Internet based process control usage has grown in the past years. Industry field demands were behind this, and it ranges from factory, office and home automation to tasks simplifications and cost reduction. In this book a hardware interface circuit and a software system used to control the temperature and level of a liquid tank is described. The advantage of the designed interface circuit is its simplicity and low cost. The same can be true for the software system in which we (...) used C and Java programs to accomplish the communication. Both C and Java can be obtained freely and the development cost could be small. C language has been used to communicate with the designed interface circuit due to its strength in low level operations and communication with ports and hardware. In Java we have used mainly the Servlet for communication between the Client and the Server, which is a new approach and more reliable approach than the CGI based method that has common problems of speed and data persistence. This book is useful for people and researchers working in the field of control, remote access and computer based control. (shrink)

An important part of the student nurse’s training involves reflection on practice, as expressed in written assignments and seminar discussions. In this, students make use of material drawn from their work with clients. A key ethical question is, therefore: should clients’ permission be sought by students for this use of case material in coursework assignments. This article examines in some detail the arguments both for and against seeking clients’ permission and concludes that, in view of the principle of respect for (...) autonomy, there is a moral obligation to gain consent. It is argued, however, that there may be legitimate exceptions to this. (shrink)

This book focuses on the client issues which are now becoming an integral part of the work of all practising solicitors. It focuses on the pro-active way that will enable the practising solicitor. as well as the new entrant to the profession. to learn and apply techniques and work practices that will help to ensure that the needs and perceptions of clients are satisfied regularly and systematically. This is set out in simple. practical and realistic stages throughout the book. (...) The author suggests that solicitors and law firms adopt a new and exciting strategy which focuses everyone in the firm. from senior partner to office junior. on meeting and exceeding client expectations. (shrink)

Background: Enhancing client autonomy requires close coordination of interactional practices between nurse and client, which can cause challenges when interaction takes place in video-mediated settings. While video-mediated services have become more common, it remains unclear how they shape client autonomy in telehomecare. Research aim: To analyse how video mediation shapes client autonomy when nurses guide medicine taking remotely through video-mediated home care. Research design: This is a conversation analytic case study using video recordings of telehomecare encounters. (...) The theoretical approach draws on ethnomethodology and empirical ethics. Participants and research context: Four home-dwelling older adults and three nurses participated in the data collection; data extracts include one client and two nurses. The study was conducted in Finland. Ethical considerations: Special attention was given to protect the rights of home care clients. An ethical statement for the study was given by the Ethics Committee of the Tampere Region Findings: Video mediation complicates interacting remotely with care-relevant artefacts because of nurses’ limited visual access to the medicine and client’s need to simultaneously engage in vocal interaction and medicine taking. This can be overcome by dividing the guidance into manageable steps which invite the client to explicate their readiness to take the medicine and situating the video-mediation equipment and medicine close together. Different interactional practices and ways of situating video-mediation equipment and medicine have consequences for client autonomy. Discussion: Understanding client autonomy in digitalised settings demands empirical examination that recognises the importance of different human and non-human aspects of care that shape client autonomy. Conclusions: To harness the benefits of video-mediated home care, communication technologies’ reliance on home space and interactional practices should be recognised. Empirical ethics research is needed in order to make normative suggestions that fit a wide variety of care situation. (shrink)

(1984). Lawyer‐client confidences under the A.B.A. model rules: Ethical rules without ethical reason. Criminal Justice Ethics: Vol. 3, No. 2, pp. 3-8.

Moral case deliberation (MCD) is a form of clinical ethics support in which the ethicist as facilitator aims at supporting professionals with a structured moral inquiry into their moral issues from practice. Cases often affect clients, however, their inclusion in MCD is not common. Client participation often raises questions concerning conditions for equal collaboration and good dialogue. Despite these questions, there is little empirical research regarding client participation in clinical ethics support in general and in MCD in particular. (...) This article aims at describing the experiences and processes of two MCD groups with client participation in a mental healthcare institution. A responsive evaluation was conducted examining stakeholders’ issues concerning client participation. Findings demonstrate that participation initially creates uneasiness. As routine builds up and client participants meet certain criteria, both clients and professionals start thinking beyond ‘us-them’ distinctions, and become more equal partners in dialogue. Still, sentiments of distrust and feelings of not being safe may reoccur. Client participation in MCD thus requires continuous reflection and alertness on relational dynamics and the quality of and conditions for dialogue. Participation puts the essentials of MCD (i.e., dialogue) to the test. Yet, the methodology and features of MCD offer an appropriate platform to introduce client participation in healthcare institutions. (shrink)

‘Client involvement’ has been a mantra within health policies, education curricula and healthcare institutions over many years, yet very little is known about how ‘client involvement’ is practised in home‐care services. The aim of this article is to analyse ‘client involvement’ in practise seen from the positions of healthcare professionals, an elderly person and his relative in a home‐care setting. A sociologically inspired single case study was conducted, consisting of three weeks of observations and interviews. The study (...) has a focus on the relational aspects of home care and the structural, political and administrative frames that rule home‐ care practice. Client involvement is shown within four constructed analytical categories: ‘Structural conditions of providing and receiving home care’; ‘Client involvement inside the home: performing a professional task and living an everyday life’; ‘Client involvement outside the home: liberal business and mutual goal setting’; and ‘Converting a home to a working place: refurnishing a life’. The meaning of involvement is depending on which position it is viewed from. On the basis of this analysis, we raise the question of the extent to which involvement of the client in public home‐care practice remains limited. (shrink)

Psychotherapy clients read two consumer-oriented brochures: a general brochure on psychology and a brochure on the topic of client-therapist intimacy. Half of the participants read the general brochure first and the brochure on client-therapist intimacy second, and half the participants did the reverse. Participants reported favorable reactions to the brochures, indicating they thought both should be made available to psychotherapy clients; that neither were too long, too sensitive, or too difficult to read; and that the brochures should be (...) made available early during the therapeutic process. After reading the client-therapist intimacy brochure, participants also showed some changes in Likert-type scores measuring attitudes regarding intimate contact between clients and therapists. Although participants were more negative about issues of sexual misconduct after reading the client-therapist intimacy brochure, they did not indicate a decrease in trust of therapists, nor did they indicate a greater likelihood of filing a false complaint. We concluded that therapists' reservations about presenting clients with factual information regarding therapist sexual exploitation of clients are not empirically founded. (shrink)

An explicit linking of the minutiae of everyday parenting practices and the good of society as a whole has been a feature of government policy. The state has taken responsibility for instilling the right parenting skills to deal with what is said to be the societal fall-out of contemporary and family change. ?Knowledge? about parenting is seen as a resource that parents must access in order to fulfil their moral duty as good parents. In this policy portrait, caring for children (...) is posed as a classless and gender-neutral activity. A key theme of this article is that parents from different social class groups are positioned and understand themselves in quite distinct ways in relation to parenting skills advice and expert intervention into their family and home lives. We take a ?relational? perspective to show how mothers and fathers from different social class groups see themselves, and are located by policy and practice, as clients or consumers, and as commonplace or pioneers, in relation to parenting support for themselves and the education system for their children. We identify the lived gendered and classed disparities of power, and associated moral worth, attached to particular parenting practices. (shrink)

Thirty-five current therapy clients, 47 former clients, and 42 college students with no therapy experience rated 27 items in terms of importance for inclusion in informed consent discussions. The current and former client samples rated information about inappropriate therapeutic techniques, confidentiality, and the risks of alternative treatments as most important, and information about the personal characteristics of the therapist and the therapist's degree as least important. The results of this study provide evidence for differential informed consent disclosure practices.

In welfare encounters, clients may from time to time report about other peoples’ doings in ways that are heard as more or less downgrading. This article examines how these reports are brought off in Norwegian vocational rehabilitation encounters, and especially, how the professional party aligns. Do such practices represent what Levinson calls ‘allowable contributions’ in the vocational rehabilitation meeting or are they treated as matter out of place? The analysis of five data extracts suggests that it is very important for (...) the reception that the report is well contextualized and attuned to the institutional agenda. The counsellors displayed a neutral but cooperative alignment to reports integrated neatly in the business-at-hand in a top-down fashion. Here, the reports served as a tool to inform the recipient about the client’s own character and/or her experience of the rehabilitation process. However, in the two latter cases, where the client had a more initiating role, the reports appeared to have a more humorous or entertaining function. In response, the counsellors did not display alignment but searched for institutional relevance before re-contextualizing the report into a proper context. This suggests that out-of-frame reports about other people delivered on a humorous footing do not straightforwardly fall into the category of ‘allowable contributions’ in this setting. (shrink)

Summary Criticism of the traditional institution?based system of teacher training for primary schools is reviewed and recent responses to GATE requirements summarised. It is argued that such criticisms, and any radical reforms involving the transfer of training responsibility to the schools, should take account of client opinion of its likely effects. Clients here are taken to refer to students in training and school teachers including headteachers. For this study an open?ended questionnaire on the advantages and disadvantages of traditional institution?based (...) and radical school?based systems was administered to all students at the end of a PGCE course, and to a part?opportunity and part?random sample of teachers and headteachers in local schools. Their responses are tabulated and discussed. The vast majority of these clients foresaw considerable problems with a radically reformed system and, balancing the gains and losses that such a reform might bring, they demonstrated a clear preference for the existing system. (shrink)

One ethical issue that commonly comes up in clinical practice is the negotiation of fees with clients. Although the APA Ethics Code provides standards regarding clients who are unable to or do not pay, little guidance is given pertaining to fee limits for clients who want to pay more. This issue is explored using a real case example, including the relevant ethical codes to be considered. The necessary “gray” areas of ethical decision-making are demonstrated through my own decision process. Implications (...) for future scenarios are discussed. (shrink)

Recognizing the importance of health‐promoting relationships in engaging people who are experiencing homelessness in care, most research on health clinics for homeless persons has involved some recognition of client–provider relationships. However, what has been lacking is the inclusion of a critical analysis of the policy context in which relationships are enacted. In this paper, we question how client–provider relationships are enacted within the culture of community care with people who are experiencing homelessness and how clinic‐level and broader social (...) and health policies shape relationships in this context. We explore these questions within a critical theoretical perspective utilizing a critical ethnographic methodology. Data were collected using multiple methods of document review, participant observation, in‐depth interviews and focus groups. The participants include both clients at a community health clinic, and all clinic service providers. We explore how clients and providers characterized each other as ‘good’ or ‘bad’. For providers, this served as a means by which they policed behaviours and enforced social norms. The means by which both providers’ and clients’ negotiated relationships are explored, but this is couched within both local and system‐level policies. This study highlights the importance of healthcare providers and clients being involved in broader policy and systemic change. (shrink)

Hawley introduced the idea of the client's perspective on knowledge, which she used to illuminate knowing-how and cases of epistemic injustice involving knowing-how. In this paper, I explore how Hawley's idea might be used to illuminate not only knowing-how, but other forms of knowledge that, like knowing-how, are often claimed to be distinct from mere knowing-that, focusing on the case studies of moral understanding and ‘what it is like’-knowledge.

The purpose of this paper is to examine what heals and harms the client in the psychotherapeutic encounter, from the client's perspective. The experience of eight clients was explicated using a model based on Giorgi and Schweitzer. The counselling experienced as healing by clients has at its core a vibrantly warm and honest relationship where the client feels held in the safety of the good heart space of the counsellor. The counsellor is experienced as providing an intense (...) beingness for the client that embraces the client's suffering and provides solid ground created out of the crucible of the counsellor's own encounter with his or her shadow. The counsellor is emptied out of his/her own agenda and provides space for the client's experience. The counsellor can evoke the higher resources of the client. The counselling is experienced as renewing and reconnecting the clients to his/her sense of self, of other and the lifeworld. The counselling relationship experienced as harming is described as being drained of human presence and transforming power. There is no alive human connection. The counsellor is experienced as insubstantial, and has no ability to hold traumatic experience. The counsellor's cold reception to the client's vulnerabilities has the power to shatter, fragment and splinter the client. The counsellor is full of self. This fullness may be ego that manifests as dry intellectualising or playing manipulative games as a substitute for human presence. This may lead the client to terror, sickness and anxiety. The counsellor may be full of their own fears and are experienced by the client as chaotic, avoidant and overwhelmed. Their unavailability leads clients to experience emotional depletion, exhaustion and frustration. The counsellor's self-righteousness, judgement and critical disengagement are experienced by clients as being belittled, condemned and diminished. The therapeutic encounter results in a weakening of the human potential for recovery. Both client and counsellor emerge as lesser human beings, with weakened relationships to self, others and the world. Indo-Pacific Journal of Phenomenology , Volume 1, Edition 2 September 2001. (shrink)

Depuis plus de deux décennies, les gouvernements scandinaves expriment leur volonté d’augmenter le taux d’emploi des personnes handicapées. Malgré la réaffirmation ininterrompue de cette volonté politique, ce taux est resté jusqu’à ce jour nettement inférieur à celui des personnes non handicapées. Les centres municipaux pour l’emploi – et, par conséquent, les travailleurs sociaux qui y œuvrent – disposent d’une grande latitude pour classer les clients présentant des déficiences permanentes susceptibles d’entraîner un handicap dans la recherche d’un emploi. Jusqu’à maintenant, les (...) recherches se sont principalement concentrées sur le processus de classification des déficiences des personnes en recherche d’emploi. Par contraste, cette étude explore le processus par lequel les personnes souffrant de handicaps permanents sont catégorisées dans les centres d’emploi danois lors de leurs premières interactions avec les travailleurs sociaux. Les résultats d’un sondage (n=69) et d’entretiens qualitatifs (n=9) montrent un très faible degré de catégorisation formelle ainsi qu’un manque d’attention portée aux problématiques du handicap et de l’accès à l’emploi. Toutefois, ce manque d’attention ne signifie pas qu’aucune classification n’est effectuée, car les travailleurs sociaux utilisent des catégories issues de catégories politiques ou sociales adjacentes comme le système d’emploi flexible. L’une des conséquences de cette absence de classification pourrait être que les agences pour l’emploi n’identifient pas les défaillances des chômeurs, ce qui réduit la possibilité de les aider. Toutefois, un niveau de classification plus élevé comporte également des inconvénients tels que la stigmatisation. (shrink)

Publication date: 15 October 2018 Source: Author: Ehiosun O. Marvel NHIS was launched officially on 6th of June 2005. The Scheme is designed to provide comprehensive health care at affordable costs, covering employees of the formal sector, self-employed, as well as rural communities, the poor and the vulnerable groups. However, client satisfaction of services rendered continues to be a major concern for the improvement of NHIS. This study is designed to determine the level and causes of dissatisfaction of clients (...) accessing NHIS clinic at the Kubwa General Hospital, Kubwa, FCT, Abuja. This study employed a descriptive cross sectional survey. 279 NHIS enrollees were recruited for this study at the Kubwa General Hospital. Questionnaires were administered and the level of dissatisfaction and satisfaction of NHIS services were analyzed. The satisfaction rate was 69.2% while the dissatisfaction rate was 22.9%. The respondents were satisfied with the attitude of health workers in NHIS clinic, Kubwa. However, they were dissatisfied with waiting time, attitude of record officers and those in pharmacy department. This study found that the level of dissatisfaction with NHIS services is high despite a high satisfaction level. The Attitude of health workers may influence the dissatisfaction of enrollees. NHIS is still limited to the formal sector. (shrink)

This comparative study shows biases relative to client age, gender and behaviour demon strated by 268 female nurse subjects. A repeated measures design was utilized. All three main effects were significant (p < 0.001) for how respondents predicted that they would react to various clients and also how they predicted that their colleagues would react. Most two-way and three-way interaction effects were significant. Subjects demonstrated more favourable reactions to nice, young, male clients and least favourable reactions to not nice, (...) old, male clients. Study subjects predicted more favourable self-reactions to simulated clients than for their colleagues. What should be important to every professional as a result of this study is the need to be aware of self-biases, which may cause errors in decision-making and nursing care interventions and lead to ethical violations with clients. (shrink)

Intermediaries are social agents who can be found in all types of different environments, cultures, and organizations. More often than enough, intermediaries are middlepersons between two power centers, yet their agency is precarious due to their position as brokers who gain from bridging otherwise unconnected parties, or marginalized vulnerable individuals who suffer from the invasion of the neighboring power holders. How can these two different perspectives of the intermediaries be reconciled? Under what conditions do they shift from one type of (...) agency to another? Previous scholarship attributes the agency of intermediaries to static positionality. This paper treats the position of the intermediary as an opportunity structure, which is shaped by multi-level relational dynamics. We show the changing agency of three intermediary tribal groups (i.e. the Tibetans in northwestern China, Uriyangqad Mongols, and Jurchens) who were situated between the sedentary Chinese and nomadic Mongols during the Ming dynasty (1368–1644) through a systematic study with horse trade data. The group-based and officially-regulated horse trade constituted the most important linkage between the intermediaries and these two power centers. We study the changes in the dynamics of their contact during trade, and explain why these intermediaries became client, client to two patrons, and broker in their trade with the Chinese and Mongols in different eras. We argue that the position of the intermediaries did not provide definite advantages for their exploitation, nor did it paralyze them with any concrete disadvantages. Rather, their position offered them unpredictable opportunities that arose from their relational dynamics with the power centers. Moreover, the self-serving and local interests of the intermediaries, and the strategies and tactics that they used, determined their capacity to respond to emerging and unpredictable opportunities and capitalize on them. (shrink)

This paper argues that independent auditors have lost sight of their obligation to be truly impartial, and have increasingly adopted an attitude of client advocacy. We argue that auditors have a professional obligation to go beyond merely passing judgment on whether client accounting methods are acceptable under GAAP, and to judge whether the principles adopted are the most appropriate under the circumstances. We then review recent evidence which suggests that auditors have abandoned this objective in favor of advocating (...) client-preferred principles. The results of a survey of public accountants employed by small CPA firms indicates that, in a scenario in which an auditor did not feel that the client's accounting treatment was the most appropriate under the circumstances but it was recognized as an acceptable alternative under GAAP, advocacy of the client-preferred approach is considered appropriate and is very likely to occur in practice. In less subtle cases (e.g., when the auditor did not feel that the client's treatment provided the best reflection of the economic substance of the underlying transactions), survey participants as a group were ambivalent regarding the appropriateness of client advocacy, and felt that subordination of judgment was likely to occur in practice. The results also indicate that engagement risk, or the risk that the firm will be harmed by aggressive behavior, affects judgments of both the appropriateness and likelihood of subordination of judgment. These findings suggest that auditors have adopted an ideology of client advocacy, within the constraints of engagement risk. (shrink)

In psychotherapy, the norm and expectation is for clients to self-disclose, thus disregarding and discouraging self-disclosure by therapists. This study aimed to investigate clients’ subjective experience of therapist disclosure, and in particular how clients interpret, appraise and react to therapist disclosure, using semi-structured interviews to gather data from eight research participants. By means of Interpretative Phenomenological Analysis of the data three basic themes were revealed: perceived underlying conditions of the disclosure event, disclosure type and disclosure impacts. The findings indicate that (...) the underlying conditions surrounding the therapist’s disclosure are the determinant factor as to how clients experience therapist disclosure, regardless of either the disclosure type or the impact of the disclosure on clients’ lives. (shrink)

Workers with involuntary clients influence the behaviour of their clients. One of the methods by which workers influence their clients relates to the way they model, encourage or reinforce their comments and behaviours. Practitioners may be aware or unaware of this process and of the extent to which it can impact on clients. This paper describes the process of modelling and reinforcement and discusses some of the ethical issues it raises. It suggests some guidelines by which the process may be (...) undertaken in an ethical manner and recommends the use of the ethics of care and concept of human dignity as additional theoretical resources to assist in working with this client group. (shrink)

Resumen. En México, la mercadotecnia promocional se ha erigido como la segunda más grande inversión demercadotecnia, principalmente debido a que las compañías tienden con más frecuencia a subcontratar laresponsabilidad de los aspectos operativos de la mercadotecnia. Las empresas contratantes exigen cada vezmás la garantía de seguridad y certidumbre en la prestación de los servicios, por lo que la calidad de éste seha convertido en un factor determinante en la elección de una agencia de promociones. El presentedocumento técnico busca compartir un (...) caso de estudio relacionado a una empresa de promoción de ventasque enfrenta una alta tasa de deserción de clientes con su consecuente contracción en las ventas, pero quecontradictoriamente está inmersa en un mercado que tiene un crecimiento sostenido del 15 por ciento en losúltimos años. El problema fue abordado desde la perspectiva de la calidad en el servicio y la satisfacción delcliente a través de la aplicación de encuestas Servqual a algunos clientes de la compañía. Dichas encuestaspermitieron: identificar las dimensiones de calidad relevantes en el servicio, detectar las áreas de oportunidadentre el servicio esperado y el servicio real, y la elaboración de un plan de acción que posteriormente fuesistematizado e implementado. Los resultados muestran que la implementación del sistema de calidad redujola deserción de los clientes; además, se descubrió que las dimensiones de calidad del Servqual afectan enproporciones diferentes a la satisfacción del cliente.Palabras Claves. Calidad en el servicio, deserción de clientes, mercadotecnia promocional, promoción deventas, QFD, satisfacción del cliente, Servqual, sistema de calidad.. In Mexico, the promotional marketing has emerged as the second largest marketing investment,mainly because companies tend to outsource most often the operational aspects of marketing. Thosecompanies are increasingly demanding security and certainty in the delivery of services. As a consequence,service quality has become a determining factor in the election of a sales promotion agency. This technicalpaperwork shares a case study related to a sales promotion company facing high customer defection rate withits consequent contraction in sales, but ironically immersed in a market that has a sustained growth of 15 per cent in recent years. Approach of the problem was from quality service and customer satisfaction perspectivethrough the use of Servqual surveys applied to some customers. These surveys allowed: to identify relevantdimensions of quality service, to identify opportunities between the expected service and the actual service,and the development of an action plan which was later systematized and implemented. Results show that theimplementation of the quality system reduced customer desertion. Also, found that the quality dimensions of SERVQUAL affect customer satisfaction in different ways.Keywords. Customer defection, customer satisfaction, quality service, quality system, QFD, sales promotion,Servqual. (shrink)

Providing Single Sign-On (SSO) between service providers and enabling service providers to share user personal attributes are critical for both users to benefit from a seamless access to their services, and service providers to realize new business opportunities. Today, however, the users have several independent, partial identities spread over different service providers. Providing SSO and attribute sharing requires that links (federations) are established between (partial) identities. In SAML 2.0 (Maler et al. 2003), the links between identities are stored and managed (...) at the network side by the identity providers (network-side identity federation). This model prevents the service providers from mass-correlating the partial identities they have, but the users must fully trust the identity providers. In this paper, we propose a complementary approach where the users have a full control of the links between their partial identities. It is a client-side identity federation approach, which relies on the introduction of a new cryptographic tool, called invariable partially blind signature scheme, that may be of independent interest. (shrink)

ABSTRACTFormal representations of lawyer–client relations are often characterised by their regulative aspects, including codes of ethics and practice. In this article I look inside the relationship by returning to the sociology of Georg Simmel, who closely examined the basic units of sociality, especially dyads and triads. Using examples drawn from empirical research on corporate lawyers and clients and banks, I open up the lawyer/client dyad and show that in most cases the practices of lawyers and banks add noise (...) and interference to the relationship. The reason is that in many situations the basic unit of analysis for lawyer–client relationships should be the triad rather than the dyad. Whereas dyads are fundamentally stable, triads are the reverse, as they allow for alliances and defections creating permanent uncertainty. I take a number of examples where clients suffered in the alliances formed between their lawyers and the banks, leaving them on the periphery. It is time to recast the lawyer–client re... (shrink)

Journalists seldom consider the layers of those affected by their actions; third parties such as families, children, and even people unlucky enough to be in the wrong place at the wrong time. This article argues for consideration of the broader group, considering a range of options available for doing their duty to inform the public while also minimizing harm to others. Journalists might compare themselves with other professions that have similar roles, such as anthropologists, on such issues as confidentiality and (...) disclosure. A broader lesson is the value of applying different views, theoretical frameworks, and starting points to the ethical issues in any profession. (shrink)

This paper develops a model of persuasive demand inducement in the expert–client relationship. The expert frames the decision on whether or not to buy expert services faced by a client with prospect-theoretic preferences, by making the client see this decision from the perspective of a particular reference point. When inducing a client to buy risky curative services, the expert should set a high reference point, and frame all outcomes as losses. When instead inducing a client (...) to buy safe preventive services, as long as the client’s loss aversion is sufficiently high, the expert should set an intermediate reference point, framing high outcomes as gains and low outcomes as losses. (shrink)

Public professionals do not only serve their clients but also – by doing so – the public at large. The state often has a direct grip on their work, through financing, regulation or otherwise. This leads to a deeply felt conflict in contexts where authoritarian, illiberal leadership is widespread. Public professionals then face a moral dilemma: should they resist illiberal pressures by the state, or continue to obey their states? The paper's main question is how this practical dilemma for public (...) professionals should be interpreted. First, it presents a framework to interpret the professional situation, characterising it as a fiduciary relation, which we can understand through the lens of Thomas Hobbes's theory of authorisation/representation. On this theoretical basis, the paper discusses three competing models for understanding the public professional's predicament. The teleological model revolves around loyalty to one's clients. The conscientious professional model which is about loyalty to one's own moral convictions. The constitutional model is about loyalty to constitutional principles. The paper argues in favour of the constitutional model. Standing up against illiberal pressures is best interpreted as a matter of loyalty to the principles of constitutionality that underly the fiduciary relation between citizens and their states. (shrink)

BackgroundWhile most studies on HIV/AIDS often identify stigmatization and patients’ unwillingness to access health care as critical problems in the control of the pandemic, very few studies have focused on the possible consequences of accessing health care by sero-positives. This paper examines the socio-psychological trauma patients experience in their desire to access health care in two health facilities in the Ashanti Region of Ghana.MethodsThrough participant observation, informal conversation and in-depth interviews, data were collected from health workers and clients of the (...) voluntary counselling and antiretroviral therapy units in the two hospitals.The data gathered were analysed and categorized into themes and supported with illustrative quotes obtained from health workers and clients.ResultsThe study found that the mere presence of a person at the HIV counselling centre or clinic is enough for the person to be labelled as or suspected to be HIV patient. It demonstrates that stigmatization may occur not only in the community but also overtly or covertly, in the health facility itself. Consequently, for many HIV/AIDS patients, access to antiretroviral therapy and treatment of related nosocomial infections are problematic. Besides, the study found that many clients and potential users of services were uncomfortable with the quality of care given by some health workers, especially as they overtly and covertly breached confidentiality about their clients’ health status. This has compelled many patients and potential users of the services to adopt a modus vivendi that provides them access to some care services while protecting their identity.ConclusionThe paper argues that by examining issues relating to privacy and confidentiality in the provision of care for and use of services by seropositives, more light will be shed on the whys of the limited uptake of HIV-related health care services in Ghana. (shrink)

Background: Health institutions can be considered as complex organizations because they need to be prepared to receive and satisfy patients. This clientele differs from other organizations because the use of hospital services is not a matter of choice. Another motive for this difference is that, most often, the patients do not determine what services and products they will use during their stay. Although they are the clients, usually, health professionals decide which service or product they will consume. Hence, nursing care (...) delivery based on competence, efficiency and ethics represents a challenge. Objective: This critical reflection is meant to draw attention to the relevance of the ethical aspects of nurses' actions involving patients' satisfaction with nursing care. Research design: This paper highlights the responsibility of nurses to develop ethical actions in their commitment to manage and provide care with quality, commitment and efficiency. Findings and discussion: Possibilities of actions needed emerged from this discussion, such as the provision of reliable and updated information to clients, respect for standards, routines of care, exams and others, as well as clients' education, in order to further their involvement and participation in decisions concerning the care planned for them. Conclusion: The adoption of this paradigm entails a change in the performance of nurses' management and care roles, which may have to observe attitudes previously disregarded in most services provided. (shrink)

This article is currently available as a free download on ingentaconnect.

This article aims to explore the ethical issues arising from the sharing of information in the context of interprofessional collaboration. The increased emphasis on interprofessional working has highlighted the need for greater collaboration and sharing of client information. Through the medium of a case study, we identify a number of tensions that arise from collaborative relationships, which are not conducive to supporting interprofessional working in an ethically sound manner. Within this article, it is argued that the way forward within (...) these collaborative relationships is to set clear parameters to the professional-client relationship, paying full regard to the autonomy of both the clients and the professionals involved. We conclude that this approach to working will place the client at the centre of care provision and arguments used for not collaborating that are based on breaches of confidentiality will be negated. Using the approach offered, collaborative working will be not only possible but desirable. (shrink)

Trust is a crucial component of the relationship between a professional and those whom the professional serves because those served often lack the past experience and specialized training necessary to adequately assess the reliability of the professional’s judgments on their behalf. This article is an attempt to enhance our understanding of the conditions under which client trust of a professional is plausible. Trust, I will explain, is an emotional attitude with a unique evaluative dimension that can lead the one (...) who trusts to anticipate that the one trusted will not betray her even when she cannot adequately assess evidence of the trusted’s reliability. It is, however, precisely because evaluating someone’s trustworthiness differs in important respects from assessing their reliability that substantive trust of a professional is implausible in cases where those served by a particular profession, for example, medicine or journalism, conceive of it as merely a commercial enterprise. (shrink)