BackgroundDespite its ubiquity in academic research, the phrase ‘ethical challenge(s)’ appears to lack an agreed definition. A lack of a definition risks introducing confusion or avoidable bias. Conceptual clarity is a key component of research, both theoretical and empirical. Using a rapid review methodology, we sought to review definitions of ‘ethical challenge(s)’ and closely related terms as used in current healthcare research literature.MethodsRapid review to identify peer-reviewed reports examining ‘ethical challenge(s)’ in any context, extracting data on definitions of ‘ethical challenge(s)’ (...) in use, and synonymous use of closely related terms in the general manuscript text. Data were analysed using content analysis. Four databases (MEDLINE, Philosopher’s Index, EMBASE, CINAHL) were searched from April 2016 to April 2021.Results393 records were screened, with 72 studies eligible and included: 53 empirical studies, 17 structured reviews and 2 review protocols. 12/72 (17%) contained an explicit definition of ‘ethical challenge(s), two of which were shared, resulting in 11 unique definitions. Within these 11 definitions, four approaches were identified: definition through concepts; reference to moral conflict, moral uncertainty or difficult choices; definition by participants; and challenges linked to emotional or moral distress. Each definition contained one or more of these approaches, but none contained all four. 68/72 (94%) included studies used terms closely related to synonymously refer to ‘ethical challenge(s)’ within their manuscript text, with 32 different terms identified and between one and eight different terms mentioned per study.ConclusionsOnly 12/72 studies contained an explicit definition of ‘ethical challenge(s)’, with significant variety in scope and complexity. This variation risks confusion and biasing data analysis and results, reducing confidence in research findings. Further work on establishing acceptable definitional content is needed to inform future bioethics research. (shrink)

This book takes a new approach to ethics by focusing on the kinds of dilemmas that confront people almost daily on the job.

This paper challenges contemporary portrayals in the nursing literature of the spaces within which care of patients in hospital settings is conducted. Within the wider discourse of fiscal restraint on health care spending, professional nursing has cast its disciplined eyes on details of the nurse‐patient relationship for the ostensible purpose of repairing that which is treated as individual failings of nurses to practise in ways prescribed by nursing theories. Set aside in this approach to the so‐called ‘problems’ of nursing practice (...) has been an examination of the conditions within which nurses come in contact with patients, and a critical recognition that such contacts represent skilled accomplishments of social action. In this paper, these conditions are treated as resources available to both nurses and patients to generate accounts for the nurse's presence as well as the nurse's absence. Examples from an ethnographic study of nursing practice are used to illustrate how the spaces operating between nurses and patients are not empty voids but aresocialspaces through which particular meanings about nursing care can be conveyed. (shrink)

Business and society scholars have analyzed the citizenship activities of private firms, but what of their own institutions? This article introduces the concept of business school citizenship (BSC), examining it as a response to the legitimacy pressures created by competing corporate and university interests in the U.S. management-education context. Theories of corporate and of university social responsibility are used to explain BSC, and these theories form the basis of the argument that such activities can be justified and should be increased.

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)

‘With woman’, ‘woman centred’ and ‘in partnership with women’ are new terms associated with midwifery care in Australia, and the underlying philosophy has emerged both as an antidote to the medicalisation of pregnancy and in a bid to reacquaint women with their natural capacity to give birth successfully and without intervention. A reorientation of midwifery services in the 1990s, a shift towards midwifery‐led care (MLC) and the subsequent introduction of direct entry midwifery programs all contributed to this new direction. Central (...) concepts are a focus on the childbearing woman and a valuing of women's experiences. While this philosophical re‐alignment has been applauded by many midwives in terms of maternal empowerment and improved autonomy for midwives, there are nonetheless some concerns that, with its emphasis on normality, midwifery‐led care is in danger of becoming an exclusionary model. Particular concerns include meeting the needs of a growing cohort of women, those with ‘high risk’ pregnancies, and the educational adequacy of direct entry midwifery programs. To date, there has been no thorough evaluation of this emerging midwifery philosophy in Australia. In order to open the debate, this paper aims to initiate a discussion of ‘with woman’ midwifery care as it applies to Australian practice. (shrink)

Cancer rates in men and women of reproductive age have continued to increase in recent years; however, therapy has dramatically decreased the mortality rates. Since 1990, the prevalence of cancer survivors in young adults increased from 1 in 1,000 to 1 in 250 patients due to more aggressive therapies. Current therapies may have profound toxic effects on gamete function with infertility as an expected consequence of cancer therapy. Depending on the site and stage of cancer, age of the patient, and (...) the type of treatment, approximately 90% of men and women diagnosed with cancer may be at risk of permanent infertility.Fertility preservation has emerged as a discipline dedicated to improving the future reproductive potential of cancer survivors. Significant progress in the advancement of fertility preservation therapies and a heightened awareness of the availability of therapies has occurred in the past 10 years. The American Society of Clinical Oncology and the American Society of Reproductive Medicine have advanced these efforts by formally recognizing the importance of fertility awareness. (shrink)

This study examines public health nurses’ perceptions and concerns about the implications of Japan’s new long-term care insurance law concerning care provision for elderly people and their families. Respondents voiced their primary concern about this law as access to services for all elderly people needing care, and defined their major responsibility as strengthening health promotion and illness prevention programmes. Although wanting to expand their roles to meet the health care, social and public policy advocacy needs of elderly persons and their (...) families, respondents also stated their concern for the possible lack of enough resources for this expansion to support family caregivers adequately. They viewed their first function as developing collaborative relationships with local government officials to help to assure sufficient resources to provide the necessary foundation for long-term care programmes to deliver services to all those in need. These concerns fall within the larger ethical issue of distributive justice in a society based on the obligations of the state to citizens and the family to its members, especially elderly relatives, who, according to traditional Japanese values, retain respect. (shrink)

Aircraft with increasingly high performance were important to the war effort in World War II. Changes in technology allowed aircraft to reach faster speeds and to complete missions at higher altitudes. With these changes came new obstacles for pilots who had to tolerate these stresses. Of primary concern to the U.S. War Department was the loss of consciousness that often occurred with high-speed maneuvers and especially during pull-up after dive-bombing missions. In some cases, pilots would experience up to 9G of (...) force during rapid ascent, much more than the 6G threshold that typically leads to loss of consciousness. In 1941, a research team in Red Wing, MN, proposed experiments to elucidate the mechanism .. (shrink)

Economic growth requires a focus on building the assets of the poor, a strategic approach that is considerably broader than developing the poor only asconsumers and workers. The long-term sustainability of business and society will be enhanced if corporate investments that impact on poverty alleviation are far reaching, multi-faceted, and built through multi-sector partnerships. Emerging evidence indicates that corporations are increasingly involved on two important fronts: directly investing in ways that reduce poverty, and advocating for public policy investments to build (...) the assets of the poor. Corporate involvement in asset policy can be understood as a new manifestation of corporate/business citizenship. (shrink)

Economic growth requires a focus on building the assets of the poor, a strategic approach that is considerably broader than developing the poor only asconsumers and workers. The long-term sustainability of business and society will be enhanced if corporate investments that impact on poverty alleviation are far reaching, multi-faceted, and built through multi-sector partnerships. Emerging evidence indicates that corporations are increasingly involved on two important fronts: directly investing in ways that reduce poverty, and advocating for public policy investments to build (...) the assets of the poor. Corporate involvement in asset policy can be understood as a new manifestation of corporate/business citizenship. (shrink)

The neuropsychological and functional characterisation of mental state attribution (‘‘theory of mind’’ (ToM)) has been the focus of several recent studies. The literature contains opposing views on the functional specificity of ToM and on the neuroanatomical structures most relevant to ToM. Studies with brain-lesioned patients have consistently found ToM deficits associated with unilateral right hemisphere damage (RHD). Also, functional imaging performed with non-braininjured adults implicates several specific neural regions, many of which are located in the right hemisphere. The present study (...) examined the separation of ToM impairment from other deficits associated with brain injury. We tested 11 patients with unilateral right hemisphere damage (RHD) and 20 normal controls (NC) on a.. (shrink)

Everything we do in life involves a connection with information, experience and know-how: together these represent the most valuable of intangible human assets encompassing our history, cultures and wisdom. However, the more easily new technologies gather information, the more we are confronted with our limited capacity to distinguish between what is essential, important or merely ‘nice-to-have’. This article presents the case study of a multilingual Knowledge Management System, the Business enabling e-Platform that gathers and protects tacit knowledge, as the key (...) to developing structured intellectual capital, while acknowledging the urgent need here to integrate Ethics-by-design alongside AI-by-design, in view of the far-reaching consequences involved, for good or ill. It also explains how a beneficial Circular Economy of Knowledge depends on evidence-based answers, and how harmonising taxonomies, terminology and standards promotes global trust as the basis for the unhindered transfer of tacit knowledge between generations in a way that benefits everyone. (shrink)

Ellen Meiksins Wood is a leading contemporary political theorist who has elaborated an innovative approach to the history of political thought, the social history of political theory .

Der Aufsatz wendet sich Walter Benjamins Aquarell Vorführung des Wunders von Paul Klee zu, also jenem Werk, das bereits 1920 – ein Jahr vor der aquarellierten Ölfarbezeichnung des Angelus novus – in seine Sammlung gelangt. Wesentliches Element des Bildes sind die Liniengefügen, von denen sich die Figuren und der Schauplatz mitsamt schmaler Bühne absetzen. In der damaligen Kunstkritik und Ästhetik werden solche Konstruktionen aus Linien im Sinn eines Architektonischen verstanden, das heißt als ein das Bild konstituierendes Regime. Benjamin beschäftigt sich (...) mit entsprechenden Liniengebilden als Grundproblem der Malerei des Kubismus schon 1917 in Briefen an Gershom Scholem. Die dabei entstandenen Reflexionen bereiten gewissermaßen Benjamins Begegnung mit Klees Vorführung des Wunders und den sich dort zeigenden Liniengebilden vor. Die These lautet, dass Benjamin eine analoge, mittels Linie hergestellte Bildkonstruktion als Architektur begreift. Der Beitrag analysiert Benjamins Überlegungen zum Architektonischen im Verhältnis zur zeitgenössischen Kunstkritik und Ästhetik. (shrink)

The mobile internet provides new and easier ways for people to organise themselves, raise issues, take action, and interact with their city. However, lack of information or motivation often prevents citizens from regularly contributing to the common good. In this paper, we present DoGood, a mobile app that aims at motivating citizens to join civic activities in their local community. Our study asks to what extent gamification can motivate users to participate in civic activities. The term civic activity is not (...) yet well defined, so we collect activities citizens consider to be civic to work towards a broadly accepted definition of the term. The DoGood app uses gamified elements that we studied to gauge their role in encouraging citizens to submit and promote their civic activities as well as to join the activities of others. DoGood was implemented and deployed to citizens in a five-week-long user study. The app succeeded in motivating most of its users to do more civic activities, and its gamified elements were well received. (shrink)

The formation of the modern state, the rise of capitalism, the Renaissance and Reformation, the scientific revolution and the Age of Enlightenment have all been attributed to the “early modern” period. Nearly everything about its history remains controversial, but one thing is certain: it left a rich and provocative legacy of political ideas unmatched in Western history. The concepts of liberty, equality, property, human rights and revolution born in those turbulent centuries continue to shape, and to limit, political discourse today. (...) Assessing the work and background of figures such as Machiavelli, Luther, Calvin, Spinoza, the Levellers, Hobbes, Locke and Rousseau, Ellen Wood vividly explores the ideas of the canonical thinkers, not as philosophical abstractions but as passionately engaged responses to the social conflicts of their day. (shrink)

One antidote to moral distress is stronger moral agency—that is, an enhanced ability to act to bring about change. The Clinical Ethics Residency for Nurses, an educational program developed and run in two large northeastern academic medical centers with funding from the Health Resources and Services Administration, intended to strengthen nurses’ moral agency. Drawing on Improving Competencies in Clinical Ethics Consultation: An Education Guide, by the American Society for Bioethics and Humanities, and on the goals of the nursing profession, CERN (...) sought to change attitudes, increase knowledge, and develop skills to act on one's knowledge. One of the key insights the faculty members brought to the design of this program is that knowledge of clinical ethics is not enough to develop moral agency. In addition to lecture‐style classes, CERN employed a variety of methods based in adult learning theory, such as active application of ethics knowledge to patient scenarios in classroom discussion, simulation, and the clinical practicum. Overwhelmingly, the feedback from the participants (sixty‐seven over three years of the program) indicated that CERN achieved transformative learning. (shrink)

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)

Although affective facial pictures are widely used in emotion research, standardised affective stimuli sets are rather scarce, and the existing sets have several limitations. We therefore conducted a validation study of 490 pictures of human facial expressions from the Karolinska Directed Emotional Faces database (KDEF). Pictures were evaluated on emotional content and were rated on an intensity and arousal scale. Results indicate that the database contains a valid set of affective facial pictures. Hit rates, intensity, and arousal of the 20 (...) best KDEF pictures for each basic emotion are provided in an appendix. (shrink)

Traditional Chinese culture, Confucianism, in particular, has a non-individualist conception of what it is to be human. It conceives of people fundamentally as members of social groups—specifically, the family, the clan, the political community and the state—not as atomic individuals as perceived in modern society. The communist ideology since the middle of the last century also emphasizes the significance of ‘the common good’ of the state which describes a specific ‘good’ that is shared and beneficial for all (or most) members (...) of a given community. Nevertheless, marketization and decentralization in China today have significantly challenged the notion of a state-oriented community that directly impacts China's healthcare system, beginning with the dismantling of the rural collectives and state-owned enterprises as part of the reform and opening process. This article will address healthcare challenges in China today, examining the conceptual/ethical issues raised by public healthcare, and contending that public health concerns should go beyond the dichotomy between individualism and collectivism. The article will argue that the family-oriented model of Confucianism offers an alternative way to look at what constitute a community and common goods. The Confucian approach to ethics is relevant to healthcare today. For example, it will be much easier to find a shared idea of common good in terms of complicated issues like healthcare; it would make sense to give a larger role to families via family savings accounts, and not have everything determined by the government. (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)

Biological theory demands a clear organism concept, but at present biologists cannot agree on one. They know that counting particular units, and not counting others, allows them to generate explanatory and predictive descriptions of evolutionary processes. Yet they lack a unified theory telling them which units to count. In this paper, I offer a novel account of biological individuality, which reconciles conflicting definitions of ‘organism’ by interpreting them as describing alternative realisers of a common functional role, and then defines individual (...) organisms as essentially possessing some mechanisms that play this role. (shrink)

Putting the ethical tools of philosophy to work, Ellen K. Feder seeks to clarify how we should understand "the problem" of intersex. Adults often report that medical interventions they underwent as children to "correct" atypical sex anatomies caused them physical and psychological harm. Proposing a philosophical framework for the treatment of children with intersex conditions—one that acknowledges the intertwined identities of parents, children, and their doctors—Feder presents a persuasive moral argument for collective responsibility to these children and their families.