This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Second, we expand on the discussion in the original paper of the role and significance of the concept of (...) ‘integrating’ empirical methods and ethical argument as a standard for research practice within empirical bioethics. (shrink)

In a number of membrane-bound viruses, ion channels are formed by integral membrane proteins. These channel proteins include M2 from influenza A, NB from influenza B, and, possibly, Vpu from HIV-1. M2 is important in facilitating uncoating of the influenza A viral genome and is the target of amantadine, an anti-influenza drug. The biological roles of NB and Vpu are less certain. In all cases, the protein contains a single transmembrane α-helix close to its N-terminus. Channels can be formed by (...) homo-oligomerization of these proteins, yielding bundles of transmembrane helices that span the membrane and surround a central ion-permeable pore. Molecular modeling may be used to integrate and interpret available experimental data concerning the structure of such transmembrane pores. This has proved successful for the M2 channel domain, where two independently derived models are in agreement with one another, and with solid-state nuclear magnetic resonance (NMR) data. Simulations based on channel models may yield insights into possible ion conduction and selectivity mechanisms. BioEssays 20:992–1000, 1998. © 1998 John Wiley & Sons, Inc. (shrink)

A growing body of literature critical of ethics review boards has drawn attention to the processes used to determine the ethical merit of research. Citing criticism on the bureaucratic nature of ethics review processes, this literature provides a useful provocation for (re)considering how the ethics review might be enacted. Much of this criticism focuses on how ethics review boards _deliberate,_ with particular attention given to the lack of transparency and opportunities for researcher recourse that characterise ethics review processes. Centered specifically (...) on the conduct of ethics review boards convened within university settings, this paper draws on these inherent criticisms to consider the ways that ethics review boards might enact more communicative and deliberative practices. Outlining a set of principles against which ethics review boards might establish strategies for engaging with researchers and research communities, this paper draws attention to how _Deliberative communication_, _Engagement with researchers_ and the _Distribution of responsibility_ for the ethics review might be enacted in the day-to-day practice of the university human ethics review board. This paper develops these themes via a conceptual lens derived from Habermas’ (The theory of communicative action. Volume 1: Reason and the rationalization of society, 1984 ) articulation of ‘communicative action’ and Fraser’s (Social Text, 25(26), 56–80, 1990 ) consideration of ‘strong publics’ to cast consideration of the role that human ethics review boards might play in supporting university research cultures. _Deliberative communication_, _Engagement with researchers_ and the _Distribution of responsibility_ provide useful conceptual prompts for considering how ethics review boards might undertake their work. (shrink)

COVID-19 continues to dominate 2020 and is likely to be a feature of our lives for some time to come. Given this, how should health systems respond ethically to the persistent challenges of responding to the ongoing impact of the pandemic? Relatedly, what ethical values should underpin the resetting of health services after the initial wave, knowing that local spikes and further waves now seem inevitable? In this editorial, we outline some of the ethical challenges confronting those running health services (...) as they try to resume non-COVID-related services, and the downstream ethical implications these have for healthcare professionals’ day-to-day decision making. This is a phase of recovery, resumption and renewal; a form of reset for health services.1 This reset phase will define the ‘new normal' for healthcare delivery, and it offers an opportunity to reimagine and change services for the better. There are difficulties, however, healthcare systems are already weakened by austerity and the first wave of COVID-19 and remain under stress as the pandemic continues. The reset period is operating alongside, rather than at the end, of the pandemic and this creates difficult ethical choices. ### Balancing the greater good with individual care Pandemics—and public health emergencies more generally—reinforce approaches to ethics that emphasise or derive from the interests of communities, rather than those grounded in the claims of the autonomous individual. The response has been to draw on more public health focused ethics, ‘if demand outstrips the ability to deliver to existing standards, more strictly utilitarian considerations will have to be applied, and decisions about how to meet the individual's need will give way to decisions about how to maximise overall benefit’.2 Alongside this, effective …. (shrink)

The editors of the _Journal of Medical Ethics_ support the call of the UK Health Alliance on Climate for urgent action to ensure that the current Conference of the Parties to the United Nations Framework Convention on Climate Change ‘finally delivers climate justice for Africa and vulnerable countries’. 1 As they note ‘Africa has suffered disproportionately although it has done little to cause the crisis’. The burden of climate change has thus far fallen disproportionately on Global South countries. The monsoon (...) in Pakistan this year killed over 1100 people and the public health implications of the flooding might affect the health of over 5 million people. 2 The South Asian monsoon impacts the lives of a billion people and the flooding associated with wet seasons is likely to occur eight times more frequently in future years than at present. 3 For many pacific islands such as Kiribati,... (shrink)

Rather than using literary texts to evidence an analytic argument, within this piece we read Julia McNair Wright's (US, 1840?1902), Sidonie-Gabrielle Colette's (France, 1873?1954), and Willa Cather's (US, 1873?1947) texts through theoretical lenses that expose their educational meaning and value and that create conversation among them concerning girls? and women's educations. While we do not claim that one can generalize these women's works and lessons to every life, we contend that these women and the literary products they created offer girls (...) and women powerful lessons about resistance, subversion, and nurturing one's intellect, lessons that in some ways transcend class and race in particular. First, we define and explain Bruner's concept of the more using Rosenblatt, Gallagher, and Gardner's theories and findings to illuminate his concept. Next, we identify and examine three themes that emerge across these authors? texts?subverting through the everyday, becoming one's own steward, and moving from survival to self-actualization. Establishing these themes first in Wright's texts, we then use them to frame Colette's and Cather's fiction and support these themes by focusing on one lesson that emerges from each author's work(s). Finally, we ask what one might learn about educating girls and women from these texts and others whose educative meaning and value remain hidden. (shrink)

A fundamental fact about human minds is that they are never truly alone: all minds are steeped in situated interaction. That social interaction matters is recognized by any experimentalist who seeks to exclude its influence by studying individuals in isolation. On this view, interaction complicates cognition. Here, we explore the more radical stance that interaction co-constitutes cognition: that we benefit from looking beyond single minds toward cognition as a process involving interacting minds. All around the cognitive sciences, there are approaches (...) that put interaction center stage. Their diverse and pluralistic origins may obscure the fact that collectively, they harbor insights and methods that can respecify foundational assumptions and fuel novel interdisciplinary work. What might the cognitive sciences gain from stronger interactional foundations? This represents, we believe, one of the key questions for the future. Writing as a transdisciplinary collective assembled from across the classic cognitive science hexagon and beyond, we highlight the opportunity for a figure-ground reversal that puts interaction at the heart of cognition. The interactive stance is a way of seeing that deserves to be a key part of the conceptual toolkit of cognitive scientists. (shrink)

To gain an insight into how those entering the teaching profession regard cyberbullying, two focus groups were conducted with nine pre-service teachers. Thematic analytical approach revealed...

We have been researching the distinctive ethical issues raised by what we have called “the reset period,” when non-Covid services resumed alongside the continuing pandemic in the UK. In this commen...

Introduction : philanthropy in democratic societies / Rob Reich, Lucy Bernholz, and Chiara Cordelli -- Altruism and the origins of nonprofit philanthropy / Jonathan Levy -- Why is the history of philanthropy not a part of American history? / Olivier Zunz -- On the role of foundations in democracies / Rob Reich -- Contributory or disruptive : do new forms of philanthropy erode democracy? / Aaron Horvath and Walter W. Powell -- Reconciling corporate social responsibility and profitability : guidelines (...) for the conscientious manager / Paul Brest -- When is philanthropy? : how the tax code's answer to this question has given rise to the growth of donor-advised funds and why it's a problem / Ray D. Madoff -- Creating digital civil society : the Digital Public Library of America / Lucy Bernholz -- The free-provider problem : private provision of public responsibilities / Eric Beerbohm -- Philanthropy and democratic ideals / Ryan Pevnick -- Reparative justice and the moral limits of discretionary philanthropy / Chiara Cordelli. (shrink)

Globalization theories posit organizational convergence, suggesting that Codes of Ethics will become commonplace and include greater consideration of global issues. This study explores the degree to which the Codes of Ethics of 157 corporations on the Global 500 and/or Fortune 500 lists include the "third generation" of corporate social responsibility. Unlike first generation ethics, which focus on the legal context of corporate behavior, and second generation ethics, which locate responsibility to groups directly associated with the corporation, third generation ethics transcend (...) both the profit motive and the immediate corporate environment. Third generation ethics are grounded in responsibilities to the larger interconnected environment. The results of the study suggest convergence, insofar as Codes of Ethics are becoming standard communication features of corporations across region and industrial sector but still manifest a primary concern with profits and those behaviors which are mandated by law. Only corporations headquartered in the European Union demonstrate a significant degree of global consciousness and reflexivity. However, there is some evidence that third generation ethics and thinking are becoming part of the corporate landscape. More then three quarters of the corporations made at least some reference to third generation ethics. (shrink)

The use of psychometric tools to investigate the impact of school-based wellbeing programs raises a number of ethical issues around students’ rights, confidentiality and protection. Researchers have explicit ethical obligations to protect participants from potential psychological harms, but guidance is needed for effectively navigating disclosure of identifiable confidential information that indicates signs of psychological distress. Drawing on a large-scale study examining student, school, and system-based factors that impact the implementation of a school-based social and emotional learning program, we describe patterns (...) of distress attained from quantitative and qualitative questions and describe the process that we evolved to monitor and disclose sensitive mental health information, providing one example of how researchers might effectively address the responsibilities that emerge when collecting sensitive information from students within an education system. The patterns and processes that emerged illustrate that the inclusion of mental distress information can elicit important insights, but also brings responsibilities for minimising risks and maximising benefits. (shrink)

Companies are faced with a choice of which type of power to use in their efforts to persuade their first-tier suppliers to adopt socially responsible procurement practices with key second-tier suppliers. However, we know little about how first-tier suppliers will react to different types of power and which are most effective in encouraging the adoption of socially responsible procurement practices. We are also ignorant of the impact of these practices on first-tier suppliers’ performance. This paper uses bases of power theory (...) to examine the impact of buyer companies’ power usage on first-tier suppliers’ adoption of socially responsible procurement practices with their own suppliers. We surveyed managers responsible for sustainable supply chain management in 156 firms and analyzed the results using structural equation modeling. Our findings show that non-mediated power use influences the adoption of process-based and market-based practices, while mediated power use has no significant impact on the adoption of either type of practice. Additionally, we find that the adoption of market-based socially responsible procurement practices leads to enhanced performance for first-tier suppliers who adopt these practices with their second-tier suppliers. (shrink)

To study how religiosity affects family business goals, we merge literatures on goal setting, temporal orientation, and family business to argue that family business goals can be distinguished into short-term and long-term orientations and propose that religiosity affects both orientations, but to varying degrees. Drawing on a sample of private U.S. family businesses and applying partial least squares structural equations modeling, we find tentative support that religiosity has a stronger positive effect on long-term goal orientation than on short-term goal orientation. (...) We discuss implications for theory development and future research involving religiosity and family business goals. (shrink)

Processing information in the context of personal survival scenarios elicits a memory advantage, relative to other rich encoding conditions such as self-referencing. However, previous research is unable to distinguish between the influence of survival and self-reference because personal survival is a self-referent encoding context. To resolve this issue, participants in the current study processed items in the context of their own survival and a familiar other person’s survival, as well as in a semantic context. Recognition memory for the items revealed (...) that personal survival elicited a memory advantage relative to semantic encoding, whereas other-survival did not. These findings reinforce suggestions that the survival effect is closely tied with self-referential encoding, ensuring that fitness information of potential importance to self is successfully retained in memory. (shrink)

Using a parallel mixed-methods design, the current study examined university students’ perceptions of academic cheating through collecting and analyzing both the quantitative and qualitative data. Our quantitative findings corroborate previous research that male students have engaged more in academic cheating than females based on students’ self-reports, and that undergraduate students are less willing to discuss issues on academic cheating as compared with their graduate counterparts. Five themes emerged from the thematic analysis of the qualitative data: flexible definitions for cheating, environmental (...) promotion of cheating, the moral transgression of cheating, cheating as an ambiguous justification, and cheating as a conscious decision making process. The mixed-methods findings indicate that there is no relationship between students’ gender or classification and their endorsements of the qualitative themes. However, non-White students are more likely to endorse the theme “cheating as an ambiguous justification.” Implications for reducing and preventing academic cheating at the university level are discussed. (shrink)

Population-level biomedical research offers new opportunities to improve population health, but also raises new challenges to traditional systems of research governance and ethical oversight. Partly in response to these challenges, various models of public involvement in research are being introduced. Yet, the ways in which public involvement should meet governance challenges are not well understood. We conducted a qualitative study with 36 experts and stakeholders using the World Café method to identify key governance challenges and explore how public involvement can (...) meet these challenges. This brief report discusses four cross-cutting themes from the study: the need to move beyond individual consent; issues in benefit and data sharing; the challenge of delineating and understanding publics; and the goal of clarifying justifications for public involvement. The report aims to provide a starting point for making sense of the relationship between public involvement and the governance of population-level biomedical research, showing connections, potential solutions and issues arising at their intersection. We suggest that, in population-level biomedical research, there is a pressing need for a shift away from conventional governance frameworks focused on the individual and towards a focus on collectives, as well as to foreground ethical issues around social justice and develop ways to address cultural diversity, value pluralism and competing stakeholder interests. There are many unresolved questions around how this shift could be realised, but these unresolved questions should form the basis for developing justificatory accounts and frameworks for suitable collective models of public involvement in population-level biomedical research governance. (shrink)

A new temperament construct based on recent brain physiology literature has been investigated using the Fisher Temperament Inventory (FTI). Four collections of behaviors emerged, each associated with a specific neural system: the dopamine, serotonin, testosterone, and estrogen/oxytocin system. These four temperament suites have been designated: (1) Curious/Energetic, (2) Cautious/Social Norm Compliant, (3) Analytical/Tough-minded, and (4) Prosocial/Empathetic temperament dimensions. Two functional magnetic resonance imaging (fMRI) studies have suggested that the FTI can measure the influence of these neural systems. In this paper, (...) to further the behavioral validation and characterization of the four proposed temperament dimensions, we measured correlations with five variables: (1) gender; (2) level of education; (3) religious preference; (4) political orientation; (5) the degree to which an individual regards sex as essential to a successful relationship. Subjects were 39,913 anonymous members of a US Internet dating site and 70,000+ members in six other countries. Correlations with the five variables characterize the FTI and are consistent with mechanisms using the proposed neuromodulators. We also report on an analysis between the FTI and the NEO-Five Factor Inventory, using a college sample ( n = 215), which showed convergent validity. The results provide novel correlates not available in other questionnaires: religiosity, political orientation, and attitudes about sex in a relationship. Also, an Eigen analysis replicated the four clusters of co-varying items. The FTI, with its broad systems and non-pathologic factors complements existing personality questionnaires. It provides an index of some brain systems that contribute to temperament, and may be useful in psychotherapy, business, medicine, and the legal community. (shrink)

This study uses the longitudinal data from the Building a New Life in Australia survey to examine the relationships between human capital and labour market participation and employment status among recently arrived/approved humanitarian migrants. We find that the likelihood of participating in the labour force is higher for those who had pre-immigration paid job experience, completed study/job training and have better job searching knowledge/skills in Australia and possess higher proficiency in spoken English. We find that the chance of getting a (...) paid job is negatively related to having better pre-immigration education, but it is positively related to having unpaid work experience and job searching skills in Australia, and better health. We also explore the ethical implications of the findings. (shrink)

Community engagement (CE) contributes to successful research. There is, however, a lack of literature on the effectiveness of different models of CE and, specifically, on CE strategies for the conduct of genomic research in sub-Saharan Africa. There is also a need for models of CE that transcend the recruitment stage of engaging prospective individuals and communities and embed CE throughout the research process and after the research has concluded. The qualitative study reported here was designed to address these knowledge gaps (...) and comprised of 36 key informant semi-structured interviews and fifteen focus groups with 50 participants. We interviewed selected stakeholders in genomic research in Nigeria: biomedical researchers, community rulers, opinion leaders, community health workers, and prospective research participants. We explored these stakeholders’ views on their understanding of community engagement, their expectations, experiences, and their opinions on acceptable processes of community consultation in genomic research. The methodological design, adapted from grounded theory, used the constant comparative method of data analysis; while normative conclusions were made using the symbiotic empirical ethics approach. Data analysis revealed five main themes important for successfully engaging communities in genomic research: effective communication, diversity of community gatekeeping, trust, cultural integration of research, and conservation of the research setting. From these themes, we have developed a four-stage model of community engagement that covers all stages of the research process; namely, the Community Approach, Intermediate phase, Collaboration and Post-research Cordiality model (CICP). This model could be used to improve the integration of CE in genomic research among local communities. (shrink)

Esta investigación reconoce la paz como un escenario en el que el conflicto está presente y en el que las diferentes posiciones deben aprender a convivir. Para ello, se plantea la pregunta: ¿Cómo se han transformado las prácticas pedagógicas de docentes y profesores en los últimos 20 años para la reconstrucción del tejido social en territorios afectados por el conflicto armado en Colombia? Estas prácticas buscan mediar las relaciones entre los individuos y sus tensiones, enseñando resiliencia y la capacidad de (...) mitigar los efectos negativos que las expresiones de violencia pueden tener en el desarrollo de los jóvenes que viven en este contexto. (shrink)

The COVID-19 pandemic will generate vexing ethical issues for the foreseeable future and many journals will be open to content that is relevant to our collective effort to meet this challenge. While the pandemic is clearly the critical issue of the moment, it’s important that other issues in medical ethics continue to be addressed as well. As can be seen in this issue, the Journal of Medical Ethics will uphold its commitment to publishing high quality papers on the full array (...) of medical ethics. At the same time, JME aims to be a premiere home for ground-breaking scholarship on the ethical issues raised by COVID-19. Toward this end, we have a number of papers that are freely available online and for which production has been fast-tracked.1–5 A challenge for authors who want to write about the pandemic is the rapidly evolving nature of the situation and the time it takes for journal content to be reviewed and published, even when fast-tracked. For that reason, all authors who would like to submit a paper on the pandemic can also submit a post to the JME blog prior to submitting a full paper to the journal. Those interested in writing for the JME blog should contact one of its editors, Hazem Zohny or Mike King. Over the last 3 weeks, 30 high-quality commentaries on the pandemic have been posted to the blog. These posts are circulated widely via the JME Twitter and Facebook feeds and have stimulated significant …. (shrink)

Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human (...) rights. Methods This study used qualitative data from an internet-based survey distributed to the mailing list of the UK charity Bipolar UK, which contained multiple closed and open questions on advance decision-making in bipolar disorder. Quantitative analysis of a closed question about self-binding directives had already demonstrated endorsement amongst a very high proportion of participants with bipolar disorder who completed the survey. We conducted thematic analysis of responses from those participants who answered a subsequent open question about reasons for their view. Research was co-produced within a multi-disciplinary team, with clinical, legal, and ethical expertise, and lived experience of bipolar disorder. Ideas and methodologies associated with all these areas of expertise were used in the analysis of these reasons and to gain insight into the thoughts of individuals with bipolar disorder about self-binding directives and associated issues. Findings Between Oct 23 and Dec 5, 2017, 932 individuals with a self-reported clinical diagnosis of bipolar disorder completed the internet survey, with 565 (154 men; 400 women; 11 transgender or other) providing free text answers to the open question. A large majority of respondents endorsed self-binding directives, nearly all describing a determinate shift to types of distorted thinking and decision-making when unwell as their key justification. Responses indicating ambivalence were dominated by logistical concerns about the drafting and implementation of self-binding directives, while those who rejected self-binding directives also cited logistical concerns, validity of their thinking when unwell, and potential contravention of human rights. Interpretation This study is, to our knowledge, the first large study of reasons why mental health service users might endorse or reject the use of self-binding directives. The findings provide empirical support for introducing self-binding directives into mental health advance decision-making practice and policy and may help to address enduring ethical concerns surrounding possible implementation of the directive while a person retains decision-making capacity. The opinions expressed here in responses given by multiple service users with bipolar disorder challenge a prominent view within international disability rights debates that involuntary treatment and recognition of impaired mental capacity constitute inherent human rights violations. Funding The Wellcome Trust . (shrink)

The study of church growth has historically been divided into two strands of research: the Church Growth Movement and the Social Science approach. This article argues that Dunbar’s Social Brain Hypothesis represents a legitimate and fruitful third strand in the study of church growth, sharing features of both previous strands but identical with neither. We argue that five predictions derived from the Social Brain Hypothesis are accurately borne out in the empirical and practical church growth literature: that larger congregations (...) lead to lower active engagement from members; that single-leader congregations are limited to around 150 members; that congregations of 150 are further stratified into smaller functioning groups; that congregations expanding beyond 150 members undergo internal tensions and are forced to reorganise; and that congregations larger than 150 will require structural sub-divisions to retain active member involvement. While these assertions are reflected in the church growth literature and articulate the common sense assumptions of church growth experts, the Social Brain Hypothesis offers a coherent theoretical framework which unifies these observations and thereby represents a distinctive contribution to church growth studies. (shrink)

Peripheral vision has different functional priorities for mammals than foveal vision. One of its roles is to monitor the environment while central vision is focused on the current task. Becoming distracted too easily would be counterproductive in this perspective, so the brain should react to behaviourally relevant changes. Gist processing is good for this purpose, and it is therefore not surprising that evidence from both functional brain imaging and behavioural research suggests a tendency to generalize and blend information in the (...) periphery. This may be caused by the balance of perceptual influence in the periphery between bottom-up and top-down processing channels. Here, we investigated this interaction behaviourally using a peripheral numerosity discrimination task with top-down and bottom-up manipulations. Participants compared numerosity between the left and right peripheries of a screen. Each periphery was divided into a centre and a surrounding area, only one of which was a task relevant target region. Our top-down task modulation was the instruction which area to attend – centre or surround. We varied the signal strength by altering the stimuli durations i.e., the amount of information presented/processed. We found that numerosity perceived in target regions was affected by contextual information in neighbouring areas. This effect appeared as soon as stimulus duration allowed the task to be reliably performed and persisted even at the longest duration. We compared the pattern of results with an ideal-observer model and found a qualitative difference in the way centre and surround areas interacted perceptually in the periphery. When participants reported on the central area, the irrelevant surround would affect the response as a weighted combination – consistent with the idea of a receptive field focused in the target area to which irrelevant surround stimulation leaks in. When participants report on surround, we can best describe the response with a model in which occasionally the attention switches from task relevant surround to task irrelevant centre – consistent with a selection model of two competing streams of information. Overall our results show that the influence of spatial context in the periphery is mandatory but task dependent. (shrink)

Recently the World Health Organization has highlighted the need to strengthen mental health systems following emergencies, including natural and manmade disasters. Mental health services need to be informed by culturally attuned evidence that is developed through research. Therefore, there is an urgent need to establish rigorous ethical research practice to underpin the evidence-base for mental health services delivered during and following emergencies.

The age-old debate about the relation between science and society has, in the last two decades, materialized in novel forms at many universities. In this article, we follow the reconfiguration of relevance at one institute of higher education that aspires to become an impact-driven university. We employ a socio-technical instrumentation perspective to this institutional transformation so that we can follow how relevance is being enacted in terms of impact at different organizational levels. To grasp the links between organizational changes and (...) the conditions for academic practices, we analyze three policy instruments in-the-making and in-use: impact narratives as novel evaluation tool, the creation of impact profiles as part of human resource policy and new data infrastructures to monitor impact on the sustainable development goals. We investigate their problematizations and imaginaries through qualitative methods, namely document analysis and semi-structured interviews with researchers at various career levels and faculties at Erasmus University Rotterdam. Through the cases, we analyze how these new impact-oriented instruments open up or close down opportunities for academic practices. Our observations show that the reconfiguration of relevance as impact implies the advancement of a strategic approach to relevance and to academic work and institutions more generally. Ultimately, the site-specific case also includes bottom-up problematizations of impact that lead us to reflect on the limitations of a policy instrument approach and stress the importance of addressing the politics of the social relations of ‘relevant’ scientific work. (shrink)

Background At the beginning of the coronavirus (Covid-19) pandemic, many non-Covid healthcare services were suspended. In April 2020, the Department of Health in England mandated that non-Covid services should resume, alongside the continuing pandemic response. This ‘resetting’ of healthcare services created a unique context in which it became critical to consider how ethical considerations did (and should) underpin decisions about integrating infection control measures into routine healthcare practices. We draw on data collected as part of the ‘NHS Reset Ethics’ project, (...) which explored the everyday ethical challenges of resetting England’s NHS maternity and paediatrics services during the pandemic. Methods Healthcare professionals and members of the public participated in interviews and focus group discussions. The qualitative methods are reported in detail elsewhere. The focus of this article is our use of Frith’s symbiotic empirical ethics methodology to work from our empirical findings towards the normative suggestion that clinical ethics should explicitly attend to the importance of relationships in clinical practice. This methodology uses a five-step approach to refine and develop ethical theory based on a naturalist account of ethics that sees practice and theory as symbiotically related. Results The Reset project data showed that changed working practices caused ethical challenges for healthcare professionals, and that infection prevention and control measures represented harmful barriers to the experience of receiving and offering care. For healthcare professionals, offering care as part of a relational interaction was an ethically important dimension of healthcare delivery. Conclusions Our findings suggest that foregrounding the importance of relationships across a hospital community will better promote the ethically important multi-directional expression of caring between healthcare professionals, patients, and their families. We offer two suggestions for making progress towards such a relational approach. First, that there is a change of emphasis in clinical ethics practice to explicitly acknowledge the importance of the relationships (including with their healthcare team) within which the patient is held. Second, that organisational decision-making should take into account the moral significance afforded to caring relationships by healthcare professionals, and the role such relationships can play in the negotiation of ethical challenges. (shrink)