Background: A small minority of nurses are investigated when they fail to meet the required professional standards. Unprofessional conduct does not just affect the nurse but also patients, colleagues and managers. However, it has not been clearly defined. Objective: The objective was to identify unprofessional conduct by registered nurses by examining disciplinary decisions by a national regulator. Design: A retrospective document analysis. Data and research context: Disciplinary decisions delivered to 204 registered nurses by the Finnish national (...) regulatory authority from 2007 to 2016. The data were analysed with quantitative statistics. Ethical consideration: The study received permission from the Finnish National Supervisory Authority for Welfare and Health and used confidential documents that were supplied on the basis of complete anonymity and confidentiality. Findings: The mean age of the registered nurses who were disciplined was 44 years and 81% were female. Two-thirds had worked for their employer for 5 years or less, 53% had two or more employers and 18% had a criminal history. All the decisions included a primary reason for why the nurses were investigated, but there were also 479 coexisting reasons. In most cases, unprofessional conduct was connected to substance abuse (96%). In addition, stealing of medicine, a decreased ability to work and neglect of nursing guidelines were reported. Discussion: We found that the nurses were investigated for unprofessional conduct for complex combinations of primary and coexisting reasons. Our study highlighted that more attention needs to be paid to the key markers for unprofessional conduct. Conclusion: Unprofessional conduct is a complex phenomenon that is connected to nurses’ individual and working backgrounds and has an impact on their work performance. More research is needed to identify how nursing communities can detect, manage and limit the serious effects and consequences of unprofessional conduct. (shrink)

Although researchers have paid much attention to the widespread cheating by students during their college careers and the possible sources behind such unethical behaviors, there has been less attention given to the unethical behaviors of faculty. Research on the types of unethical behaviors of faculty has pointed out the unique nature of higher education and the particular pressures placed on faculty as potential drivers of such behavior. In this paper, we examine the factors and underlying cognitive processes that may drive (...) faculty to engage in such behaviors. Specifically, we identify potential drivers of faculty unethical behavior, the cognitive processes activated by these drivers, and the types of behaviors that are considered most ethically questionable among faculty as they carry out their professional roles. We conclude with research considerations and implications of faculty misconduct on the profession. (shrink)

ABSTRACTA lawyer's behaviour derives from their own principles and values, the norms of professionalism, the professional conduct rules and the common law. In the past, much emphasis has been placed upon the first two sources as they formed the basis of self-regulation and influenced the development of legal ethics. Recently, the Australian codes of ethics explicitly detail an increasing range of duties which might reasonably have been thought to be implicit characteristics of sound ethical values and professionalism, for example, (...) a duty to be civil, and an explicit prohibition against harassment, intimidation and bullying. Such additions have been deemed necessary as a response to increasing concerns about lawyer incivility and empirical reports detailing high levels of harassment, intimidation and bullying within law firms. We suggest that the expansion of duties in the codes raises intriguing and troubling questions: Does the expansion of duties in the codes suggest that lawyers, as a group, need rules... (shrink)

Our recent paper reported that 43% of reviewer comment sets shared with authors contained at least one unprofessional comment or an incomplete, inaccurate of unsubstantiated critique. Publication of this work sparked an online conversation surrounding professionalism in peer review. We collected and analyzed these social media comments as they offered real-time responses to our work and provided insight into the views held by commenters and potential peer-reviewers that would be difficult to quantify using existing empirical tools. Overall, 75% of (...) comments were positive, of which 59% were supportive and 16% shared similar personal experiences. However, a subset of negative comments emerged, that provided potential insight into the reasons underlying unprofessional comments were made during the peer-review process. These comments were classified into three main themes: forced niceness will adversely impact the peer-review process and allow for publication of poor-quality science ; dismissing comments as not offensive to another person because they were not deemed personally offensive to the reader ; and authors brought unprofessional comments upon themselves as they submitted substandard work. Here, we argue against these themes as justifications for directing unprofessional comments towards authors during the peer review process. We argue that it is possible to be both critical and professional, and that no author deserves to be the recipient of demeaning ad hominem attacks regardless of supposed provocation. Suggesting otherwise only serves to propagate a toxic culture within peer review. While we previously postulated that establishing a peer-reviewer code of conduct could help improve the peer-review system, we now posit that priority should be given to repairing the negative cultural zeitgeist that exists in peer-review. (shrink)

Recently there has been increased attention paid to the behaviour of those who call themselves professionals. The idea of acceptable professional conduct incorporates the expectations of a number of groups affected by the activities of professionals. The framework of professional behaviour considered acceptable at a point in time is an equilibrium among these groups' expectations. This paper argues that shifts in the expectations of any of these groups will disturb this equilibrium. This process of disequilibrium and change leads to (...) altered views of professional behaviour. Professional misconduct or unprofessional behaviour, that is, the failure to meet expectations, is inherent in the underlying framework of a profession.The framework is applied to the public (chartered) accounting profession, where the interacting groups are accounting professionals, their clients and the general public. Current issues of debate about professional behaviour are identifiable as consequences of altered expectations about acceptable behaviour. Acceptable conduct has become misconduct (and vice versa) and written rules of conduct conflict with unwritten rules. (shrink)

The paper questions the effectiveness of the United Kingdom Central Council's (UKCC's) Code of Professional Conduct upon the moral climate of nursing. It challenges the claim that the empowerment of nurses is significantly enhanced by the Code or that it necessarily makes them more accountable for their practice. The position is taken that the Code, in the absence of an effective support network for whistle-blowers, places an unreasonable burden upon nurses in its exhortations to report unprofessional conduct. (...) The paper acknowledges the need to retain the Code, but with more modest claims being made concerning its empowering qualities. It is argued that unless more attention is focused on ways to support potential whistle-blowers, the Code will come to be seen as an irrelevance. Cet article met en question l'effet du Code du UKCC sur le climat moral des soins infirmiers. Il conteste l'affirmation que les infirmiers/ères sont considérablement plus fort à cause du Code ou qu'il les rend plus responsables dans leur pratique. La position est prise que le Code, en l'absence d'un réseau efficace de soutien pour les 'Whistleblowers' (personnes qui dévoilent un système), met un fardeau excessif sur les infirmiers/ères dans ses exhortations de signaler une conduite contraire au Code professionnel. Cet article reconnâit la nécessité de retenir le Code, mais avec des demandes plus modestes concernant ses pouvoirs de rendre fort. Il est soutenu que si non plus d'attention est concentré sur les moyens de soutenir les 'Whistlebowers', le Code va devenir hors de propos. Dieser Artikel bezweifelt die Wirksamkeit des Kodex des UKCC über das moralische Klima der Krankenpflege. Er stellt die Behauptung in Frage, dass der Kodex das Pflegepersonal bedeutend ermächtigt, oder dass er es mehr verantwortlich macht für seine Praxis. Die Position ist hier, dass der Kodex, in der Abwesenheit von effektiver Unterstützung für 'Whistleblowers' (d.h. Leute, die ein System verpfeifen), zu viel vom Pflegepersonal verlangt, in seiner Ermahnung, berufswidrige Praxis zu melden. Dieser Artikel anerkennt die Notwendigkeit, den Kodex zu behalten, aber mit kleineren Ansprüchen für seine ermächtigenden Qualitäten. Wenn nicht mehr Aufmerksamkeit gelegt wird, auf welche Weise die 'Whistleblowers' unterstützt werden können, dann wird der Kodex als eine Nebensächlichkeit verurteilt. (shrink)

The goal of this project is to argue for ethics as a necessary component of the institutional health. The authors offer an epidemiology of ethics for a large, metropolitan, very-high-research-activity university in the U.S. Where epidemiology of a pandemic looks at quantifiable data on infection and exposure rates, control, and broad implications for public health, an epidemiology of ethics looks to parallel data on those same themes. Their hypothesis is that knowing more about how undergraduates are exposed to ethics will (...) help us understand to what extent they are infected with interest in ethics literacy, and potentially what immunity they develop against unethical and unprofessional conduct. These data also tell a story about the ethical health of institutions: to what extent its members are empowered to cultivate a culture of ethics and inoculated against ethical missteps. The authors argue that pro-ethics inoculation at research institutions is shaped by issues of complexity, connotation, and collaboration. These issues make assessment of where ethics is taught all the more difficult. The methodology used in this project can readily be taken up by other institutions, with much to be learned from inter-institutional comparisons about the distribution of ethics across the curriculum and within the disciplines. (shrink)

The pursuit of unproven stem cell-based interventions is an emerging issue that raises various concerns. Physicians play different roles in this market, many of which engage their legal, ethical and professional obligations. In Canada, physicians are members of a self-regulated profession and their professional regulatory bodies are responsible for regulating the practice of medicine and protecting the public interest. They also provide policy guidance to their members and discipline members for unprofessional conduct.

The teaching profession in South Africa, like elsewhere in the world, is regulated by the specific codes of conduct, as stipulated by the South African Council for Educators. While common criticisms against SACE include failing to ensure the registration of all teachers, and not adequately dealing with the unprofessional conduct of teachers, it is the question of whether SACE can act as an ethical regulator, which attracts the most attention. Seemingly, there exists a tension between the legalistic (...) approach to ethical deliberation, as contained in SACE, and the real experiences of teachers, which teachers argue, are neither understood nor taken into account by SACE. In considering whether it is at all possible to teach teachers how to act ethically, or how to use their ethical judgement, the article turns its attention to the inter-related practices of deliberation, belonging and inclusion, as manifestations of ethical teaching. (shrink)

Two nurses diagnosed with opioid addiction launched legal action after being found guilty of unprofessional conduct due to addiction‐related behaviors. When covered by the media, their cases sparked both public and legal controversies. We are curious about the broader discursive framings that led to these strong reactions, and analyze the underlying structures of knowledge and power that shape the issue of opioid addiction in the profession of nursing through a critical discourse analysis of popular media, legal blogs and (...) hearing tribunals. We argue that addiction in nursing is framed as personal choice, as a failure in the moral character of the nurses, as decontextualized from addiction as disease arguments, and as an individualized issue devoid of contextual factors leading to addiction. Our investigation offers a critical case study of a nursing regulatory body that upheld popular assumptions of addiction as an autonomous, rational choice replete with individual‐based consequences – a framing that is inconsistent with evidence‐based practice in health‐care. We put forth this critical interrogation to open up possibilities for counterdiscourses that may promote more nuanced and effective responses to the issue of addiction in nursing. (shrink)

This study examines 14,900 disciplinary actions by the professional licensing boards for attorneys, CPAs, and physicians in four states from 2008 through 2014. It was found that both attorneys and physicians are disciplined at a rate at least seven times that of CPAs. While the majority of disciplinary actions are for misconduct directly related to the professional practice, nearly 14% of sanctions were the result of “social crimes” such as failure to pay child support or student loans, driving under the (...) influence, and general unprofessional conduct. The severity of licensure sanctions varied with the cause for discipline, but was inconsistent both within and between jurisdictions. These results raise important questions about the purpose and performance of state licensing boards and possible reasons for inequitable treatment. Additionally, the widespread and severe sanctions for conduct not related to the professional practice suggest that moral turpitude clauses may violate both equal protection and prohibitions on excessive fines. (shrink)

Purpose This study investigates the incidence of ethical violations in the Ghanaian press which has become topical in the wake of misinformation in a charged political atmosphere. Public interest institutions have questioned the unprofessional conduct of journalists covering election campaigns in recent years. This study content analysed political stories from two leading Ghanaian newspapers (Daily Graphic and Daily Guide) to determine the nature and extent of ethical violations, and to examine the level of prominence accorded to political news (...) stories by the two dailies. Design/methodology/approach This paper relied on qualitative content analysis for data gathering and analysis. A total of 387 political news items published between 1 October and 30 November 2020, were analysed. Findings This study found infractions of various nature to Article 1 of the Ghana Journalists Association (GJA) codes of ethics, chief among which is the deliberate publications of news stories without cross-checking facts. Other infractions to Articles 17, 11, 6 and 5 of the GJA codes of ethics were observed. Political news coverage favours the governing New Patriotic Party (NPP) and the main opposition National Democratic Congress (NDC) than any other parties, with the two parties (NPP-NDC) given greater prominence and salience by the Ghanaian press. Originality/value The research makes a modest contribution to the growing concern of journalism ethics in an increasing ecology of fake news. (shrink)

The UK accountancy industry has traded upon its professional status as a means of expanding and legitimating its activities. Extensive appeals are made to ethical codes and disciplinary arrangements as part of its claim to professional status. This study examines some recent events relating to audit failures and alleged unprofessional conduct by accountancy firms and their partners in the UK with a view to assessing the validity of the claims to professional status. It concludes that the rhetoric of (...) the claims is belied by the failure/inability of the professional accountancy bodies to take effective action against the offending firms or their partners. (shrink)

The purpose of this article is to address the questions as to whether a criminal conviction of a healthcare practitioner should affect his or her professional standing, and whether such conviction constitutes ‘unprofessional conduct’ in terms of the Health Professions Act. The article also explores a related matter, namely whether the Health Professions Council of South Africa (HPCSA) has a legal duty to refer complaints regarding unprofessional conduct that displays criminal elements for criminal prosecution. After considering (...) relevant case law on these issues, the article concludes that a practitioner, after being convicted of an offence, should be afforded an opportunity to explain him- or herself to the board, not only in extenuation of the conduct in question, but also in response to the question of whether the conduct constitutes improper or disgraceful conduct. Moreover, the article explains why the HPCSA and professional boards have a legal duty to refer matters of unprofessional conduct with criminal elements in terms of section 34 of the Prevention and Combating of Corrupt Activities Act to law enforcement agencies. (shrink)

The traditional roles of Christian chaplains in aiding patients, physicians, nurses, and hospital administrators in repentance, right belief, right worship, and right conduct are challenged by the contemporary professionalization of chaplaincy guided by post-Christian norms located in a public space structured by three defining postulates: the non-divinity of Christ, robust ecumenism, and the irrelevance of God’s existence. The norms of this emerging post-Christian profession of chaplaincy make interventions with patients, physicians, nurses, and hospital administrators in defense of specifically Christian (...) bioethical norms and goals unprofessional, because the chaplain is now directed as a professional to support health care services held to standards articulated within a secular morality. These changes are exemplar of the profound recasting of the dominant moral culture with wide-ranging implications for bioethics. (shrink)

Background: Social media has become an integrated part of nursing profession, requiring nursing students to develop confidentiality and professional fitness to practice. The aim of this study was to investigate nursing students’ usage, professionalism and attitudes toward social media. Methods: A cross-section study was conducted online among undergraduate nursing students (n = 654). Questionnaires of self-directed learning, self-efficacy and usage and views toward social media were administered. Ethical considerations: Ethical approval was obtained from the Hubei University of Chinese Medicine. Results: (...) All participants were social media users. QQ (93.2%) was the most frequently used. 74.5% respondents spent 2–6 h on social media daily. The majority held positive attitudes toward social media. Year group and gender had influence on perceptions and attitudes toward social media. Furthermore, 81.5% students believed that social media positively influenced self-directed learning. Self-directed learning and learning motivation acted as predictors of the attitudes toward social media. Meanwhile, 67.3% students had posted personal photos and videos online, and 82.4% of them did not have privacy setting on social media. In addition,13.8% students attacked others or posted improper photos online. 22.9% participants witnessed improper posts from schoolmates or teachers, such as complaints about schoolmates or teachers (22.2%), foul language (11.1%), violence (3.9%), sexually suggestive photos (2.6%) and patient confidentiality (0.7%). In all, 15.0% respondents accepted “friend request” from patients. A total of 58.2% students were not aware of professional standards of behavior online for health care providers. In addition, 52.3% participants insisted that it is essential to develop social media and professionalism course for nursing students. Conclusion: Nursing students use social media extensively. Some students are at risk of carrying out unprofessional behavior which have detrimental effects on students’ future opportunities. This suggests that best practices and training in nurse education should be implemented to help students to be informed of professionalism. (shrink)

Background: Nurses and midwives have a professional obligation to promote health and prevent disease, and therefore they have an essential role to play in vaccination. Despite this, some nurses and midwives have been found to take an anti-vaccination stance and promulgate misinformation about vaccines, often using Facebook as a platform to do so. Research question: This article reports on one component and dataset from a larger study – ‘the positives, perils and pitfalls of Facebook for nurses’. It explores the specific (...) issue of nurses and midwives who take an anti-vaccination stance, deemed to be unprofessional by crossing professional boundaries and by providing medical information on Facebook that is not within their scope of practice. Participants: Data were collected via an online worldwide survey from nurse and midwife participants, distributed and ‘snowballed’ through relevant nursing and midwifery groups on Facebook. In total, 1644 Registered Nurses and Midwives, and Enrolled Nurses worldwide attempted the online survey. There were 1100 (66.9%) completed surveys and 54 partially (33.1%) completed surveys. Semi-structured interviews were also conducted online using Skype® with 17 participants in Australia. Ethical considerations: Ethical processes and procedures have been adhered to relating to privacy, confidentiality and anonymity of the participants. Findings/results: A mixed-methods approach was used, including descriptive and content analysis of the quantitative survey data and thematic analysis of the qualitative interview data. The main theme ‘blurred boundaries’ was generated, which comprised three sub-themes: ‘follow the science, ‘abuse of power and erosion of trust’ and ‘the moral and ethical responsibility to safeguard public health’. The results offer an important and unique understanding of how nurses and midwives interpret the conduct of fellow health professionals as unprofessional and crossing the professional boundary if they used Facebook to promulgate anti-vaccination messages and/or give medical advice online. Conclusion: There are many positives and negatives for nurses and midwives associated with using Facebook for personal and professional communication, which is in keeping with the results of the larger study from which this article is taken. Professional behaviour is a key theme in the larger research as is the ethical construct of ‘every act has a consequence’; however, in this article, the theme ‘blurred boundaries’ offers an overall understanding of how nurses and midwives interpret the behaviour of their colleagues who espouse anti-vaccination sentiment and/or give medical advice online that is outside their scope of practice and education. (shrink)

Background: Nurses exposed to community health nursing commonly encounter situations that can be morally distressing. However, most research on moral distress has focused on acute care settings and very little research has explored moral distress in a community health nursing setting especially among nursing students. Aim: To explore the moral distress experiences encountered by undergraduate baccalaureate nursing students in community health nursing. Research design: A descriptive qualitative design was employed to explore the community health nursing experiences of the nursing students (...) that led them to have moral distress. Participants and research context: The study included 14 senior nursing students who had their course in Community Health Nursing in their sophomore year and stayed in the partner communities in their junior year for 6 and 3 weeks during their senior year. Ethical considerations: Institutional review board approval was sought prior to the conduct of the study. Self-determination was assured and anonymity and confidentiality were guaranteed to all participants. Findings: Nursing students are vulnerable and likely to experience moral distress when faced with ethical dilemmas. They encounter numerous situations which make them question their own values and ideals and those of that around them. Findings of the study surfaced three central themes which included moral distress emanating from the unprofessional behavior of some healthcare workers, the resulting sense of powerlessness, and the differing values and mindsets of the people they serve in the community. Conclusion: This study provides educators a glimpse of the morally distressing situations that often occurs in the community setting. It suggests the importance of raising awareness and understanding of these situations to assist nursing students to prepare themselves to the “real world,” where the ideals they have will be constantly challenged and tested. (shrink)

Background: Through education, individuals acquire knowledge, skill and attitudes that facilitate professional socialization; it involves intellectual, emotional and psychomotor skill development. Teachers are role models for behaviour modification and value development. Objective: To examine students’ perceptions of faculty members’ ethical and unethical attitudes during interactions in undergraduate nursing. Research design: This descriptive study consisted of two phases. In Phase I, we developed an instrument, which was administered to nursing students to assess validity and reliability. Exploratory factor analysis yielded 32 items. (...) Cronbach’s α was 0.83, and test–retest reliability was good. In Phase II, a 32-item version of the instrument was administered to nursing students from another university. Participants and research context: Participants included 219 nursing students from one university in Phase I and 196 from another university in Phase II. The study was conducted at the universities attended by the participants. Ethical considerations: Ethical approval was granted by the institutions involved, and all participants provided informed consent. Findings: In Phase I, the instrument demonstrated good psychometric properties for measuring nursing students’ perceptions of faculty members’ ethical and unethical behaviours. In Phase II, students considered certain professional and personal qualities, including respecting confidentiality and students’ private lives and assuming an impartial stance during interactions in the classroom, examinations, or clinical practice, ethical. They considered using obscene examples or unprofessional speech during teaching, selling textbooks in class, using university facilities for personal interests, engaging in romantic relationships with students, and humiliating students in front of patients or staff in clinical settings unethical. Conclusion: Results of this study suggest that nurse educators should be aware of their critical role in the teaching–learning process, and they must scrutinize their attitudes towards students from an ethical point of view. (shrink)

BackgroundThe process of peer-review in academia has attracted criticism surrounding issues of bias, fairness, and professionalism; however, frequency of occurrence of such comments is unknown.MethodsWe evaluated 1491 sets of reviewer comments from the fields of “Ecology and Evolution” and “Behavioural Medicine,” of which 920 were retrieved from the online review repository Publons and 571 were obtained from six early career investigators. Comment sets were coded for the occurrence of “unprofessional comments” and “incomplete, inaccurate or unsubstantiated critiques” using an a-prior (...) rubric based on our published research. Results are presented as absolute numbers and percentages.ResultsOverall, 12% of comment sets included at least one unprofessional comment towards the author or their work, and 41% contained incomplete, inaccurate of unsubstantiated critiques.ConclusionsThe large number of unprofessional comments, and IIUCs observed could heighten psychological distress among investigators, particularly those at an early stage in their career. We suggest that development and adherence to a universally agreed upon reviewer code of conduct is necessary to improve the quality and professional experience of peer review. (shrink)

Background Medical boards and fitness-to-practice committees aim to ensure that medical students and physicians have “good moral character” and are not impaired in their practice of medicine. Method Presented here is an ethical analysis of stalking behavior by physicians and medical students, with focus on the case of Teleka Patrick, MD (a psychiatry resident practicing medicine while under a restraining order due to her alleged stalking behavior). Conclusions While a restraining order is not generally considered a criminal conviction, stalking behavior (...) is clearly unprofessional and a marker of inappropriate character and fitness, yet the reporting obligations for such matters are complex. Medical schools and training programs that fail to assess, record, and report matters of moral conduct such as this potentially allow impaired students to graduate and enter the work force (unless a robust licensing process identifies them). Patrick’s case should be a wake-up call for medical schools and medical boards to better integrate the professionalism domain into their operations. Further, the professionalism of students and doctors need to be integrated into the legal domain, so that those who are unfit to practice are, in fact, prevented from doing so. Guidance for integration is provided. (shrink)

PurposeThis paper discusses the need for health information specialists who can promote patient empowerment by tailoring the information patients receive as they cope with illness. The objectives of this study are to distinguish the various stages of coping with illness, examine the informational needs of patients during these stages, explore how web information contributes to patient empowerment, and describe the potential role of the health information specialist.Design/methodology/approachIn order to meet the study's objectives, a qualitative research method was used in which (...) 110 in‐depth interviews were conducted with patients who told their story of coping throughout the course of illness. By distinguishing and understanding the different stages of coping with illness, we came to distinguish the distinct informational needs during the coping process, and understand how web information contributes to patient empowerment.FindingsThe process of coping with illness has four stages. In each stage, the patient's informational needs differ, as does his ability to absorb and process information. Health systems do not provide information to match the coping stage of the patient. Patients turn to professional and unprofessional internet sites in their search for medical knowledge. The current study, integrated with other studies that show patients' difficulties using the internet, emphasizes the importance of the information specialist in the patient empowerment process.Originality/valueThe study will aid policy makers in the process of empowering patients by demonstrating patients' dynamic informational needs when coping with illness. This study proposes a role for the information specialists that will enable them to expand into the health domain. This role is the health information specialist, a professional who will, among other things, learn how health systems work, identify types of web information sources, assess medical site quality, recognize patients' coping stages, and adapt information to individual characteristics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Microaggressions among Healthcare Providers Facilitate Microaggressions toward PatientsH. Rhodes Hambrick (bio) and Sonya Tang Girdwood (bio)In the conclusion of Freeman and Stewart's (2024) book, Microaggressions in Medicine, the authors specifically recognize the existence of microaggressions among healthcare professionals but have chosen not to focus on these microaggressions in the book. However, it is imperative to acknowledge that microaggressions committed among healthcare professionals can perpetuate microaggressions toward patients by creating (...) a permissive culture wherein microaggressions are committed and accepted as the norm.Microaggressions among healthcare professionals, especially when there are hierarchal differences, often masquerade as concerns regarding "professionalism" (Miller et al. 2023). While we recognize that establishing standards of professional behavior (e.g., thorough and timely communication with patients and healthcare staff, commitment to providing safe and effective care) is crucial to the ethical practice of medicine, the precise definition of professionalism in medicine is nebulous. Therefore, individuals in power within medicine can overlay their personal opinions about what constitutes "professional" behavior. This subjectivity and the lack of a consensus definition can lead to the policing of trainees both within the walls of the hospital and within their personal lives.Given that microaggressions are often centered on aspects of a person's behavior, dress, or personality that may pertain to a particular identity, these are also coined by Freeman and Stewart as self-identity microaggressions (chapter 6) and are distressingly common in medicine. Enforcing dress codes is an example of policing trainees under the guise of professionalism that may simultaneously constitute microaggressions toward people of certain demographics, specifically those who are nonwhite and nonmale. For example, women are often given advice to wear dark-colored, conservative suits for interviews and instructed that dresses and skirts must be long in clinical settings to avoid distracting men. Black trainees may be told that their natural hairstyles are [End Page 157] "unprofessional" and are given advice on how to appear more "presentable" in interviews and on rotations. To cite a recent example of a self-identity microaggression, it made news when a Latina student had points deducted during her practical exam with a standardized patient for wearing large hoop earrings, a type of jewelry she has worn her whole life and represents her cultural heritage (Hatzipanagos 2021).Disappointingly, this policing even extends beyond clinical and "professional" settings. One surgical residency searched the social media profiles of their residents to investigate how many "unprofessional" photos trainees posted, and the results were published in a journal prior to retraction of the publication (Hardouin et al. 2020). Among the list of "unprofessional photos" were those of residents in "inappropriate attire," which included bikinis and swimsuits being worn in non-clinical settings. Fortunately, when the findings were published, the journal received severe backlash on social media. Physicians, both men and women, posted pictures of themselves in swimsuits on social media under the hashtag "#medbikini," arguing that what we wear, especially in our private lives, does not affect our abilities as physicians. While the article was retracted, it was made clear that trainees are judged by their appearance by their superiors and that microaggressions can even be published in reputable journals. Conducting and publishing research like this constitute a type of self-identity microaggression, in which trainees are made to feel that part of their identity outside of work, such as their choice of swimwear, which, in the case of a bikini, may be tied to their gender identity, is fundamentally "unprofessional," even when it has no bearing on their ability to function as doctors.Microaggressions can also be committed when trainees are policed on their behaviors, speech patterns, or mannerisms. They may be reprimanded for using certain vocabulary or speaking with subculture-specific idioms because they will be seen as "unprofessional," when in reality, these forms of speech may simply reflect a cultural or personality difference. Superiors may express their preferences or dislike of certain behaviors by using the threat of labeling them "unprofessional." For example, using bright colors or personal touches on presentations might be given as feedback of "looking unprofessional." Expressing preferences and labeling them as opinions are encouraged, but tagging on the term unprofessional carries a weight that removes any choice from... (shrink)

Background: Body touch and close physical proximity are inevitable in some healthcare procedures and can evoke feelings of shame, humiliation, and anger in patients. Given the increasing recognition of human dignity, exploring the occurrence of these negative emotional experiences and identifying mechanisms for their prevention are crucial.Aim: To develop and define the concept of “patient’s sexual dignity discomfort.” Design: A hybrid model of concept development was utilized.Methods: In the theoretical phase, a scoping review was conducted to establish a working definition (...) of patient’s sexual dignity discomfort. This definition was refined and validated using qualitative data collected during the fieldwork phase. In the analytical phase, a final conceptual model of patient’s sexual dignity discomfort was proposed by integrating findings from both the theoretical and fieldwork phases.Ethical considerations: All participants completed an informed consent process, and interviews were conducted via Zoom or phone by a certified psychiatric nurse to ensure confidentiality, anonymity, and comfort.Results: Four themes describing attributes of patient’s sexual dignity discomfort were explored: experiencing shame and embarrassment, vulnerability-induced loss of control, dehumanization and objectification, and uncertain sexual autonomy. Patient’s sexual dignity discomfort occurs when patients perceive care procedures as sexually inappropriate or as involving unnecessary sexual activity, particularly when healthcare providers display unprofessional attitudes or when patients lack consent or are not mentally prepared for the procedure because of insufficient information. This discomfort leads patients to refuse or avoid healthcare treatments and prioritize finding better healthcare services over their health. It can also prompt providers to avoid patients, resulting in a compromised quality of care and poor health outcomes.Conclusions: Patient’s sexual dignity discomfort poses a significant threat to the quality of patient care and preservation of dignity. Nurses can trigger this intentionally or unintentionally, highlighting the need for comprehensive education and training to prevent it. (shrink)

Purpose – The purpose of this study is to investigate the reasons behind unethical behaviour in the Australian Information and Communications Technology workplace. Design/methodology/approach – The study employed a qualitative research methodology. A total of 43 ICT professionals were interviewed during the month of February 2014 in six Australian capital cities. All interviews were conducted face-to-face and followed a semi-structured interviewing format utilising open-end questions and further probing questions. The purposive sample represented ICT professionals from large and small organisations, government (...) and private sector, different geographic locations, ages, genders, types of jobs and employment experience. Data analysis was completed with the help of QSR NVivo 10, a software package for managing qualitative data. Findings – Of the 25 reasons identified for unethical behaviour in ICT workplaces, 30 per cent of participants agreed on five major ones: pressure, bad management, greed, lack of respect towards ICT and communication issues. Practical implications – By focussing on the reasons behind unethical behaviour in the Australian ICT workplace, this article helps those identifying strategies for dealing with unprofessional behaviour to take into account the root causes of unprofessional behaviour. Originality/value – There is hardly any literature on reasons for unethical behaviour in the ICT workplaces. This article seeks to address this imbalance in the literature. Also, integrity systems in ICT are a new focus in collective, organisational ethics. Identification of and resolving unethical ICT workplace practice is an innovative contribution to the literature. (shrink)

Background: Dignity is a fundamental concept that has been threatened by the COVID-19 pandemic. Several factors threaten the dignity of COVID-19 patients, whether in palliative care departments, medical or surgery wards, intensive care units, or long-term care facilities. This threat is exacerbated by the increasing number of affected patients, the high transmission of the virus and problems such as limited resources, shortage of workforce, and ineffective communication. Recognizing the threats and challenges that currently affect the patients’ dignity and managing them (...) can help maintain the patients’ dignity and increase their satisfaction. Research objective: This study seeks to explain the threats to the dignity of hospitalized COVID-19 patients. Research design: This qualitative study was conducted using conventional content analysis. Data were collected through in-depth, semi-structured, face-to-face interviews with 21 COVID-19 patients with maximum variation. Data were analyzed using Graneheim and Lundman’s conventional content analysis and encoded with MAXQDA-10 software. The participants had already recovered from COVID-19 when the interviews were held. Ethical considerations: The study protocol was approved by the Research Ethics Committee of medical universities in northwestern Iran (IR.UMSU.REC.1399.345). Ethical principles were observed during the study. Findings: The analysis of the interviews revealed three main categories and 11 subcategories for the threats to the dignity of COVID-19 patients. The main categories included facing imposed conditions (five subcategories), facing unprofessional performance (four subcategories), and ineffective communication (two subcategories). Conclusion: The findings of the present study can help health officials and policymakers in taking positive steps to maintain patients’ dignity by designing and implementing beneficial programs. (shrink)

Background Cardiopulmonary resuscitation and subsequent care are subject to various ethical and legal issues. Few studies have addressed ethical and legal issues in post-resuscitation care. Objective To explore nurses’ experiences of ethical and legal issues in post-resuscitation care. Research design This qualitative study adopted an exploratory descriptive qualitative design using conventional content analysis. Participants and research context In-depth, semi-structured interviews were conducted in three educational hospital centers in northwestern Iran. Using purposive sampling, 17 nurses participated. Data were analyzed by conventional (...) content analysis. Ethical considerations The study was approved by Research Ethics Committees at Tabriz University of Medical Sciences. Participation was voluntary and written informed consent was obtained. For each interview, the ethical principles including data confidentiality and social distance were respected. Findings Five main categories emerged: Pressure to provide unprincipled care, unprofessional interactions, ignoring the patient, falsifying documents, and specific ethical challenges. Pressures in the post-resuscitation period can cause nurses to provide care that is not consistent with guidelines, and to avoid communicating with physicians, patients and their families. Patients can also be labeled negatively, with early judgments made about their condition. Medical records can be written in a way to indicate that all necessary care has been provided. Disclosure, withdrawing, and withholding of therapy were also specific important ethical challenges in the field of post-resuscitation care. Conclusion There are many ethical and legal issues in post-resuscitation care. Developing evidence-based guidelines and training staff to provide ethical care can help to reduce these challenges. (shrink)

My paper has three parts. First I will outline the act/object theory of perceptual experience and its commitments to (a) a relational view of experience and (b) a view of phenomenal character according to which it is constituted by the character of the objects of experience. I present the traditional adverbial response to this, in which experience is not to be understood as a relation to some object, but as a way of sensing. In the second part I argue that (...) acceptance of (a) is independent of acceptance of (b). I then present a modified adverbialism that presents experience as relational in nature but whose character is nevertheless to be explained in terms of the way in which one senses an object. Finally, I will offer an explanation of how a naïve realist about experience can adopt this modified adverbialism and in so doing accommodate the possibility of perceptual error. (shrink)

Disjunctivism about sensory experience is frequently put forward in defence of a particular conception of perception and perceptual experience known as naïve realism. In this paper, I present an argument against naïve realism that proceeds through a rejection of disjunctivism. If the naïve realist must also be a disjunctivist about the phenomenal nature of experience, then naïve realism should be abandoned.

I argue that the possibility of non-perceptual experience need not compel a naïve realist to adopt a disjunctive conception of experience. Instead, they can maintain that the nature of perceptual and hallucinatory experience is the same, while still claiming that perceptual experience is presentational of the objects of perception. On such a view the difference between perceptual and non-perceptual experience will lie in the nature of the objects that are so presented. I will defend a view according to which in (...) non-perceptual experience one is presented with mere universals, while in perceptual experience one is presented with the instantiation of a universal by a particular. This is to adopt disjunctivism about the objects of experience, about that which is apparently present in experience. (shrink)

The goal of this article is to present a first list of ethical concerns that may arise from research and personal use of virtual reality (VR) and related technology, and to offer concrete recommendations for minimizing those risks. Many of the recommendations call for focused research initiatives. In the first part of the article, we discuss the relevant evidence from psychology that motivates our concerns. In Section “Plasticity in the Human Mind,” we cover some of the main results suggesting that (...) one’s environment can influence one’s psychological states, as well as recent work on inducing illusions of embodiment. Then, in Section “Illusions of Embodiment and Their Lasting Effect,” we go on to discuss recent evidence indicating that immersion in VR can have psychological effects that last after leaving the virtual environment. In the second part of the article, we turn to the risks and recommendations. We begin, in Section “The Research Ethics of VR,” with the research ethics of VR, covering six main topics: the limits of experimental environments, informed consent, clinical risks, dual-use, online research, and a general point about the limitations of a code of conduct for research. Then, in Section “Risks for Individuals and Society,” we turn to the risks of VR for the general public, covering four main topics: long-term immersion, neglect of the social and physical environment, risky content, and privacy. We offer concrete recommendations for each of these 10 topics, summarized in Table 1. (shrink)

This study investigates the portrayal of five female journalists on the Aaron Sorkin television series Sports Night. The women were depicted as acting unprofessionally, displaying motherly qualities, choosing their personal lives over work, being deferential to men for ethical decisions, and showing a lack of sports knowledge compared to the male characters. The researchers use social responsibility theory to suggest why these portrayals were ethically problematic.

Recognizing that truth is socially constructed or that knowledge and power are related is hardly a novelty in the social sciences. In the twenty-first century, however, there appears to be a renewed concern regarding people’s relationship with the truth and the propensity for certain actors to undermine it. Organizations are highly implicated in this, given their central roles in knowledge management and production and their attempts to learn, although the entanglement of these epistemological issues with business ethics has not been (...) engaged as explicitly as it might be. Drawing on work from a virtue epistemology perspective, this paper outlines the idea of a set of epistemic vices permeating organizations, along with examples of unethical epistemic conduct by organizational actors. While existing organizational research has examined various epistemic virtues that make people and organizations effective and responsible epistemic agents, much less is known about the epistemic vices that make them ineffective and irresponsible ones. Accordingly, this paper introduces vice epistemology, a nascent but growing subfield of virtue epistemology which, to the best of our knowledge, has yet to be explicitly developed in terms of business ethics. The paper concludes by outlining a business ethics research agenda on epistemic vice, with implications for responding to epistemic vices and their illegitimacy in practice. (shrink)

Introduction Numerous guidelines and policies for ethical research practice have evolved over time, how this translates to global health practice in resource-constrained settings is unclear. The purpose of this paper is to describe how the concept of ancillary care has evolved over time and how it is included in the ethics guidelines and policy documents that guide the conduct of research in the global south with both an international focus and providing a specific example of Malawi, where the first (...) author lives and works, as a case study. Methods Discourse analysis was conducted on 34 international ethics guidelines and policy documents. Documents were purposively selected if they contained a set of key terms that reflect the concept of ancillary care. Following a process of inductive discourse analysis, five key interrelated text phrases relating to ancillary care were extracted from the documents. The evolution of these phrases over time was explored as they represented the development of the concept of ancillary care as a component of ethical health research guidance and practice. Results We found key interrelated phrases that represent discourses regarding the evolution of ancillary care including participant protection; provide care as appropriate; supererogation; patient needs prevail over science; and ancillary care as an obligation. Arguments for the provision of ancillary care were characterised by safeguarding the safety, health rights and well-being of study participants. However, despite the evolution of discourse around ethical obligations to provide ancillary care, this is rarely made explicit within guidance documents, leaving interpretive space for differential application in practice. Conclusion While there have been major changes to the ethics guidance that reflect significant evolution in the ethical conduct of research, the specific vocabulary or language used to explain the ethics of researchers' ancillary care obligations to the health needs of their research participants, lacks clarity and consistency. As a result, the concept of ancillary care continues to be under-represented in local ethical guidelines and regulations, with no clear directives for country-level research ethics committees to apply in regulating ancillary care responsibilities. (shrink)

While the debate on values in science focuses on normative questions on the level of the individual (e.g. should researchers try to make their work as value free as possible?), comparatively little attention has been paid to the institutional and professional norms that researchers are expected to follow. To address this knowledge gap, we conduct a content analysis of leading national codes of conduct for research integrity of European countries, and structure our analysis around the question: do these (...) documents allow for researchers to be influenced by “non-epistemic” (moral, cultural, commercial, political, etc.) values or do they prohibit such influence in compliance with the value-free ideal (VFI) of science? Our results return a complex picture. On the one hand, codes of conduct consider many non-epistemic values to be a legitimate influence on the decision-making of researchers. On the other, most of these documents include what we call _VFI-like positions_: passages claiming that researchers should be free and independent from any external influence. This shows that while many research integrity documents do not fully endorse the VFI, they do not reject it and continue to be implicitly influenced by it. This results in internal tensions and underdetermined guidance on non-epistemic values that may limit some of the uses of research integrity codes, especially for purposes of ethical self-regulation. While codes of conduct cannot be expected to decide how researchers should act in every instance, we do suggest that they acknowledge the challenges of how to integrate non-epistemic values in research in a more explicit fashion. (shrink)

Corporate social responsibility has an impact on many areas of society, and it has recently been active in the digital space, a growing area of business activity. However, certain factors prevent it from firmly establishing itself in this area. One of these factors is the lack of user trust. Certain instruments have been created to address this issue, such as codes of conduct that seek to mitigate the causes of distrust by making significant improvements in the regulations and ethical (...) standards applicable to business transactions. These instruments are the product of industry self-regulation and complement rather than substitute for effective legal regulations. In light of some European Community directives, European legislators are addressing certain issues in this area, especially unfair business practices. (shrink)

In three studies, factors influencing the incidence of fraudulent financial reporting were assessed. We examined (1) the effects of personal values and (2) codes of corporate conduct, on whether managers misrepresented financial reports. In these studies, executives and controllers were asked to respond to hypothetical situations involving fraudulent financial reporting procedures. The occurrence of fraudulent reporting was found to be high; however, neither personal values, codes of conduct, nor the interaction of the two factors played a significant role (...) in fraudulent financial reporting. (shrink)

Offers two complementary works, unabridged, in modernised, annotated texts. Suitable for classroom use, this title provides an introduction, a note on the texts, and a select bibliography.

Business ethics research has long examined the dichotomy between remaining silent or reporting ethical misconduct to a third party. Little is known, however, about ethical conversations within a work group after observing misconduct. Specifically, we do not know how many members of their work group individuals choose to communicate with. These conversations could have important implications for creating an ethical workplace. We propose that psychological standing is an important driver of individuals’ decisions not to remain silent and to instead raise (...) moral concerns with a greater number of others in their work group. In addition, integrating existing work on structural power, psychological standing, and the bystander effect, we develop a moderated mediation model with both structural power position and work group size as contextual drivers of psychological standing. Our model is supported across four studies using different designs and methodological approaches. Our results contribute to the understanding of when and why individuals raise moral concerns, and they provide insights into how an ethical context is created in organizations. (shrink)

Abstract: In this article, we explore what are ethical forms of holding service users responsible in mental health care contexts. Hanna Pickard has provided an account of how service users should be held responsible for morally wrong or seriously harmful conduct within contexts of mental health care, called the clinical stance. From a clinical stance one holds a person responsible for harm, but refrains from emotionally blaming the person and only considers the person responsible for this conduct in (...) a detached sense. Her account is based on what are considered best practices in the treatment of people with borderline personality disorder and addiction. We ask if this account generalizes across different diagnostic criteria and different clinical contexts. To begin to answer this question, we compare the clinical stance to an account of what are considered best practices in the treatment of service users at a specialized clinic for people with autism spectrum disorder in the Netherlands. We refer to this alternative account as the nurturing stance and highlight relevant similarities and differences between the clinical stance and the nurturing stance. We conclude with suggestions for further research and theorizing. (shrink)

Years of research clearly shows that relying on traditional organizational power bases is not effective when companies want to promote business ethics and performance. It is not only that the use of legitimate power to establish ethics codes and coercive power to punish employees who do not comply does not work; this study—based on a multi-method research approach in the retail industry—indicates that the classic iron fist leads to unethical business values and lower service performance. But there is a light (...) at the end of the tunnel for forward-looking managers. The ethical attitudes and behaviors of employees within international organizations is a dynamic variable that is possible to change by the use of values-based leadership. Our extensive study of a large grocery store chain owned by a multinational corporation indicates that managers who lead by example will boost team values and commitment. (shrink)

Historically, scientists in training have learned the rules of ethical conduct by the example of their advisors and other senior scientists and by practice. This paper is intended to serve as a guide for the beginning scientist to some fundamental principles of scientific research ethics. The paper focuses less on issues of outright dishonesty or fraud, and more on the positive aspects of ethical scientific behavior; in other words, what a scientist should do to maintain a high level of (...) ethical conduct in research.There are a number of fairly specific rules, guidelines, or commonly accepted operating principles that have evolved for the ethical conduct of science. In order to discuss this code of ethics, this paper is divided into sections dealing with specific areas of scientific ethics. These areas are: data collection and storage, ownership of data, confidentiality, communication, authorship, collaboration, the peer review system, and rules of dealing with ethical complaints. Illustrative case histories are presented to provide examples of the type of ethical dispute or problem being discussed. If scientific trainees learn the accepted rules of behavior that govern the conduct of science, ethical problems that arise out of ignorance, misunderstanding, or poor communication can be avoided. (shrink)