethics content in undergraduate programmes to extend beyond concepts that form the basis of professional codes to consider relationality and context of engineering practice. Yet there is debate on how this might be done, and we argue that the design and pedagogy for engineering ethics has to consider what and to whom ethics is taught in a particular context. Our interest is in the possibilities and challenges of pursuing the (...) dual imperatives of socialization and critique. Socialization involves creating opportunities for all, in a diverse cohort of students, to access and engage with the dominant professional engineering ethics knowledge, while critique involves engaging with a range of ways of knowing, valuing, being and using language as relevant in contemporary engineering practice. We identify conceptual tools from engineering ethics and ethical pedagogy in education scholarship for our context. We illustrate how we use these tools systematically to strengthen our reflective practice in a first-year university engineering ethics module to a deeper form of reflexivity. Specifically, we explore the ways in which we attend to the dual imperatives and also highlight opportunities that we miss. We identify as key opportunities design choices such as how we formulated questions and prompts, and how we attended to content, context and language in selecting classroom texts. Other key opportunities were pedagogical choices of when and how to use student contributions in discussion, and what was made explicit in the classroom and assessment. We share our plans to take our learnings forward in our practice and consider the generative possibilities of these learnings and the concepts in other contexts. (shrink)

This paper presents a new model for how to jointly analyze the ethical and evidentiary dimensions of environmental science cases, with an eye toward making science more participatory and publically...

Antiracist white feminists and ecofeminists have the tools but lack the strategies for responding to issues of social and environmental justice cross-culturally, particularly in matters as complex as the Makah whale hunt. Distinguishing between ethical contexts and contents, I draw on feminist critiques of cultural essentialism, ecofeminist critiques of hunting and food consumption, and socialist feminist analyses of colonialism to develop antiracist feminist and ecofeminist strategies for cross-cultural communication and cross-cultural feminist ethics.

Multidrug resistant organisms are a public health threat that have reduced the effectiveness of many available antibiotics. Antimicrobial stewardship programs have been tasked with reducing antibiotic use and therefore the emergence of MDROs. While fecal microbiota transplant has been proposed as therapy to reduce patient colonization of MDROs, this will require additional evidence to support an expansion of the current clinical indication for FMT. This article discusses the evidence and ethics of the expanded utilization of FMT by ASPs for (...) reasons other than severe recurrent or refractory Clostridioides difficile infection. (shrink)

This article considers ethical dilemmas that nurse managers may confront and suggests an ethical decision-making model that could be used as a tool for resolving such dilemmas. The focus of the article is on the question: Can nurse managers choose the ethically right solution in conflicting situations when nurses’ rights collide with patients’ rights to quality care in a world of cost-effective and economic constraint? Managers’ responsibility is to ensure and facilitate a safe and ethical working environment in which (...) nurses are able to give quality care to their patients. In nursing it is frequently declared that managers’ main obligations are to patients’ needs and their rights to receive quality care. However, managers’ ethical responsibilities are not only to patients but also to the nurses working in their institution. This article describes a real (but disguised) situation from an Israeli health care context to illustrate the dilemmas that may arise. The question is posed of whether nurse managers can maintain patients’ and nurses’ rights and, at the same time, fulfill their obligation to the conflicting demands of the organization. The article also offers a way to solve conflict by using an ethical decision-making model. (shrink)

In attempting to influence the moral views of others, activists sometimes employ pictures as tools of moral persuasion. In such cases, a viewer is confronted with an actual instance of the practice whose morality is at issue and invited to draw a general moral conclusion in response. This paper explores some of the philosophical issues that arise in connection with the use of pictures as tools of moral persuasion, with special attention to the roles of acquaintance and conversion in the (...) moral domain. Against concerns that relying on pictures will tend to bias or distort one’s moral judgment, the paper offers a qualified defense of the use of pictures. It then considers some implications for (i) the characterization of wide reflective equilibrium, (ii) the concept of a moral expert, and (iii) our attitudes towards our moral convictions. (shrink)

The COVID-19 pandemic has strained healthcare resources the world over, requiring healthcare providers to make resource allocation decisions under extraordinary pressures. A year later, our understanding of COVID-19 has advanced, but our process for making ethical decisions surrounding resource allocation has not. During the first wave of the pandemic, our institution uniformly ramped-down clinical activity to accommodate the anticipated demands of COVID-19, resulting in resource waste and inefficiency. In preparation for the second wave, we sought to make such ramp down (...) decisions more prudently and ethically. We report the development of a tool that can be used to make fair and ethical decisions in times of resource scarcity. We formed an interprofessional team to develop and use this tool to ensure that a diverse range of stakeholder perspectives were represented in this development process. This team, called the clinical activity recovery team, established institutional objectives that were combined with well-established procedural values, substantive ethical principles and decision-making criteria by using a variation on the well-known accountability for reasonableness ethical framework. The result of this is a stepwise, semiquantitative, ethical decision tool that can be applied to resource allocation challenges in order to reach fair and ethically defensible decisions. This ethical decision tool can be applied in various contexts and may prove useful at both the institutional and the departmental level; indeed this is how it is applied at our centre. As the second wave of COVID-19 strains healthcare resources, this tool can help clinical leaders to make fair decisions. There are no data in this work. (shrink)

BackgroundAmidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees (CEC) s to carry out effective ethics consultations (CECons). However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to (...) evaluate the quality of CECons.MethodsGuided by Levac et al’s (2010) methodological framework for conducting scoping reviews, the research team performed independent literature reviews of accounts of assessments of CECons published in six databases. The included articles were independently analyzed using content and thematic analysis to enhance the validity of the findings.ResultsNine thousand sixty-six abstracts were identified, 617 full-text articles were reviewed, 104 articles were analyzed and four themes were identified – the purpose of the CECons evaluation, the various domains assessed, the methods of assessment used and the long-term impact of these evaluations.ConclusionThis review found prevailing assessments of CECons to be piecemeal due to variable goals, contextual factors and practical limitations. The diversity in domains assessed and tools used foregrounds the lack of minimum standards upheld to ensure baseline efficacy.To advance a contextually appropriate, culturally sensitive, program specific assessment tool to assess CECons, clear structural and competency guidelines must be established in the curation of CECons programs, to evaluate their true efficacy and maintain clinical, legal and ethical standards. (shrink)

Moral Case Deliberations are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support, it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learning stays limited to the participants of the MCD; 3. MCD requires quite some organisational effort, 4. MCD deals with one individual concrete case. It does not address other, similar cases. These limitations (...) warrant research into complementary ways of providing CES to healthcare professionals. Our research objective was therefore to develop a low threshold CES tool based on a series of MCDs on autonomy in long-term care. We used a qualitative research design in which we analyzed the process and content of a series of MCDs, combined with reflections on the theoretical background of MCD. In total 28 MCDs were analyzed by means of a thematic content analysis. In various rounds of development, the results of the analysis were combined with theoretical reflections on CES. Consequently, the tool was evaluated in three focus groups and adjusted. The CES tool, called ‘moral compass’, guides the users through a series of six subsequent questions in order to methodically reflect on their concrete moral dilemma, in the form of a booklet of 23 pages. It combines a methodical element that encourages and structures a reflection process with a substantive element, including norms, values, options, strategies, and insights regarding dealing with client autonomy. By using data from a series of MCDs, combined with theoretical reflections on MCD, ethics support and moral learning, we developed a thematic, low-threshold CES tool that supports healthcare professionals in daily practice in dealing with moral questions regarding client autonomy. It integrates examples and insights from earlier MCDs on the same topic. The moral compass is not a replacement of, but can be used complementary to MCD. The feasibility and impact of the moral compass need to be investigated in an evaluative follow-up study. The methodology presented in this paper may be used to develop moral compasses on different topics in various healthcare organizations. (shrink)

This article explores what an ethicfor organic animal husbandry might look like,departing from the assumption that organicfarming is substantially based in ecocentricethics. We argue that farm animals arenecessary functional partners in sustainableagroecosystems. This opens up additional waysto argue for their moral standing. We suggestan ethical contract to be used as acomplementary to the ecocentric framework. Weexpound the content of the contract and end bysuggesting how to apply this contract inpractice. The contract enjoins us to share thewealth created in the agroecosystem (...) (by ourjoint contributions) by enjoining us to carefor the welfare and needs of the individualanimal, and to protect them from exploitation(just as human co-workers should not beexploited). The contract makes promoting goodanimal welfare a necessary condition forbenefiting farm animals. Animals for their partare guaranteed coverage under the contract solong as they continue to contribute to thesystem with products and services. (shrink)

Background: Nurses require specific knowledge, skills and attitudes to participate competently in various forms of ethics meetings. The literature does not state the contents of the knowledge, skills and attitudes nurses need for ethics meetings. Without such a competency profile, it cannot be assessed in how far nurses actually possess these qualities for ethics meetings. Objective: Corroborating an existing profile of the requisite knowledge, skills and attitudes in the form of a questionnaire contributes to the development of (...) a tool to determine the competence nurses need for ethics meetings. Question: In how far can this profile be confirmed by a quantitative follow-up in a random sample? Design: A questionnaire was developed to determine in how far nurses with prior involvement in ethics meetings recognise the earlier competency profile as important and comprehensive. Participants: It was made available to subscribers of the digital newsletter of three widely read nursing journals in the Netherlands. Data collection and analysis took place in the spring of 2013. Ethical considerations: Care was taken to state explicitly in the questionnaire that participation in the survey was completely voluntary and anonymous. Findings: To a high degree, nurses with involvement in ethics meetings recognise the knowledge, skills and attitudes from the earlier interviews when presented as a survey. Discussion: Although the sample was small, the respondents and the results reflect known characteristics of nurses serving on ethics meeting. Conclusion: This may be helpful to recruit and prepare nurses for professional ethics in nursing care, and to develop a tool to assess to what extent nurses actually possess competence for ethics meetings. (shrink)

The interpretive and subjective nature of qualitative research has led to growing utilization of arts-based strategies for data collection, analysis and dissemination. The defining characteristic of all such strategies is that they are largely subjective and intended to invoke personal responses in the ‘audience.’ Following that direction, many qualitative researchers are using metaphor to capture themes emerging from their analysis. In this article, we explore ethical aspects of using metaphor in describing results of qualitative health research and illustrate some of (...) the complexities using a case study of research conducted by one of the authors. Our analysis is designed to sensitize researchers and ethics reviewers to some unique ethical issues inherent to this approach towards data analysis and presentation. Issues related to participant dignity, respect and vulnerability led us to suggest that researchers should take these points into consideration in designing their research and seeking informed consent. Metaphors can be linguistic devices, but also conceptual aids that help develop patterns in analysis or that facilitate re-interpretation. However, there is a thin line between artistic licence for better expression and distorting the participants’ actual experience and meanings. Researchers, and reviewers, must be aware of the danger to participant dignity and integrity when aesthetics overshadow actuality. The use of metaphor may also trigger tensions between researchers and participants, especially if member checking is used. The implications of participant withdrawal must be considered and conveyed to ethics reviewers and participants. It is important to have a plan in place for dealing with some of these issues. These should be detailed in the proposal and communicated to participants. Institutional research ethics boards should, on their part, be prepared to ask questions if such details are lacking in the proposal. (shrink)

Generative artificial intelligence (GenAI) is a subset of artificial intelligence (AI) that can generate content such as texts, images, videos, sounds, etc. While GenAI tools have been utilized in various contexts, their utilization in the academic context is still a controversial topic. Scholars observed that many universities have banned GenAI due to the potential for unethical usage. In this opinion article, we promote the utilization of GenAI tools as feedback agents to alleviate challenges in conventional feedback provision. Feedback is a (...) valuable learning source, especially in writing instructions. However, conventional feedback provision is challenging due to the increase in teacher’s workload and social irritation issues in peer feedback. Utilized ethically, GenAI tools can alleviate these challenges. A few critical considerations are briefly presented. (shrink)

Human subjects research has increased in Myanmar since 2010 and, accordingly, the establishment of research ethics committees has increased review of these research studies. However, characteristics that reflect the operations of RECs in Myanmar have not been assessed. To assess the structures and processes of RECs at medical institutions in Myanmar, we used a self-assessment tool for RECs operating in low- and middle-income countries. This tool consists of the following ten domains: organizational aspects, membership and ethics (...) training, submission arrangements and materials, meeting minutes, policies referring to review procedures, review of specific protocol and informed consent items, communication a decision, continuing review, REC resources and institutional commitment. We distributed this self-administered questionnaire to RECs from 15 medical institutions in Myanmar and one representative from each REC completed this questionnaire and returned it anonymously. We used descriptive, bivariate and multivariate statistics to analyse the data. Out of a maximum 200 points, the total mean score for Myanmar medical institutions was 112.6 ± 12.77, which is lower compared with the aggregate mean score of 137.4 ± 35.8 obtained from RECs in other countries. Domains in which the average percentage score was less than 60% included organizational commitment, membership and ethics training, continuing review and REC resources. Many RECs have a diverse membership and appropriate gender balance but lacked essential policies. The results show that for Myanmar RECs, there is significant room for improvement in their “structures and processes” as well as the extent of institutional commitment. The self-assessment tool proved to be a valuable method to assess the quality of RECs. (shrink)

Computational design uses artificial intelligence (AI) to optimise designs towards user-determined goals. When combined with 3D printing, it is possible to develop and construct physical products in a wide range of geometries and materials and encapsulating a range of functionality, with minimal input from human designers. One potential application is the development of bespoke surgical tools, whereby computational design optimises a tool’s morphology for a specific patient’s anatomy and the requirements of the surgical procedure to improve surgical outcomes. This (...) emerging application of AI and 3D printing provides an opportunity to examine whether new technologies affect the ethical responsibilities of those operating in high-consequence domains such as healthcare. This research draws on stakeholder interviews to identify how a range of different professions involved in the design, production, and adoption of computationally designed surgical tools, identify and attribute responsibility within the different stages of a computationally designed tool’s development and deployment. Those interviewed included surgeons and radiologists, fabricators experienced with 3D printing, computational designers, healthcare regulators, bioethicists, and patient advocates. Based on our findings, we identify additional responsibilities that surround the process of creating and using these tools. Additionally, the responsibilities of most professional stakeholders are not limited to individual stages of the tool design and deployment process, and the close collaboration between stakeholders at various stages of the process suggests that collective ethical responsibility may be appropriate in these cases. The role responsibilities of the stakeholders involved in developing the process to create computationally designed tools also change as the technology moves from research and development (R&D) to approved use. (shrink)