Background: Ethical sensitivity has been identified as a foundational component of ethical action. Diminished or absent ethical sensitivity can result in ethically incongruent care, which is inconsistent with the professional obligations of nursing. As such, assessing ethical sensitivity is imperative in order to design interventions to facilitate ethical practice and to ensure nurses recognize the nature and extent of professional ethical obligations. Aim: To review and critique the state of the science of nurse ethical sensitivity and (...) to synthesize findings across studies. Research design: Whittemore and Knafl’s revised framework for integrative reviews guided the analysis. Research context and data sources: A comprehensive, computer-assisted search of literature published in Cumulative Index of Nursing and Allied Health Literature and PubMed was performed. A systematic approach was used to extract, reduce, and synthesize the data. Findings: Four major conceptualizations of ethical sensitivity emerged from the literature. A sample of 25 reports met inclusion criteria, including 17 empirical reports and 8 theoretical reports. Discussion: Despite the existence of a concept analysis and a validated tool, ethical sensitivity remains a highly theoretical concept with multiple, and at times competing, conceptualizations. Ethical sensitivity has been assessed extensively in the context of ethical dilemmas; however, little attention has been paid to the way the concept operates in day-to-day practice. Conclusion: Future research should focus on better ways to operationalize and assess the concept, with particular attention to nurse awareness of the ethical content of everyday practice. (shrink)

Ethical sensitivity was introduced to caring science to describe the first component of decision making in professional practice; that is, recognizing and interpreting the ethical dimension of a care situation. It has since been conceptualized in various ways by scholars of professional disciplines. While all have agreed that ethical sensitivity is vital to practice, there has been no consensus regarding its definition, its characteristics, the conditions needed for it to occur, or the outcomes to professionals and society. The (...) purpose of this article is to explore the meaning of the concept of ethical sensitivity based on a review of the professional literature of selected disciplines. Qualitative content analysis of the many descriptors found within the literature was conducted to enhance understanding of the concept and identify its essential characteristics. Ethical sensitivity is considered to be an emerging concept with potential utility in research and practice. (shrink)

Background: Rising levels of burnout and decreasing job satisfaction can inhibit healthcare professionals from providing high-quality care due to a corresponding decrease in their ethical sensitivity. Aim: This study aimed to determine the relationship between the level of ethical sensitivity in emergency service nurses and their levels of burnout and job satisfaction. Research design: This research employed a descriptive and cross-sectional design. Participants and research context: This study was conducted with a sample of 236 nurses, all of whom (...) worked in emergency service between 24 July 2015 and 28 April 2016. Data were collected using the Moral Sensitivity Questionnaire, Maslach Burnout Inventory, and Minnesota Job Satisfaction Scale. Ethical considerations: This study was approved by the Institutional Ethics Review Board of Ondokuz Mayıs University. Findings: There was a weak and negative correlation (r = –0.158, p = 0.015) between Moral Sensitivity Questionnaire and Maslach Burnout Inventory scores. There was also a weak and negative correlation (r = –0.335, p < 0.001) between the Maslach Burnout Inventory and Minnesota Job Satisfaction Scale scores. Discussion and conclusion: Decreased job satisfaction and increased burnout levels among emergency service nurses might result in them indulging in improper practices, frequently facing ethical problems, and a decrease in the overall quality of service in hospitals. In order for emergency service nurses to recognize ethical problems and make the most accurate decisions, a high level of ethical sensitivity is critical. In this respect, it is suggested that continuing education after graduation and training programs should be organized. (shrink)

Background and aim: Surgical intensive care nurses should have ethical sensitivity allowing them to identify ethical issues in order that they can recognize them and make the right decisions. This descriptive study was conducted with the aim of evaluating the ethical sensitivity of surgical intensive care nurses. Materials and methods: The research was carried out with the participation of 160 nurses in six Turkish hospitals, four state, one university, and one private. The data were collected using the “Nurse (...) Description Form” developed by the researcher and the “Ethical Sensitivity Questionnaire.” The percent, mean, standard deviation, median, minimum and maximum values, significance test for the difference between two means, variance analysis, Mann–Whitney U test, and Kruskal–Wallis Variance Analysis test were used to evaluate the data. Ethical considerations: Ethical commission permission and the corporate permission of the hospitals were received before conducting the research. Results: It was determined that the ethical sensitivities of surgical intensive care nurses were moderate based on the Ethical Sensitivity Questionnaire total score and subdimension score averages. A statistical difference was determined between the Ethical Sensitivity Questionnaire total score of surgical intensive care nurses and the institution where they worked, the period of working in the occupation, and the period of working in the intensive care unit (p < 0.05). Conclusion: Based on the results of the research, the organization of training and studies devoted to the elimination of ethical sensitivity differences between institutions and workers is suggested. (shrink)

. This descriptive study discusses cognitive mapping as a technique for analyzing ethical sensitivity, examines whether the method allows comparisons between people, compares the ethical sensitivity levels of participants from three organizations, examines which indicators of ethical sensitivity are most salient to members of specific organizations, and examines whether education level or organizational membership is the best predictor of an individual’s ethical sensitivity level. Subjects from three organizations read background information, listened to two audiotaped scenarios containing (...) multiple ethical issues related to organizational communication, responded to focused interview questions, and completed questionnaires. The interviews were taped, transcribed, and analyzed using cognitive mapping techniques. Significant differences in levels of ethical sensitivity were found between the members of the three organizations. However, a hierarchical regression model demonstrated that the difference was likely due to the differences in level of education in each organization. Organizational membership seemed to affect the particular aspects of the scenarios that participants noticed. (shrink)

Background: High ethical sensitivity positively affects the quality of nursing care; nevertheless, Chinese nurses’ ethical sensitivity and the factors influencing it have not been described. Research objectives: The purpose of this study was to describe ethical sensitivity and to explore factors influencing it among Chinese-registered nurses, to help nursing administrators improve nurses’ ethical sensitivity, build harmony between nurses and patients, and promote the patients’ health. Research design: This was a descriptive, cross-sectional study. Participants and research context: (...) We recruited 500 nurses from several departments in three tertiary hospitals. The Chinese Moral Sensitivity Questionnaire–Revised version and the Jefferson Scale of Empathy-Health Professionals were used to assess the nurses’ ethical sensitivity and empathy ability, respectively. Fifteen sociodemographic variables were included in the questionnaires. Ethical considerations: Informed consent was obtained from the participants regarding participation and data storage and handling. This program has been examined and supported by the research center of medical ethics and professional ethics of Guilin Medical University. The Approval No. was 2016RWYB04. The whole research process is conducted strictly according to ethical requirements. Results: The valid response rate was 84.40% ( n = 422). The total score of Chinese Moral Sensitivity Questionnaire–Revised was 35.82 ± 8.17. The subscale scores of moral responsibility and strength and sense of moral burden were 21.50 ± 4.91 and 14.33 ± 3.98, respectively. Significant differences were found among age groups, gender, years of working, category of profession, and quality of family communication regarding nurses’ ethical sensitivity ( p < 0.05). Regression analysis showed that the main factors influencing nurses’ ethical sensitivity were gender, years of working, quality of family communication, career satisfaction, and empathic ability. Discussion: Our findings suggest that Chinese nurses’ ethical sensitivity in tertiary hospitals in Guilin is at a medium level. Conclusion: The director of nursing schools and hospitals in China should pay attention to nurses’ ethical sensitivity and should intensify education and training to improve nurses’ ethical sensitivity. Further studies should focus on interventions aimed at improving Chinese nurses’ ethical sensitivity. (shrink)

Background With an increasing older population, the pressure on home care resources is growing, which makes it important to ensure the maintenance of quality care. It is known that compassion and ethical sensitivity can improve the quality of care, but little is known about care leaders’ perceptions on ethical sensitivity and compassion in home care and how it is associated with staff competence and thus quality of care. Aim The aim of the study was to explore home care (...) leaders’ perceptions of ethical sensitivity and compassion associated with care quality in home care. Research design, participants, and research context A hermeneutical approach with a qualitative explorative design was used. The data consists of texts from 10 in-depth interviews with home care leaders. Content analysis was used as a method. Ethical considerations The study was conducted following the ethical guidelines of the Declaration of Helsinki and the Finnish Advisory Board of Research Ethics. Research ethics permission was applied for from a Research Ethics Board. Findings One overall theme and four subthemes were found. The overall theme was: “Compassion provides deeper meaning and ethical sensitivity provides means for knowing how to act”. Discussion If nurses fail to be sensitive and compassionate with patients, good and high qualitative home care cannot be achieved. Ethical sensitivity and compassion can be seen as resources in home care but the organization and the care leaders need to provide the support for these to develop. Conclusion This study provides an understanding of the meaning of ethical sensitivity and compassion as sources of strength and their link to quality of care in a home care context. Further studies could focus on how to build compassion and ethical sensitivity into home-based care and how to ensure adequate support for healthcare professionals’ compassion and ethical sensitivity. (shrink)

Ethical sensitivity is a precursor to mora1 judgment in that a person must recognize the existence of an ethical problem before such a problem can be resolved. It is an important concept, yet it has received little attention from ethics scholars. This preliminary and exploratory study indicates that ethical sensitivity can be identified in viewers' reactions to and evaluations of ethically controversial television news stories, that diferent levels of ethical sensitivity are evident in discussions of television (...) news stories, and that there are at least 3 dimensions by which ethnic sensitivity may be evaluated: time, breadth, and depth. (shrink)

Background: In research on co-creation in nursing, a caring manner can be used to create opportunities whereby the patient’s quality of life can be increased in palliative home care. This can be described as an ethical cornerstone and the goal of palliative care. To promote quality of life, nurses must be sensitive to patients’ and their relatives’ needs in care encounters. Co-creation can be defined as the joint creation of vital goals for patients through the process of shared knowledge between (...) nurses, patients and their relatives. Aim: The aim of this study was to explore nurses’ experiences of caring encounters and co-creation in palliative home care from an ethical perspective. Research design, participants, and research context: A hermeneutical approach was used. The material consisted of texts from interviews with 12 nurses in a home care context. The method was inspired by thematic analysis. Ethical considerations: Informed consent was sought from the participants regarding study participation and the storage and handling of data for research purposes. Findings: An overall theme, a main theme and four sub-themes emerged. Through ethical sensitivity and perceptivity, nurses can balance their actions in the moment and change their nursing care actions according to the patient’s wishes through co-creation in encounters. Here the time is crucial, as the time needed is unique to each patient. Discussion: The themes together can be considered prerequisites for good palliative home care. If nurses fail to be sensitive and perceptive in encounters with dying patients, good palliative home care cannot be achieved. Ethical sensitivity and perceptiveness can also be considered a part of nurses’ ethical competence. Conclusion: Patients’ dignity can be preserved through ethical sensitivity and perceptiveness, which is fundamental for good palliative care. Co-creation from patients’ perspectives should be the focus of future research. (shrink)

In this study we tried to gain information about the ethical sensitivity (as well as the ethical knowledge) of nurses working at the bedside in our country. Four scenarios were presented to 165 nurses working in hospital wards in Kocaeli. More than half of the nurses can be considered to have made decisions based on beneficence for the first scenario, while more than half of them preferred to make decisions based on autonomy for the second and the fourth scenarios. (...) For the third scenario, most of the nurses (76.4%) can be said to have based their decisions on veracity. These results suggest that these nurses were sensitive to issues of confidentiality, truth telling and beneficence; however, they were not equally sensitive when the right to refuse treatment was concerned. (shrink)

This article is an attempt to develop a measure of ethical sensitivity to racial and gender intolerance that occurs in schools. Acts of intolerance that indicate ethically insensitive behaviors in American schools were identified and tied to existing professional ethical codes developed by school-based professional organizations. The Racial Ethical Sensitivity Test consists of 5 scenarios that portray acts of racial intolerance and ethical insensitivity. Participants viewed 2 videotaped scenarios and then responded to a semistructured interview protocol adapted from (...) Bebeau and Rest. After a 2-week interval, this procedure was repeated. Stability of the REST across time was determined by using the overall test-retest coefficient. Internal as well as interrater consistency was also calculated for each scenario. Overall findings indicate promise for the REST as a reliable measure to assess racial and ethnic sensitivity. (shrink)

For many years questions have been posed about the way ethics is taught in accounting education. The teaching of ethics is often criticized for emphasizing the legal dimension to the detriment of the moral one, among other reasons. This case study focuses on an accounting course intended to develop and stimulate students’ critical thinking on accounting and its role in daily life. The investigation is based on an empirical study that took place in the 2015–2016 academic year, when (...) the first author undertook non-participant observation and examined the final term assignment (a short essay) of the great majority of the 120 students enrolled in this course. One of the course’s main features was to expose the students to critical thinking, through analyses and discussions of the roles of accounting and accountants in organizations and society—using research articles as a backdrop to stimulate analysis and discussion. Our investigation suggests that the course is able to sensitize students to professional ethics and responsibilities. Our argument, broadly supported by an empirical case analysis, is that a course centered on a dialogical approach and critical thinking on the role of accounting and accountants in society may impact the development of ethical sensitivity in future accounting practitioners. (shrink)

Measures of student ethical sensitivity and their increases help to answer questions such as whether accounting ethics should be taught at all. We investigate different sensitivity measures and alternatives to the well-established Defining Issues Test (DIT-2, Rest, J. R. et al. [1999, Postconventional Moral Thinking: A Neo-Kohlbergian Approach (Lawrence Erlbaum Associates, Mahwah, NJ]), frequently used to measure the effects of undergraduate accounting ethics education. Because the DIT measures cognitive development, which increases with age, the DIT scores (...) for younger accounting students are typically lower, have limited range, and are not likely to vary sufficiently with corresponding choices in ethical dilemmas. Since the DIT measures only the moral judgment component of ethical decision-making, we consider the multidimensional ethical scale (MES) to allow respondents to provide explanations for their moral and other judgments. The MES has been used to measure attitudes related to justice, utility, contractualism, egoism, and relativism. Unfortunately, the MES is not comparable in one-dimension to the DIT, and unlike the DIT, the MES has no theoretical or objective base. Therefore, we construct a comparable one-dimensional relative measure, a Composite MES Score, obtained from previous research on practicing accountants. We compare the reliability of this measure to the DIT in explaining the ethical choices of 54 specially chosen, somewhat homogeneous students, whose ages range from 18 to 19, and who are taking a second semester freshman accounting course at a private, religion-affiliated university. These particular students are relatively untrained in the formal use of questionable accounting choices. These students are less likely to recognize the dilemmas of the MES and are also less likely to demonstrate sufficient variation in their DIT scores, traditionally low for freshmen students. As freshmen, they are recent graduates of high school and more likely guided by other ethical influences including friends, family, or contractual obligations (some of the MES constructs) rather than higher cognitive development. This study confirms suspicions. We find the DIT scores do not vary sufficiently to explain the moral reasoning of freshmen. For eight dilemmas and 24 choices we find the DIT score correlates with only three choices, whereas the MES regression models have at least one significant construct for 23 out of 24 ethical choices. The Composite MES Score (a relative measure) also explains 23 out of 24 choices and is statistically related to the DIT in only one of the choices. Unlike the DIT, the Composite MES permits pretest and retesting with different dilemmas to evaluate changes in ethical sensitivity. These results argue for relative rather than absolute measures of sensitivity and guides beyond cognitive development (the DIT-score) to explain undergraduate student sensitivity. (shrink)

BackgroundRapid advances in medical technology, changing healthcare policies, and increasing patient diversity have exacerbated the ethical challenges. As nursing students are an integral part of the future nursing workforce, ethical sensitivity has a critical impact on their future careers.PurposeThis study aims to promote research in related fields by systematically reviewing the origin and development of the concept of ethical sensitivity in nursing students, comparing currently available tools for assessing ethical sensitivity in nursing students, and exploring their applicability (...) and reliability.MethodsA literature review method was used in this study. A literature search was conducted for assessment tools published between 1995 and 2024. A total of six articles focusing on assessment tools they developed to measure ethical or moral sensitivity were included and analyzed.ResultsOur analysis revealed significant variations in the reliability and applicability of these assessment tools, particularly when used in diverse cultural settings. The study also identified a need for localized modifications of these tools to ensure their accuracy and relevance in different regions.ConclusionThe findings provide valuable guidance for nursing educators in selecting appropriate assessment tools and offer a foundation for developing new tools that are more contextually relevant. This study contributes to the advancement of ethical sensitivity education for nursing students worldwide, ultimately enhancing patient care and professional development. (shrink)

Many commentators call for a more ethical approach to planning for influenza pandemics. In the developed world, some pandemic preparedness plans have already been examined from an ethical viewpoint. This paper assesses the attention given to ethics issues by the Ghana National Integrated Strategic Plan for Pandemic Influenza.

The economic globalization process has integrated different competitive markets and pushes firms in different countries to improve their managerial and operational efficiencies. Given the recent empirical evidence for the benefits to firms and stakeholders of good corporate governance (CG) practice, it is expected that good CG practice would be a common strategy for firms in different countries to meet the increasingly intense competition; however, this is not the case. This study examines the differences in CG practices in firms across different (...) countries using the concept of ethical sensitivity. Through the regression analysis of 271 firms in 12 countries and regions, it is found that Hofstede’s cultural dimensions can explain the differences in CG practices. Furthermore, the results demonstrate the influence of culture on ethical sensitivity, which eventually determines the CG practices in different regions. (shrink)

Background: An overview of ethical sensitivity among Chinese registered nurses is needed to develop and optimize the education programs and interventions to cultivate and improve ethical sensitivity. Aim: The study was conducted to explore the barriers to and facilitators of ethical sensitivity among Chinese registered nurses working in hospital settings. Research design: A convergent parallel mixed-methods research design was adopted. Participants and research context: In the cross-sectional quantitative study, the Chinese Moral Sensitivity Questionnaire–revised version was used (...) to assess the levels of ethical sensitivity among registered nurses, and the scores were correlated with key demographics, training experiences in ethics, and workplace cultural environments ( n = 306). In the qualitative study, semi-structured interviews were used to elicit the nurses’ perceptions of the barriers and facilitators in nurturing ethical sensitivity ( n = 15). The data were collected from February to June 2014. Ethical considerations: This study was approved by the Institutional Review Boards of Yale University and Central South University. Results: Despite moderately high overall Chinese Moral Sensitivity Questionnaire–revised version scores, the ethical sensitivity among Chinese nurses lags in practice. Barriers to ethical sensitivity include the lack of knowledge related to ethics, lack of working experience as a nurse, the hierarchical organizational climate, and the conformist working attitude. The positive workplace cultural environments and application of ethical knowledge in practice were considered potential facilitators of ethical sensitivity. Discussion: The findings of this study were compared with studies from other countries to examine the barriers and facilitators of ethical sensitivity in Chinese nurses. Conclusion: This mixed-methods study showed that even though the Chinese nurses have moderately high sensitivity to the ethical issues encountered in hospitals, there is still room for improvement. The barriers to and facilitators of ethical sensitivity identified here offer new and important strategies to support and enhance the nurses’ sensitivity to ethical issues. (shrink)

Prior researchers have studied individual components of a theoretical decision-making model. This paper presents the results of a more complete study of the model components and presents limited support of theory. The study examines the relative importance of regulatory, organizational, and personal constructs on an individual''s ethical sensitivity. Auditors from the major international accounting firms, located in two southeastern cities, are surveyed. Structural equation modeling is used to allow for the simultaneous evaluation of the three constructs of interest. The (...) results indicate that the regulatory and organizational constructs are negatively correlated with the personal experience construct. The three constructs are not significant causal factors on ethical sensitivity. This result may be due to the manner in which ethical sensitivity is typically measured or may indicate that the complexity of the ethical decision-making process is not fully captured in the theoretical models. Thus, the models suggested in the prior literature and the results presented in prior studies of the individual components may need to be reconsidered. (shrink)

As a preliminary step to beginning to assess the usefulness of clinical vignettes to measure ethical sensitivity in undergraduate medical students, five clinical vignettes with seven to nine ethical issues each were created. The ethical issues in the vignettes were discussed and outlined by an expert panel. One randomly selected vignette was presented to first, second and third year students at the University of Toronto as part of another examination. The students were asked to list the issues presented by (...) the patient problem. Responses from 281 students were obtained. These students identified an average of 2.72 ethical issues per vignette. Each response was classified under the domains of autonomy, beneficence and justice. Comparisons were made between classes and between vignettes. There was considerable variation between classes and the responses to different vignettes seem to indicate that different vignettes measure the various domains in different ways. It does appear that the use of vignettes is one way to measure aspects of ethical sensitivity in medical students but more study is required to clarify exactly what is being measured. (shrink)

This research is motivated by the criticism levelled at the academic community for its failure to incorporate sufficient ethics education into the accounting curriculum :53–71, 2004; Madison and Schmidt 2006). The inclusion of ethics decision-making frameworks by professional bodies in their codes of conduct or as a standalone tool and the encouragement of their use as a part of ethics education to help students to identify and think through ethical issues in a business context has been subject (...) to very limited research to date. The aim of this study is to provide evidence of the impact of providing a framework on its own and providing a framework as part of a comprehensive integrated ethics education component of a first-year unit of study, on accounting students’ ethical sensitivity and judgment. Results indicate that providing students with a framework only does not increase students’ ethical sensitivity but does support their ethical judgment. In contrast, the integrated ethics component does increase student’s ethical sensitivity, however, an unexpected finding of this study is that increases in students’ ethical judgement are greater if they have not been previously exposed to the framework. Taken together, our findings suggest that it is the framework that has a significant impact on students’ ethical judgment, while an integrated ethics education can expose students to a range of ethical issues and thereby improve their ethical sensitivity, a critical component which initiates the ethical decision-making process. (shrink)

In order to maximize human performance, defence forces continue to explore, develop, and apply human performance enhancement (HPE) methods, ranging from pharmaceuticals to (bio)technological enhancement. This raises ethical, legal, and societal concerns and requires organizing a careful reflection and deliberation process, with relevant stakeholders. We discuss a range of ethical, legal, and societal aspects (ELSA), which people involved in the development and deployment of HPE can use for such reflection and deliberation. A realistic military scenario with proposed HPE application can (...) serve as a starting point for such an iterative and participatory process. Stakeholders can discuss this application, modify its features, and design appropriate processes around it – for instance, procedures for informed consent. We propose that organizing aspects into these three categories – ethical, legal, and societal – can help involve appropriate interlocutors at different moments: legal aspects with people in strategy or management roles, from the start of a project; ethical aspects with people in operations and medical roles, during development; and societal aspects with people in communication and personnel roles, during deployment. Notably, we developed and discussed this framework and the three aspects in close collaboration with personnel from the military. (shrink)

Background Nurses frequently experience ethical issues in their area of practice. In the challenging reality of today’s healthcare environment, nursing students need to be prepared to deal with ethical issues in their future roles. Nevertheless, Chinese nursing students’ ethical sensitivity status and the factors influencing it have not been described. Objective This study aims to explore the level of ethical sensitivity and its influencing factors among Chinese nursing students. Research design This was a cross-sectional study. We firstly cross-culturally (...) adapted the Japanese version of the Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) into a Chinese version. Then, we administered the Chinese version of ESQ-NS, the Caring Ability Inventory (CAI), and general information questionnaire to nursing undergraduates. Participants and research context The invitations were sent to 600 nursing undergraduates from four universities in Hunan, China. Ethical considerations The study was supported by the Institutional Review Board (IRB) of the lead university. The Approval No. was E202092. Results A total of 489 undergraduate nursing students participated in the study. The mean score for ethical sensitivity of the samples was 36.34 ± 4.90, and 187.99 ± 22.64 for their humanistic care ability. Pearson’s correlation coefficient test indicated a meaningful and positive relationship between the ethical sensitivity and humanistic care ability (r = 0.576 and p <.01). And regression analysis showed that age, school year, experience in studying nursing ethics, how much you like nursing major, and humanistic care ability were of relevance to nursing students' ethical sensitivity. Discussion Our findings suggest that the mean ethical sensitivity score of Chinese nursing students is 36.34 (13–52). The humanistic caring ability of Chinese nursing students is still at a low level. Conclusion Future interventions for improving the ethical sensitivity of the nursing students should consider general information of participants and their humanistic care ability. (shrink)

Background: It is stated that high ethical sensitivity positively affects the quality of nursing care. However, the relationship between nursing care quality and ethical sensitivity has not been clearly demonstrated in researches. Aim: This study was carried out to determine the relationship between surgical nurses’ care behaviors and their ethical sensitivity. Method: The sample of this cross-sectional, descriptive-correlational study consists of 308 nurses who worked at the surgical departments in four Turkish hospitals. The data were collected using (...) the “Nurse Description Form” developed by the researcher, “Caring Behaviours Inventory-24” and “Ethical Sensitivity Questionnaire.” Data were evaluated by the Mann Whitney U test, Kruskal Wallis one-way analysis of variance and Spearman correlation analysis. Ethical considerations: The study was approved by the ethics committee. Verbal and written consent was received from the nurses. Results: It was found in the study that nurses’ Caring Behaviours Inventory-24 total score median was 5.25 (4.83–5.58), nurses’ perception level of caring quality was high, median of Ethical Sensitivity Questionnaire total score was 89.00 (75.00–101.00) and nurses’ ethical sensitivity was moderate. A negative significant relation was found between nurses’ Caring Behaviours Inventory-24 total score and Ethical Sensitivity Questionnaire total score (r = -0.162; p = 0.009). A negative relation was also detected between nurses’ working period at the current clinic and providing benefit (r = -0.147; p = 0.012), holistic approach (r = -0.139; p = 0.018) and orientation (r = -0.175; p = 0.003) scores of Ethical Sensitivity Questionnaire sub-scales. Conclusion: Nurses’ perception levels of caring quality were high and their ethical sensitivity levels were moderate. It was found out that nurses’ ethical sensitivity increased together with their perception of caring quality, and as their working period at the current clinic increased, the ethical sensitivity also increased in terms of the sub-scales of providing benefit, holistic approach, and orientation. The factors that adversely affect the quality of nursing care and ethical sensitivity should be examined and attempts should be made to improve the working environment. (shrink)

A key goal for a professional ethics teacher is to help students improve their moral reasoning within the context of their profession, with the ultimate aim of developing a commitment to the values of their future profession. Using Rest’s Four Component Model as a framework, this study examines the relationship between the first two components of moral sensitivity and moral judgment. The study utilises two scores from the same cohort of computing undergraduates: a score for ethical sensitivity (...) using a devised dilemma analysis; and a score for change in moral judgment resulting from an educational intervention, using the Defining Issues Test (DIT). Although average DIT scores showed no significant improvement in moral judgment, this study found that levels of ethical sensitivity had a significant impact on the development of moral judgment. The paper provides evidence that ethical sensitivity appears to play a key role in the development of moral judgment. Therefore an initial key objective critical to any ethics course should be to raise student levels of ethical sensitivity as a necessary foundation for development of moral judgment. The paper also highlights the wide range of levels of ethical sensitivity measured within one cohort and suggests targeted learning support should be provided to students who score in the lower part of the scale to raise their levels of moral sensitivity early in the course. (shrink)

In order to prepare bioethics and clinical ethics courses for clinicians in Turkey, we needed to know the attitudes of physicians when placed in ethically difficult care situations. We presented four cases to 207 physicians who are members of the Physicians’ Association in Kocaeli, Turkey. Depending on the decisions they made in each case, we determined whether they were aware of the ethical aspects of the cases and the principles they chose as a basis for their decisions. We aimed (...) to gain information about their ethical tendencies and moral sensitivity. A small number of physicians stated that they would ‘show respect for a patient’s living will’ in the first case, but more stated that they would ‘let the patient refuse the treatment’ in the second. In the third case, where medical confidentiality was the significant ethical issue, most of the physicians said that they would act in order to maintain confidentiality. For the last case, more than half the physicians chose to ‘tell the truth’ to the patient. The paternalism shown in the doctors’ decisions on the first two cases was no longer observed in those made for the last two cases. We concluded that the physicians who participated in our study have low sensitivity to living wills (or advance directives) and patients refusing treatment. However, when issues of medical confidentiality and truth-telling are concerned, they take care to protect the autonomy of the individual and are relatively more aware of the ethical aspects of these cases. (shrink)

This study was carried out to determine the ethical sensitivity levels of students enrolled in the nursing faculty. The sample of the descriptive study consisted of 594 students who were taught at the Faculty of Nursing in February - May 2018 and agreed to participate in the study. The data were collected by Personal Information Form prepared by researchers to evaluate the demographic characteristics of students and The Modified Moral Sensitivity Questionnaire for Student Nurses. The data obtained from (...) the application were analyzed using SPSS for Windows 23.0 program. The majority of the students (75.9%) participating in the study were women and 74.9% stated that they internalized the profession. The total score average of The Modified Moral Sensitivity Questionnaire for Student Nurses is 4.93 ± 0.49. While the lowest average score in all classes is “Experiencing Ethical Dilemma” sub-dimension, the highest average score is in the “Interpersonal Orientation” sub-dimension. It is the 3 rd year student with the highest average score received from the scale. It was determined that the ethical sensitivity of the nursing students was medium and there was a significant difference between the ethical sensitivity levels of the students between the classes. It is thought that ensuring the continuity of the ethical education of the nursing students will be effective in increasing the awareness of the students on the subject. For this reason, it is recommended to integrate ethical issues in all courses in the structuring of nursing education curriculum programs. (shrink)

ABSTRACT All ethical systems seem to call for more ethical sensitivity. The dangers to personal life of too much ethical sensitivity have received much attention lately, in attempts to limit the demands of morality. But the ethical dangers of ethical sensitivity have hardly been noticed. I argue that, in a number of different ways, too much ethical sensitivity can be ethically harmful. The normative, the psychological and the pragmatic pictures are for more complex than is commonly (...) realised. (shrink)

Ethical sensitivity triggers the entire ethical decision-making process (i.e., recognition of ethical content in work situations). In this article, five factors are examined that affect tax practitioners' professional ethical sensitivity. The five factors that were examined include role conflict, role ambiguity, job satisfaction, professional commitment, and ethical orientation. Ethical content in work situations is examined in relation to professional ethics as enumerated by the American Institute of Certified Public Accountant's (AICPA) Statements on Responsibilities in Tax Practice (SRTP). (...) Utilizing Hunt and Vitell's (1986, 1993) General Theory of Ethics, a model of ethical sensitivity was constructed and empirically tested. Role conflict negatively and job satisfaction positively influenced tax practitioners' ethical sensitivity. Also, the covariates of the tax practitioner's professional risk level and type of employer were found to be significant. The significant factors are job specific. The tax firm may have the best opportunity to positively change a tax practitioner's ethical recognition abilities. Professional accounting organizations may need to evaluate if resources should be used to formulate, maintain, and publicize codes of conduct because of the lack of significance of professional commitment. (shrink)

This paper highlights the potential harms in the current state of business ethics education and presents an alternative new model of business ethics education. Such potential harms in business ethics education is due largely to restricted cognitive level of reasoning, a limited level of ethical conduct which remains only responsive and adaptive, and the estrangement between strategic thinking and ethical thinking. As a remedy for business ethics education, denatured by these potential harms, a new dynamic model (...) of business ethics education is proposed. The new model is composed of a basic foundation for business ethics education and three practical components of business ethics education. The basic foundation comprises of ethical reasoning, moral sentiments, and ethical praxis. Three practical components of business ethics education are, respectively, to intensify moral imagination, to develop ethical wisdom and courage, and to enhance meta-strategic competences. The ultimate purpose of these practical components is to help moral subjects to conduct ethical leadership, to actualize integrity between individuals and organization, and to fulfill the social responsibility of business firms. This new model is expected to attract attention to the effective business ethics education both in college and in industry, and to be used as a benchmark for new curriculum designs and development of teaching methods. Finally, some teaching methodologies and pedagogical experiments are introduced and discussed according to this new model of business ethics educaiton. (shrink)

Background Ethical sensitivity is a prerequisite for ethical nursing practices. Efforts to improve nurses’ ethical sensitivity are required to correctly recognise ethical conflicts and for sound decision-making. Because an emerging infectious disease response involves complex ethical issues, it is important to understand the factors that influence public health nurses’ ethical sensitivity while caring for patients with COVID-19, an emerging infectious disease. Objectives This study aims to identify the relationship between nursing professionalism, the organisation’s ethical climate, and the (...) ethical sensitivity of nurses who care for emerging infectious disease patients in Korean public health centres. Further, it sought to identify factors influencing ethical sensitivity and the mediating effect of the organisational ethical climate to inform guidelines and improve ethical sensitivity. Research design This was a cross-sectional descriptive study. Participants and research context Data were collected from February 3 to 8 March 2021. Participants included 167 nurses caring for patients with COVID-19 in public health centres in South Korea. Ethical consideration This study was approved by the Institutional Review Board of the Chung-Ang University and followed the principles of research ethics. Results The factors influencing ethical sensitivity were working at a COVID-19 disease direct response department, nursing professionalism, and organisation’s ethical climate. The organisation’s ethical climate showed a partial mediating effect on the influence of nursing professionalism on ethical sensitivity. Conclusion Our findings show that nurses’ ethical sensitivity can be improved by refining the organisation’s ethical climate and nursing professionalism. (shrink)

When a member of an organization has to make a decision or act in a way that may benefit some stakeholders at the expense of others, ethical dilemmas may arise. This paper examines ethical sensitivity regarding the duties to clients and owners (principals), employees (agents), and responsibilities to society (third parties). Within this framework, ethical perceptions of male and female managers are compared between the U.S. and Turkey – two countries that differ on power distance as well as the (...) individualism/collectivism dimensions. Our results show that ethical sensitivity varies depending upon whether the interests of principals, agents, or third parties are affected by a given ethical dilemma. We also find that, contingent upon the principal-agent–society relationships, the nationality and gender of the decision-maker influences ethical sensitivity. (shrink)

Noninvasive prenatal screening using cell-free DNA, which analyzes placental DNA circulating in maternal blood to provide information about fetal chromosomal disorders early in pregnancy and without risk to the fetus, has been hailed as a potential “paradigm shift” in prenatal genetic screening. Commercial provision of cell-free DNA screening has contributed to a rapid expansion of the tests included in the screening panels. The tests can include screening for sex chromosome anomalies, rare subchromosomal microdeletions and aneuploidies, and most recently, the entire (...) fetal genome. The benefits of this screening tool are generally framed, by both providers and commercial laboratories, as enhancing reproductive autonomy and choice by providing an earlier, simpler, and more accurate screening while potentially reducing the need for invasive follow-up testing. The majority of the literature has explored these issues empirically or conceptually from a European or North American vantage point, one that assumes normative priorities such as individual reproductive autonomy and the clinical availability of maternal health care or prenatal screening programs within which cell-free DNA screening is offered. While its implementation has raised both challenges and opportunities, very little is known about real-world experiences and the implications of the rapid introduction of cell-free DNA screening outside of North America and Europe, especially in low- and middle-income countries. To begin addressing this gap in knowledge, we organized a four-day international workshop to explore the ethical, legal, social, economic, clinical, and practical implications of the global expansion of cell-free DNA screening. We describe eight key insights that arose from the workshop. (shrink)

There are currently no instruments available to measure ethical sensitivity in the therapeutic sciences. This study therefore aimed to develop and implement a measure of ethical sensitivity that would be applicable to four therapeutic professions, namely audiology, occupational therapy, physiotherapy, and speech-language pathology. The study followed a two-phase, sequential exploratory mixed-methods design. Phase One, the qualitative development phase, employed six stages and focused on developing an instrument based on a systematic review: an analysis of professional ethical codes, focus (...) group discussions, in-depth interviews, a review of public complaints websites, and an expert panel review. The development phase culminated in the Measuring Instrument for Ethical Sensitivity in the Therapeutic Sciences (MIEST), a pen-and-paper measure for studying ethical sensitivity in the therapeutic sciences.Phase Two, the quantitative stage, focused on implementing the MIEST in two different stages. A total of 100 participants completed the instrument. MIEST scores were found to be comparable for all four professions, which confirmed the multidisciplinary usability of the instrument. Participants tended to base decisions on the ethical principle of beneficence. The MIEST is effective to assess and describe the ethical sensitivity of professionals in the four specified therapeutic sciences. The constructed vignettes also make the MIEST appropriate for use in problem-based learning programs. (shrink)

This article explores the ethics sensitivity and awareness of a sample of employees in six organizations in Kuwait. We identify which sorts of questionable organizational behaviors are believed to be most unethical by these employees, as well as which behaviors are reported to occur most often within the organizations. On the whole, the employees evidence a high level of ethical sensitivity, perceiving the moral hazards of all of the behaviors presented to them. At the same time, the (...) reported occurrence of these behaviors within the sampled organizations is relatively high. We produce conclusions about the correspondence between moral theory and moral practice within the Kuwaiti workplace. We find a basic correspondence between what is believed to be wrong within these organizations, and the types of unethical behavior reported within them. In general, behaviors thought to be most unethical occur less frequently within the organizations. (shrink)

Background Intensive and critical care nurses need to demonstrate ethical sensitivity especially in recognizing and dealing with ethical dilemmas particularly as they often care for patients living with life-threatening conditions. Theories suggest that there is a convergence between nurses’ empathy and ethical sensitivity. Evidence in the literature indicates that nurses’ emotional, demographic, and work characteristics are associated with their level of empathy and ethical sensitivity. Aim To investigate the relationship between nurses’ empathy and ethical sensitivity, considering (...) their emotional states (depression, anxiety, and stress), demographic and work characteristics, and test an empirical model describing potential predictors of empathy (as a mediator) and ethical sensitivity using path analysis. Research design Using a cross-sectional design, the philosophical theory of care ethics and empathy was extended and adopted as a conceptual framework for this study and tested by path analysis. Participants and research context Data were collected from 347 intensive care nurses recruited by ten educational-medical hospitals in Iran using a questionnaire between February and March 2021. Ethical considerations The study was reviewed by the Ethical Advisory Board in Iran and conducted according to the Declaration of Helsinki. Findings Study participants demonstrated a mild level of stress, anxiety, and depression, alongside a relatively high level of empathy and ethical sensitivity. Nurses with good socioeconomic status had higher empathetic behavior with patients than those with weak status. Nurses aged over 40 who had received ethics training and had higher work experience were associated with higher ethical sensitivity compared to nurses under 20 years of age. Empathy directly affected ethical sensitivity; however, anxiety had an indirect effect on ethical sensitivity through empathy. Among demographic factors, age had a positive direct effect on ethical sensitivity. Conclusions Less anxiety and a high level of empathy contribute to higher levels of ethical sensitivity among intensive and critical care nurses. (shrink)

An instrument to assess 'ethical sensitivity' has been developed. The instrument presents four clinical vignettes and the respondent is asked to list the ethical issues related to each vignette. The responses are classified, post hoc, into the domains of autonomy, beneficence and justice. This instrument was used in 1990 to assess the ethical sensitivity of students in all four medical classes at the University of Toronto. Ethical sensitivity, as measured by this instrument, is not related to age (...) or grade-point average. Sensitivity increases between the 1st and 2nd year and then decreases throughout the rest of undergraduate medical training, such that the 4th-year students identify fewer issues than those entering medical school. Students expressing a career choice of family medicine identify more issues than their peers. Several problems with the use of the instrument and the interpretation of the data were found. Nonetheless, these findings, if reproducible, are important and their meaning needs further discussion. (shrink)

The nursing literature emphasizes that there are still inadequacies, differences, and inconsistencies in the definition of nurses' advocacy role, and that nursing education plays an important role in educating nurses for patient advocacy. The aim of the present study is to determine the effects of advocacy education onsocial justice advocacy and ethical sensitivity. Pre-test, post-test, parallel group, randomized controlled study. The study was carried out on 80 undergraduate nursing students in Turkey. Students was divided into experimental (40) and control (...) (40) groups. Experimental group received advocacy education cirruculum. Both groups were applied as Socio-Demographic Characteristics, as pre- test and post-tests Social Justice Advocacy Scale, and Moral Sensitivity Questionnaire. The data were statistically evaluated with, the chi-square test, Two-Way Anova. The study was approved by Selcuk University Faculty of Health Sciences Non-Interventional Clinical Research Ethics Committee (09.25.2019/1218). Written informed consent was obtained from all participants. The pre-test score of the intervention group and that of the control group were similar(p > 0.05). The study group's post-test score was significantly higher than its pre-test score and the post-test score of the control group “social justice advocacy skills” and “moral sensitivity Questionnaire.” In two-way analysis of variance in repeated measures, there was a significant main effect of the type of groups. The two-way ANOVA results in repeated measures showed that group-time interaction was significant. The advocacy education cirruculum the experimental group increased in the social justice advocacy knowledge, attitude and skills and moral sensitivity. The advocacy education cirruculum the experimental group increased the social justice advocacy skills and moral sensitivity. The Advocacy education cirruculum can be suggested to be integrated into the undergraduate nursing curriculum. (shrink)

Background To determine whether fetal care paediatric and maternal–fetal medicine specialists harbour differing attitudes about pregnancy termination for congenital fetal conditions, their perceived responsibilities to pregnant women and fetuses, and the fetus as a patient and whether self-perceived primary responsibilities to fetuses and women and views about the fetus as a patient are associated with attitudes about clinical care.Methods Mail survey of 434 MFM and FCP specialists .Results MFMs were more likely than FCPs to disagree with these statements : ‘the (...) presence of a fetal abnormality is not an appropriate reason for a couple to consider pregnancy termination’ ; ‘the effects that a child born with disabilities might have on marital and family relationships is not an appropriate reason for a couple to consider pregnancy termination’ ; and ‘the cost of healthcare for the future child is not an appropriate reason for a couple to consider pregnancy termination’ . 65% MFMs versus 47% FCPs disagreed that their professional responsibility is to focus primarily on fetal well-being . Specialists did not differ regarding the fetus as a separate patient. Responses about self-perceived responsibility to focus on fetal well-being were associated with clinical practice attitudes.Conclusions Independent of demographic and sociopolitical characteristics, FCPs and MFMs possess divergent ethical sensitivities regarding pregnancy termination, pregnant women and fetuses, which may influence clinical care. (shrink)

Background Caring practice begins with awareness of the suffering of patients in a given context. Understanding the interrelationship between the perceived ethical climate of the clinical environment and the ethical sensitivity and caring efficacy of nurses is crucial for strengthening the caring competency of nurses. Research aim This study aimed to examine the associations between the ethical climate of the clinical environment and the ethical sensitivity and caring efficacy of nurses and to investigate the mediating effect of ethical (...) sensitivity on the association between ethical climate and caring efficacy. Research design This was a quantitative study with a cross-sectional descriptive correlational design. The participants completed an online survey that measured the ethical climate, ethical sensitivity and caring efficacy using the Hospital Ethical Climate Survey, Moral Sensitivity Questionnaire-Revised and Caring Efficacy Scale, respectively. Participants and research context The study recruited 293 nurses from two general hospitals that provided acute in-patient and extended care in Hong Kong. Ethical considerations Ethical approval was obtained from the ethics committee of the university and the hospitals involved. Written consent was obtained from the participants. Results Ethical climate was associated with caring efficacy ( β = 0.340, p <.001) and ethical sensitivity ( β = 0.197, p <.001). After adjusting for ethical climate, ethical sensitivity was associated with caring efficacy ( β = 0.860, p <.001). Ethical sensitivity showed a significant mediating effect on the association between ethical climate and caring efficacy (indirect effect = 0.169, 95% confidence interval: 0.097 to 0.261), which accounted for 50% of the total effect. Conclusions The study reveals the complex and interwoven relationship between contextual and personal factors that affect nurses’ caring efficacy from an ethical perspective. It provides insights into the significant roles of ethical climate and ethical sensitivity in strengthening caring efficacy. The results suggest theoretical and clinical implications for professionalisation. (shrink)

This article describes the development of a computerized version of a measure of ethical sensitivity to racial and gender intolerance, the Racial Ethical Sensitivity Test. The REST was based on James Rest's 4-component model of moral development and the professional codes of ethics from school-based professions. The new version, Racial and Ethical Sensitivity Test-Compact Disk, consists of 5 videotaped scenarios followed by an interactive "interview" presented on compact discs. Data from a study with 58 students provides (...) initial validation of the REST-CD. Ethical sensitivity to racial and gender intolerance in schools, as measured by the REST-CD, was moderately related to attitudes toward racial and gender equity issues in society as measured by the Quick Discrimination Index. The results provide evidence for both interrater and internal reliability of the REST-CD scores. This study also tests the hypothesized relationship between REST-CD scores and previous multicultural and ethics course work. Students with multicultural and ethics course experience have scored significantly higher on the REST-CD than students without course work. The paper-and-pencil tests are not significantly related to previous ethics/multicultural course work. In this article, we discuss the implications of the results and directions for future research. (shrink)

Background: In the midst of the Covid-19 pandemic, healthcare workers increasingly encounter serious ethical issues that negatively affect their professionalism. Purpose: The study aims to examine the ethical sensitivity levels of physicians and nurses working in surgical units during the Covid-19 pandemic and the associating factors. Method: The sample of this cross-sectional online questionnaire–based study consists of 161 healthcare workers working at the surgical units in Turkish hospitals. The data were collected using the “Nurse Descriptive Information Form” developed by (...) the researchers and the “Ethical Sensitivity Questionnaire.” Ethical considerations: Approval was granted by the ethics committee. Verbal and written consent was received from the healthcare workers. Results: Ethical sensitivity in the dimension of conflict was found to be higher in healthcare workers who had ethical issues during the Covid-19 pandemic, who were married, who were nurses, who worked more than 45 h, and who had a work experience of 7–10 years (p < 0.05). Healthcare workers with a family member diagnosed with Covid-19 had high ethical sensitivity in the dimension of conflict (p = 0.008), while those who reported being fully competent and ready (p = 0.038) about Covid-19 were found to have low ethical sensitivity. Besides, those who experienced inadequate supplies (p = 0.045), long working hours (p = 0.038), and problems in asepsis–sterilization (p = 0.046) during the Covid-19 pandemic were found to have low sensitivity in the holistic approach dimension. Conclusion: The study revealed that ethical issues during the Covid-19 pandemic, sociodemographic characteristics, knowledge-skills about Covid-19, and the problems encountered in the work environment during the pandemic affect the ethical sensitivity of healthcare workers in the dimensions of conflict and holistic approach. Therefore, it is recommended that governments and all healthcare workers, and stakeholders in the health system in our country and other countries take action to promote ethical sensitivity in response to the rapidly increasing epidemic by considering the factors that adversely affect ethical sensitivity. (shrink)

Business ethics has become a very important concern in global business and understanding the effects of various factors on ethical judgments continues to attract research and practitioner attention. Using the Multidimensional Ethics Scale with its five generally accepted philosophical constructs, and vignettes developed by Cohen et al., current study investigates the relationship between cultural values, personality, religiosity and the ethical sensitivity of business students. We focus on a rapidly emerging country, Turkey, whose economic environment is similar to (...) that of the most Western nations but with a significantly different background and cultural values. Data for the study is collected from a major university in the southeastern Turkey. Although some significant relationships are identified between ethical sensitivity and cultural values and personality, our study findings confirm that MES dimensions had the highest influence on ethical sensitivity levels of business students. (shrink)