Some individuals and businesses have become increasingly dependent upon multiple financing sources for economic survival. Certain currently used lending policies, such as interest-only loans and revolving credit lines, may encourage borrower dependency on the lender. The paper reviews religious teachings, specifically religious safeguards on lending identified in primary Jewish sources including the Tanach and rabbinic teachings, and finds that the safeguards in place centuries ago may still be relevant for lending practices today to both protect the borrower while still providing (...) a profitable means to help borrowers. (shrink)

There is strong theoretical support for a relationship between various characteristics of religiousness and attitudes towards business ethics. This paper examines three frequently- studied dimensions of religiousness (fundamentalism, conservatism, and intrinsic religiousness) and their ability to predict students' willingness to behave unethically. Because prior research indicated a possible relationship between the religious affiliation of an institution and its members' ethical orientation, we studied students at universities with three different types of religious affiliation: evangelical, Catholic, and none.Results of the study lend (...) support to a negative relationship between the above-mentioned dimensions of religiousness and willingness to behave unethically. In addition, students at the Evangelical university were far less willing to engage in unethical behavior than were students at either the Catholic or the unaffiliated institutions. (shrink)

Over the past seventy-five years, the UN secretary-general has come to occupy a highly visible position in world politics. While the UN Charter describes the post merely as the “chief administrative officer” of the organization, today it is widely recognized that the secretary-general also plays a central role in political matters. What makes the role of the UN secretary-general special? Where does the office's authority come from? As part of the special issue on “The United Nations at Seventy-Five: Looking Back (...) to Look Forward,” this essay looks back at the tenures of previous UN secretaries-general and applies ideas from sociological institutionalism to argue that the UN secretary-general holds the position of a “guardian” of the UN Charter. The UN secretary-general, more than anyone else within the UN system, represents the UN overall. From this flows great responsibilities and challenges, as the UN secretary-general is often expected to step in when other parts of the UN are unable or unwilling to act, and to take the blame when things go wrong. But this special position also endows the office with a substantial degree of authority, which future holders of the office can use to shape policies and mobilize support as the UN seeks to address urgent global challenges. (shrink)

Interest in teaching business ethics classes on college campuses has increased dramatically during the past decade. In the United States, virtually all graduate and undergraduate business programs teach business ethics in some form. While current pedagogy relies primarily on factual recounting of actual workplace incidents and actual and hypothetical case studies, calls for multidisciplinary approaches to teaching business ethics have not yet produced significant pedagogical change. We propose the use of fiction (novels, dramas, and short stories) to enrich current teaching (...) materials. This paper illustrates the tremendous power of stories which deal with ethical dilemmas in business to illuminate moral issues in ways that lead to a clearer understanding of ethical theory. The fiction cited in this paper is all drawn from American literature. It seems likely that similar sources could be found in the literature of other countries. (shrink)

The area of services marketing is a highly crucial one for potential ethical violations. The services industry, which drives over two-thirds of our national economy, is about to experience severe changes due to increasing competition. The temptation to make ethical compromises will pose a dramatic threat to the business climate.We review conceptual approaches to the field of marketing ethics and conclude that existing models often lack an important component which affects ethical decision-making. That component includes the interorganizational variables: the primary (...) task environment, including immediate customers and suppliers to the buyer and seller; the secondary task environment, comprised of suppliers and customers to the immediate suppliers and customers, competitors, and regulatory agencies, and the macro-environment, those broader forces which impinge on the activities in the primary and secondary task environments. (shrink)

This paper examines levels of similarity in ethical outlooks in countries where economic and sociocultural values may differ markedly. We compared students from a capitalist country, the United States, with students from Ukraine, a country experiencing dramatic ideological confusion and economic change. We tested the hypothesis that greater social and moral integration, as operationalized by a lack of alienation and by religiousness, will directly affect one's willingness to engage in unethical business practices.The sample was composed of business students in both (...) Ukraine and the United States. The survey instrument consisted of widely used scales for measuring alienation and religiousness. The measure of ethical standards was a vignette-based quasi-projective technique. (shrink)

Christmas gives us that 'sweet little Jesus Boy' and Lent follows that with the 'gentle Jesus, meek and mild.' He was neither of those. In point of fact, he was the 'tough guy from Nazareth.' He was consistently abrasive, if not abusive, to his mother (Lk 2:49; Jn 2:4; Mt 12:48) and aggressively hard on males, particularly those in authority. In Mark 8 he cursed and damned Peter for failing to get Jesus' esoteric definition of Messiah correct. Nobody else understood (...) it either. Jesus had made it up himself and not adequately explained it to anybody until then. He called the religious authorities snakes, corrupt tombs, filthy chinaware, fakes, and Mosaic legalists who had forgotten God's real revelation of universal grace and salvation in the Abraham Covenant. He tore up the temple in the middle of a worship service and cursed those present for turning God's house of prayer into a den of thieves, when actually they were kind, helping out-of-town tourists obtain the proper sacrifices for the liturgical rituals. Jesus was persistently aggressive, often angry and not infrequently irrational, killing an innocent fig tree with his curse, for example. He constantly attacked the Pharisees and their proposals for renewing the spiritual vitality of the Jewish Community. He abused numerous people by healing them on the Sabbath just to make his political point against the religious leaders. He could just as well have healed them on Tuesday, if he really wanted to heal them. By healing the blind man in John 9 on the Sabbath, for example, he caused the man to be driven out of his synagogue, his family, and his community of faith; isolated and abandoned as if he were a leper. Even when he said surprising things about children, his focus was not on the children but on his disciples, using the children as tools for making an assertive teaching point. Jesus' life was one of perpetually aggressive claims for his vision of God's reign. He constantly and intentionally provoked conflict and disruption of the status quo, spiritually and politically. He refused to negotiate, compromise, palliate, or mollify his insistence upon keeping his elbow perpetually in the eye of the people in power. In all this he would not back down. The principle by which Jesus operated was absolute and that is why he did not back down, even though they killed him for this very reason. His principle was simply that the renewal of Jewish spirituality could only come from a return to the Abrahamic Covenant, which declared (Gn 12; Rm 8) that God is gracious and universally forgiving towards all humankind, unconditional to our conduct and behaviour, and radically in that it removes all fear, guilt, and shame from the equation of our relationship with God (Mi 7:18-20). He saw that the Pharisees and Scribes were absolutely wrong in assuming that the Mosaic legal system would renew the Jewish relationship with God. He was not the gentle Jesus, meek and mild. He was that tough guy from Nazareth! He had good reason and he was willing to go the distance for what he stood for, even to death on the cross. (shrink)

In applying statutory safeguards, the FDA must not regulate investigational new products so stringently that a life‐saving therapy is unavailable. But the agency must also protect dying patients from exploitation by unscrupulous or overzealous researchers. The balance between individual choice and public protection has been questioned in cases involving experimental AIDS drugs and an artificial heart.

What was really going on in the Baby K case? Many people have posed that or similar questions to me when I have been introduced as the attorney for Baby K's mother. In a nutshell, the courts in Baby K ruled that a hospital is required to provide emergency medical care to an anencephalic baby at the mother's request. In this paper, I provide some insights into the factors that underlie the litigation and the legal issues decided by the courts. (...) In my view, this case involved a myriad of legal questions, religious principles, power struggles, and health care resources arguments that could arise in other contexts. (shrink)

Mixed results regarding the role of gender in moral reasoning prompted an investigation of an alternative characteristic that may be more influential in the process: sex role orientation. We present an empirical assessment of the relationship between an individual’s moral reasoning level and his/her sex role orientation, gender, and several academic factors. Our results indicate that sex role orientation is not related to moral reasoning level. Gender is related to moral reasoning in our study, women reasoning at higher levels than (...) men. We found a positive relationship between education and moral reasoning level, and moral reasoning levels differed across academic institutions. Our results also show business students have lower moral reasoning levels than students in other fields, although this result did not reach statistical significance. (shrink)

Making Sense of Sex: Attitudes towards Sexuality in Early Jewish and Christian Literature. By William Loader. Grand Rapids, Mich.: William B. Eerdmans Publishing Co., 2013. Pp. vii + 168. $24.

Background Implementation science presents ethical issues not well addressed by traditional research ethics frameworks. There is little empirical work examining how clinicians whose work is affected by implementation studies view these issues. Accordingly, we interviewed clinicians working at sites participating in an implementation study seeking to improve patient handoffs to the intensive care unit (ICU).Methods We performed semi-structured interviews with 32 clinicians working at sites participating in an implementation study aiming to improve patient handoffs from the operating room to the (...) ICU. We analyzed the interviews using an iterative coding process following a conventional content analysis approach.Results Clinicians’ greatest concern about involvement was possible damage to interpersonal relations with more senior clinicians. They were divided about whether informed consent from clinicians was necessary but were satisfied with the study’s approach of sending out mass communications about the study. They did not think opting out of the implementation portion of the study was feasible but saw this inability to opt out as unproblematic because they equated the study with routine quality improvement. Those clinicians who helped launch the study at their sites recounted several different ways of doing so beyond simply facilitating access.Conclusions The risks that clinicians identified stemmed more from their general status as employees than their specific work as clinicians. Implementation researchers should be attuned to the ethical ramifications of involving employees of varying ranks. Implementation researchers using hybrid designs should also be sensitive to the possibility that practitioners affected by a study will equate it with quality improvement and overlook its research component. Finally, the interactions that go into facilitating an implementation study are more various than the “gatekeeping” typically discussed by research ethicists. More research is needed on the ethics of the myriad interactions that are involved in making implementation studies happen. (shrink)

Childhood obesity is in important respects a result of legal policies that influence both dietary intake and physical activity. The law must shift focus away from individual risk factors alone and seek instead to promote situational and environmental influences that create an atmosphere conducive to health. To attain this goal, advocates should embrace a population-wide model of public health, and policymakers must critically examine the fashionable rhetoric of consumer choice.

A 1999–2000 national study of U.S. hospitals raised concerns about ethics consultation (EC) practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administered a 105-item survey to “best informants” in a stratified random sample of 600 U.S. general hospitals. This primary article details the methods for the entire study, then focuses on the 16 items from the prior study. Compared with 2000, the estimated number of case consultations performed annually rose by 94% to 68,000. The (...) median number of consults per hospital was unchanged at 3, but more than doubled for hospitals with 400+ beds. The level of education of EC practitioners was unchanged, while the percentage of hospitals formally evaluating their ECS decreased from 28.0% to 19.1%. The gap between large, teaching hospitals and small, nonteaching hospitals widened since the prior study. We suggest targeting future improvement efforts to hospitals where needs are not being met by current approaches to EC. (shrink)

Screening for prostate cancer with the prostate-specific antigen blood test is controversial, as evidence to date has not demonstrated such screening does more good than harm. While the potential benefit of PSA screening on reducing prostate cancer mortality has not been documented in randomized trials, many risks of PSA screening have been well documented. These risks include a substantially higher risk of a prostate cancer diagnosis over a screenee’s lifetime, false-positive and false-negative test results, possible complications from biopsies done in (...) response to suspicious test results, and substantial risks of side effects from subsequent prostate cancer treatments. Nevertheless, PSA screening is widespread in the United States, and many physicians in a national survey reported supporting routine PSA screening as well as getting PSA tests themselves, despite the lack of evidence. (shrink)

To design effective strategies to improve ethics consultation (EC) practices, it is important to understand the views of ethics practitioners. Previous U.S. studies of ethics practitioners have overrepresented the views of academic bioethicists. To help inform EC improvement efforts, we surveyed a random stratified sample of U.S. hospitals, examining ethics practitioners’ opinions on EC in general, on their own EC service, on strategies to improve EC, and on ASBH practice standards. Respondents across all categories of hospitals had very positive perceptions (...) of their own ethics consultation service (ECS) and few concerns about quality. Our findings suggest that the ethics-related needs of small, rural, non-teaching hospitals may be very different from those of academic medical centers, and therefore, different approaches to addressing ethical issues might be warranted. (shrink)

This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity—Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on (...) the following key issues: § 1.Providing information about research integrity § 2.Providing education, training and mentoring § 3.Strengthening a research integrity culture § 4.Facilitating open dialogue § 5.Wise incentive management § 6.Implementing quality assurance procedures § 7.Improving the work environment and work satisfaction § 8.Increasing transparency of misconduct cases § 9.Opening up research § 10.Implementing safe and effective whistle-blowing channels § 11.Protecting the alleged perpetrators § 12.Establishing a research integrity committee and appointing an ombudsperson § 13.Making explicit the applicable standards for research integrity. (shrink)

In his article, “What should ChatGPT mean for bioethics?” I. Glenn Cohen explores the bioethical implications of Open AI’s chatbot ChatGPT and the use of similar Large Language Models (LLMs) (Cohen...

This article provides practical guidance for researchers who wish to enroll and collect data from pediatric research participants through online and mobile platforms, with a focus on the involvement of both children and their parents in the decision to participate.

Although many studies have revealed the importance of study skills for students' first?year performance and college retention, the extent of the impact of study skills preparation on students' academic achievement is less clear. This paper explores the impact of pre?university study skills preparation on students' first?year study experiences, academic achievement and persistence. The setting for this study is a large law school in the Netherlands which attracts students from more than 100 schools for secondary education. The results show that the (...) perceived study skills preparation concerning time management and learning skills does have a positive impact on college students' first?year study behaviour and academic achievement. However, the study also shows that the impact of perceived college preparation is far less important for college retention than other factors such as satisfaction about the chosen degree programme and tutorial attendance. (shrink)

Delivering high quality genomics-informed care to patients requires accurate test results whose clinical implications are understood. While other actors, including state agencies, professional organizations, and clinicians, are involved, this article focuses on the extent to which the federal agencies that play the most prominent roles — the Centers for Medicare and Medicaid Services enforcing CLIA and the FDA — effectively ensure that these elements are met and concludes by suggesting possible ways to improve their oversight of genomic testing.

From February 2020, the COVID-19 pandemic led to closures of educational institutions to reduce the spread of infectious disease. This forced the U.S. education system into a massive experiment with online education. Despite conducting online bioethics education for nearly twenty years, our bioethics program, a joint endeavor of Clarkson University and Icahn School of Medicine at Mount Sinai, was not immune to this disruption because our curriculum features intensive, one-week onsite courses. Even in the face of historic disruptions, it is (...) vital to ensure minimal interruptions to teaching and assessing students to provide effective education. This paper reviews the steps we took to successfully convert the onsite components of our curriculum to a synchronous online format, and it focuses on how we preserved instruction and assessment of practical skills that comprise these courses’ core. It also explains how we fostered interactive classroom environments. (shrink)

This article is a longitudinal analysis of the relation between gendered labour divisions and new data processing technologies at the Dutch Central Bureau of Statistics. Following social-constructivist and evolutionary economic approaches, the authors hold that the relation between technology and work organization is a two-way process. This means that technology does not only affect the relations between men and women at work, but that these relations also influence technological choices. The proportional numbers of men and women on the labour market (...) and changing conceptions of which work is deemed appropriate for women have been important factors in the strongly varying extent to which women participated in office work. They have also been important factors in determining the course of technological development. Shortages of women on the labour market have even determined search heuristics for new technological solutions in specific directions. (shrink)

We have previously found that attention to internal somatic sensations during a heart beat perception task increases the misperception of external touch on a somatic signal detection task , during which healthy participants erroneously report feeling near-threshold vibrations presented to their fingertip in the absence of a stimulus. However, it has been suggested that mindful interoceptive attention should result in more accurate somatic perception, due to its non-evaluative and controlled nature. To investigate this possibility, 62 participants completed the SSDT before (...) and after a period of brief body-scan mindfulness meditation training, or a control intervention . The meditation intervention reduced tactile misperception and increased sensitivity during the SSDT. This finding suggests that the perceptual effects of interoceptive attention depend on its particular nature, and raises the possibility that body-scan meditation could reduce the misperception of physical symptoms in individuals with medically unexplained symptoms. (shrink)

Background: The Clinical Ethics Residency for Nurses was offered selectively to nurses affiliated with two academic medical centers to increase confidence in ethical decision-making. Research Question/Aim: To discover how effective the participants perceived the program and if their goals of participation had been met. Research design: A total of 65 end-of-course essays (from three cohorts) were analyzed using modified directed content analysis. In-depth and recursive readings of the essays by faculty were guided by six questions that had been posed to (...) graduates. Ethical considerations: Institutional review board approval was granted for the duration of the program and its reporting period. Confidentiality was maintained via the use of codes for all evaluations including the essays and potentially identifying content redacted. Findings: An umbrella theme emerged: participants had developed ethical knowledge and skills that provided a “moral compass to navigate the many gray areas of decision-making that confront them in daily practice.” Six major themes corresponding to questions posed to the participants included the ability to advocate for good patient care; to support and empower colleagues, patients, and families; they experienced personal and professional transformation; they valued the multimodal nature of the program; and were using their new knowledge and skills in practice. However, they also recognized that their development as moral agents was an ongoing process. Discussion: Findings support that enhancing nurse confidence in their moral agency with a multimodal educational approach that includes mentored practice in ethical decision-making, enhancing communication skills and role-play can mitigate moral distress. A majority found the program personally and professionally transformative. However, they recognized that ongoing ethics discussion involvement and supportive environments would be important in their continued development of ethical agency. Conclusion: Multimodal ethics education programs have potential to be transformative and enhance nurse confidence in their ethical decision-making. (shrink)

Objective Although patients exercise greater autonomy than in the past, and shared decision making is promoted as the preferred model for doctor-patient engagement, tensions still exist in clinical practice about the primary locus of decision-making authority for complex, scarce, and resource-intensive medical therapies: patients and their surrogates, or physicians. We assessed physicians’ attitudes toward decisional authority for adult venoarterial extracorporeal membrane oxygenation (VA-ECMO), hypothesizing they would favor a medical locus. Design, Setting, Participants A survey of resident/fellow physicians and internal medicine (...) attendings at an academic medical center, May to August 2013. Measurements We used a 24-item, internet-based survey assessing physician-respondents’ demographic characteristics, knowledge, and attitudes regarding decisional authority for adult VA-ECMO. Qualitative narratives were also collected. Main Results A total of 179 physicians completed the survey (15 percent response rate); 48 percent attendings and 52 percent residents/ fellows. Only 32 percent of the respondents indicated that a surrogate’s consent should be required to discontinue VA-ECMO; 56 percent felt that physicians should have the right to discontinue VA-ECMO over a surrogate’s objection. Those who self-reported as “knowledgeable” about VA-ECMO, compared to those who did not, more frequently replied that there should not be presumed consent for VA-ECMO (47.6 percent versus 33.3 percent, p = 0.007), that physicians should have the right to discontinue VAECMO over a surrogate’s objection (76.2 percent versus 50 percent, p = 0.02) and that, given its cost, the use of VA-ECMO should be restricted (81.0 percent versus 54.4 percent, p = 0.005). Conclusions Surveyed physicians, especially those who self-reported as knowledgeable about VA-ECMO and/or were specialists in pulmonary/ critical care, favored a medical locus of decisional authority for VA-ECMO. VA-ECMO is complex, and the data may (1) reflect physicians’ hesitance to cede authority to presumably less knowledgeable patients and surrogates, (2) stem from a stewardship of resources perspective, and/or (3) point to practical efforts to avoid futility and utility disputes. Whether these results indicate a more widespread reversion to paternalism or a more circumscribed usurping of decisional authority occasioned by VA-ECMO necessitates further study. (shrink)