In the present article, we introduce an ethical evaluation methodology for clinical cases. Although rejecting proceduralism as a system, we develop a procedure that eventually could be formalized as a flow chart to help carry out an ethical evaluation for clinical cases. We clarify the elements that constitute an ethical evaluation: aim, integration, and how the action is performed. We leave aside the aspect of intentions, focusing on the object of a medical action, arguing that the internal aim of a (...) clinical action carries a moral value per se. Our evaluation system takes into account only objects and circumstances and their intrinsic morality, since we are dealing with the evaluation of a clinical case, and not with a personal and complete clinical action. DOI: 10.5294/pebi.2016.20.1.5. (shrink)

This contribution addresses some bioethical and medico-legal issues of the opinion formulated by the Italian National Bioethics Committee (CNB) in response to the dilemma between the State’s duty to protect the life and health of the prisoner entrusted to its care and the prisoner’s right to exercise his freedom of expression. The prisoner hunger strike is a form of protest frequently encountered in prison and it is a form of communication but also a language used by the prisoner in order (...) to provoke changes in the prison condition. There are no rules in the prison regulations, nor in the laws governing the legal status of prisoners, that allow the conscious will of the capable and informed subject to be opposed and forced nutrition to be carried out. However, this can in no manner make therapeutic abandonment legitimate: the medical doctor should promote every action to support the patient. In the recent opinion formulated by the CNB it was remarked how self-determination is a central concept in human rights and refers to an individual’s ability to make autonomous and free decisions about his or her life and body. (shrink)

A review on the educational experience of students with disabilities, based on qualitative and quantitative surveys, questions the stated objectives of inclusive education policies. These studies show a more favourable experience in the specialized classe, due to a deteriorated relationship to schooling in the regular classroom and a sense of isolation and incompetence developed faced of difficulties. Research conducted in a bilingual French sign language-French written device, in secondary school with deaf and hearing students schooled together in the regular classroom, (...) suggests other stories. The way in which school and teaching situations are conducted within this aid system, engages these students in a rewarding and capaciting experience, to be a recognized student in the classroom and among peers. Learning French sign language, the work of translators at the linguistic as well as pedagogical and educational level, the supporting role of auxiliary teaching systems, participate in the process of accessing school situations, especially to educational accessibility, thus providing students with a space of opportunity to attend school. (shrink)

Background Undergraduate nursing students may experience several ethical challenges during their clinical learning placement that can lead to moral distress and intention to leave the profession. Ethical challenges are complex phenomena and ethical frameworks may help improve their understanding and provide actionable recommendations to enhance students’ readiness for practice. Aim To explore undergraduate nursing students’ ethical challenges experienced during their clinical learning and their suggestions for better ethics education; to illuminate students’ experience against a foundational ethical framework. Research design Qualitative (...) study based on interpretative phenomenology. Semi-structured, in-person or at distance, one-to-one interviews were performed, audio-recorded, and transcribed verbatim. The ‘Dignity-enhancing care framework’ was employed to frame the study findings. Participants and research context Nineteen nursing graduands attending seven sites of one Northwestern Italian University were interviewed. Ethical consideration The study protocol was approved by the Ethics Committee of the University of Torino (number 0187646/2023). All participants provided written informed consent. Findings Students experienced several ethical challenges concerning daily practice such as pain control or the decision to restrain patients, and reported deficient professional ethics with healthcare professionals who demonstrated poor caring attitudes and teamwork. Moreover, they perceived professionals poorly committed to their role of educators and complained of poor support in the learning process. When a supportive, dialogical, and relational context lacked, students experienced negative feelings about the profession and the healthcare system and reported the intention to leave the profession. Dialogue with peers, family members or significant others, nursing educators, and clinical nurse supervisors, as well as self-learning activities and discussion-based teaching methods grounded on real scenarios helped to overcome challenging situations. Conclusion While complying with normative standards, nursing education policies should encourage the adoption of dynamic teaching methods and sustain a regular, dialogical approach within and between the clinical and academic contexts to improve readiness for practice. (shrink)