Clinical practice and research are governed by distinct rules and regulations and have different approaches to, for example, consent and providing results. However, genomics is an example of where research and clinical practice have become codependent. The 100 000 genomes project is a hybrid venture where a person can obtain a clinical investigation only if he or she agrees to also participate in ongoing research—including research by industry and commercial companies. In this paper, which draws on 20 interviews with professional (...) stakeholders involved in 100kGP, we investigate the ethical issues raised by this project’s hybrid nature. While some interviewees thought the hybrid nature of 100kGP was its vanguard, interviewees identified several tensions around hybrid practice: how to decide who should be able to participate; how to determine whether offering results might unduly influence participation into wide-ranging but often as yet unknown research and how to ensure that patients/families do not develop false expectations about receiving results. These areas require further debate as 100kGP moves into routine healthcare in the form of the national genomic medicine service. To address the tensions identified, we explore the appropriateness of Faden et al.’s framework of ethical obligations for when research and clinical care are completely integrated. We also argue that enabling ongoing transparent and trustworthy communication between patients/families and professionals around the kinds of research that should be permitted in 100kGP will help to understand and ensure that expectations remain realistic. Our paper aims to encourage a focused discussion about these issues and to inform a new ‘social contract’ for research and clinical care in the health service. (shrink)

This paper is sadly opportune. The general public is angry and bewildered if not hurt by the variety of strikes which are brought more or less forcibly to their attention. People used to understand what lay behind a strike - a demand for more pay, better conditions - but today a political element often intrudes, and it is this that worries those who ask themselves whether this or that dispute is either lawful or morally acceptable. Professor Dworkin, a lawyer, first (...) sets out the legal issues surrounding strikes and then advances the ethical arguments, closely relating them to the legal framework. The most interesting part of the paper, however, may well be that devoted to the moral obligation of example, in particular the example to be set by members of the medical profession and by all those caring for the sick. As public attitudes to industrial disputes `become dulled and quiescent' it is absolutely necessary that there should be a reappraisal of the moral standards of the past which coincide with a respect for the law. In the last century the term `anomie' was used to describe a `society which has shaken off its former restraints such as religion, respect for law and order and a definite moral code as to what is right and wrong'. We are living in that sort of society today, and one need not be a professional `ethicist' to recognize the signs, and hopefully, to work for the return of `ethical' values. (shrink)

We investigate the causal effects of religious service attendance on prosocial behaviours using longitudinal data from a nationally representative sample of 33,198 New Zealanders collected between 2018 and 2021. Our study innovates in three ways: (1) we use longitudinal rather than cross-sectional data; (2) we incorporate measures of help received alongside self-reported giving; and (3) our statistical models are designed to address causal questions, rather than simply to describe change over time. We model causal contrasts for three hypothetical interventions (...) – increasing, decreasing, or maintaining religious service attendance – and assess their effects on eight distinct prosocial domains. Study 1 focuses on self-reported charitable donations and volunteering. Studies 2 and 3 examine receiving help – both personal and financial – from family, friends, and the wider community. Across all analyses, we find that the causal effects of religious service attendance are notably smaller than cross-sectional correlations suggest. However, even modest increases in regular attendance would result in charitable donations equivalent to approximately 4% of the New Zealand Government’s annual spending – a considerable public benefit. By applying robust methods for causal inference to national-scale panel data, our study provides insights that can inform public policy about the social functions of religious participation and advances a methodological framework for investigating the social consequences of cultural practices. (shrink)

Resumen Ésta es la primera traducción al español de las guías “Atención después de la investigación: un marco para los comités de ética de investigación del National Health Service (NHS) (borrador versión 8.0)”. El documento afirma que existe una fuerte obligación moral de garantizar que los participantes enfermos de un estudio clínico hagan una transición después del estudio hacia una atención de la salud apropiada. Con “atención de la salud apropiada” se hace referencia al acceso para los participantes (...) a la atención de la salud, proporcionada principalmente por el National Health Service (en adelante NHS), el sistema de salud del Reino Unido, y/o a la intervención en estudio, también llamada producto o tratamiento en investigación. Las guías “Atención después de la investigación” están dirigidas principalmente a los miembros de los 79 comités de ética de investigación del NHS y a quienes presentan sus estudios de investigación ante estos comités. Se trata de un documento borrador muy avanzado, trabajado en numerosas reuniones, durante más de 3 años, que ha sido discutido por participantes de estudios y miembros de la comunidad, miembros y presidentes de comités de ética de investigación del Reino Unido, especialistas internacionales en ética de la investigación, representantes de la industria y otras partes interesadas. La redacción de las guías es producto de la colaboración de Neema Sofaer y Penney Lewis, ambas investigadoras del King’s College London, en el Centre of Medical Law and Ethics del Dickson Poon School of Law, y Hugh Davies, Asesor en Ética de la Investigación de la Health Research Authority (HRA) del NHS. El traductor del presente documento, Ignacio Mastroleo, participó del workshop en la Fundación Brocher (Ginebra, Suiza, diciembre de 2011) donde se revisó el borrador versión 7.0 y contribuyó en la revisión del borrador de la versión 8.0 durante el 2012. -/- Abstract This is the first Spanish translation of the guidelines “Care after research: a framework for NHS RECs (8th draft)”. The document states that there is a strong moral obligation to ensure that participants in a clinical study who are ill transition after the study to appropriate healthcare. The terms "appropriate healthcare" refer to participants’ access to health care, mainly provided by the National Health Service (NHS), the health system in the UK, and/or to the intervention study also named investigational treatment or product. The guides "Care after research" are mainly directed to members of the 79 NHS committees of research ethics (RECs) and to those who submit their research to these committees. This is a very advanced draft document, worked in several meetings, for more than three years, that has been discussed with study participants and community members, members and chairs of RECs in the UK, international specialists in research ethics, industry representatives and other stakeholders. The drafting of the guidelines is the result of the collaboration of Neema Sofaer and Penney Lewis, both researchers at King's College London, at the Centre of Medical Law and Ethics of Dickson Poon School of Law, and Hugh Davies, Research Ethics Advisor of the Health Research Authority (HRA) of the NHS. The translator of this document, Ignacio Mastroleo, attended the workshop at the Brocher Foundation (Geneva, Switzerland, December 2011) where draft version 7.0 was revised and contributed in the revision of draft version 8.0 during 2012. (shrink)

Resistance is a concept understudied in the context of health and healthcare. This is in part because visible forms of social protest are sometimes understood as incongruent with professional identity, leading healthcare workers to separate their visible actions from their working life. Resistance takes many forms, however, and focusing exclusively on the visible means more subtle forms of everyday resistance are likely to be missed. The overarching aim of this study was to explore how resistance was enacted within the workplace (...) amongst a sample of twelve healthcare workers, based in the United Kingdom; exploring the forms that such action took and how this intersected with health and healthcare. In depth-interviews were conducted and results were analysed utilizing Lilja’s framework ( 2022 ). Our findings suggest that resistance took a number of forms, from more direct confrontational acts, to those which sought to avoid power or which sought to create alternative or prefigurative practices or norms. These findings speak to the complexities, ambiguities, and contradictions of resistance, as carried out by healthcare workers in the workplace. While many acts had clear political motives, with issues like climate change in mind for example, participants also described how the act of providing care itself could be an act of resistance. While saying something about our participants, this also said something about the healthcare systems in which they worked. These findings also raise a range of normative issues. Perhaps needless to say, there appears to be substantial scope to expand and interrogate our findings and apply the idea of resistance to health and healthcare. (shrink)

A recent Organisation for Economic Co-Operation and Development survey demonstrated that an internationalization of genetic laboratory services currently emerged from the rarity of certain genetic abnormalities and from the small of laboratories performing specialized testing. When DNA samples cross national boundaries for genetic testing services to be performed in another country, the heterogeneity of national legal frameworks raises important questions regarding quality of genetic services available internationally.Some aspects of the genetic laboratories’ services are abundantly discussed by the literature, (...) among which most prominent are quality control standards and patients rights. Firstly, a 2003 study identified key distinctions between the different legal frameworks for genetic services. While some countries impose exhaustive regulatory requirements, others favor guidelines for good practices. Moreover, proficiency assessment, clinical validity, retention of laboratory records and test reports are not dealt with uniformly. (shrink)

This paper falls into three parts. In the first part I will briefly review the current process of reform that the United Kingdom National Health Service is undergoing. Two fundamental motivations for reform, the desire for increased efficiency and for an increased responsiveness to patients' needs and preferences will be discussed in greater detail. The second part attempts to provide a perspective on the moral debate concerning health care reform by introducing the distinction between ‘civil association’ and ‘enterprise (...) association’ as proposed by the political philosopher Michael Oakeshott. In the final part, this distinction will be used to analyze the moral and political constitution of the National Health Service, in order to establish the relevance and scope of concerns with efficiency and patient and public accountability. A framework within which the current reforms can be assessed is thereby outlined. Keywords: access to health care, civil association, enterprise association, freedom of choice, health care reform, United Kingdom National Health Service CiteULike Connotea Del.icio.us What's this? (shrink)

This research explores the perspectives of academic physicists from three national contexts concerning their roles and responsibilities within the realm of science. Using a dataset comprised of 211 interviews with scientists working in China, the United States, and the United Kingdom, the study seeks to explain whether and in what manner physicists conceptualize scientific ethics within a global or national framework. The empirical findings bring to light disparities across nations in the physicists’ perceptions of what constitutes responsible (...) mentorship and engagement in public service. These cross-national variations underscore the moral agency of physicists as they navigate the ethical standards embraced by the global scientific community vis-à-vis those that are specific to their respective national contexts. The study’s empirical insights may carry significant implications for both policymakers and ethicists, underscoring the imperative of soliciting and acknowledging the perspectives of academic scientists working and living in disparate national contexts when formulating comprehensive science ethics frameworks. Such inclusive and context-aware approaches to shaping ethics in science can contribute to the cultivation of a more robust and universally relevant ethical foundation for the scientific community. (shrink)

This study investigates the development of service-learning models for business school students in Azerbaijan. Drawing on the United Nations Sustainable Development Goals, this study identifies field projects and financial literacy immersions that benefit society while also promoting partnerships between Azerbaijan’s business schools, Central Bank, and international non-profit organizations. Based on the conceptual framework of Brower (Academy of Management Learning & Education 10:58-76, 2011) and theoretical underpinnings of Kolb (2015), this article develops two service-learning models for business schools (...) in Azerbaijan and presents new corollaries between issues of sustainable community development, service-learning, and experiential learning theory. In one service-learning model, business school students complete a service-oriented consulting project based on real-world assignments from the United Nations Food and Agriculture Organization. In a separate service-learning model, business school students partner with the Central Bank of Azerbaijan and Junior Achievement in exerting servant leadership by serving as mentors for Azerbaijan’s schoolchildren in the area of financial literacy. The service-learning models in this study are distinctive and innovative in the context of Azerbaijan, both in terms of management education development and the potential to infuse and teach the United Nations Sustainable Development Goals into the business curricula. (shrink)

This article aims to shed some light on the concepts embedded in the expressions ‘services of general interest’ (‘SGI’), ‘services of general economic interest’ (‘SGEI’), ‘non-economic services of general interest’ (‘NSGI’) and ‘social services of general interest’ (‘SSGI’). It is submitted that the expression ‘SGI’ conveys a general concept which comprises both SGEI and NSGI. SGEI may be distinguished from NSGI in that only the former involve an economic activity. In contrast to SGI, SGEI and NSGI, the expression ‘SSGI’ is (...) nowhere to be found in primary EU law. This means that it is for the EU legislator and, as the case may be, for the Member States to define such expression. Furthermore, this article supports the contention that a definition of the principles and conditions underpinning the operation of SGI must be capable of adapting to changing times and social perceptions, whilst being respectful of the vertical and horizontal allocation of powers set out in the Treaties. Vertically, a definition of SGI must not impinge upon the powers retained by the Member States. In the absence of harmonisation, it is for the Member States to define the services they consider to be of general interest, unless they commit a manifest error of assessment. In the presence of EU harmonising measures, the margin of discretion enjoyed by the Member States is, if still existent, narrowed down, given that national authorities are required to comply with the objectives pursued by the EU legislator. Horizontally, a definition of SGI must not encroach upon the prerogatives of the Commission in the realm of competition law. Moreover, in light of Article 9 TFEU and secondary EU legislation, the specific features of SSGI must be taken into consideration when determining the compatibility with EU State aid rules of public service compensation awarded to the providers of those services. An EU conceptual framework for the SGI must thus be the result of a constructive dialogue between the different levels of governance, as well as of a balanced solution among different policy areas in relation to which the EU enjoys competences. (shrink)

The history of the National Health Service research ethics system in the UK and some of the key drivers for its change into the present system are described. It is suggested that the key drivers were the unnecessary delay of research, the complexity of the array of processes and contradictions between research ethics committee (REC) decisions. It is then argued that the primary drivers for this change are and will be replicated by the systems of research ethics review (...) being put in place at UK universities in response to the Economic and Social Research Council research ethics framework. It is argued that this is particularly problematic for multi-centre review and for researchers who switch institutions. Finally, some potential solutions to this problem and their feasibility are discussed. (shrink)

Recovery is a model of care in (forensic) mental health settings across Western nations that aims to move past the paternalistic and punitive models of institutional care of the 20th century and toward more patient‐centered approaches. But as we argue in this paper, the recovery‐oriented services that evolved out of the early stages of this liberating movement signaled a shift in nursing practices that cannot be viewed only as improvements. In effect, as “recovery” nursing practices became more established, more codified, (...) and more institutional(ized), a stasis developed. Recovery had been reterritorialized. The purpose of this paper is to examine some of the threads of recovery, from its early days of antipsychiatry activism to its codification into mental health—including forensic mental health—institutions through the lens of poststructuralist philosophers Gilles Deleuze and Felix Guattari. We believe that Deleuze and Guattari's scholarship provides the necessary, albeit uncomfortable, framework for this critical examination. From a conceptualization of recovery as an assemblage, we critically examine how we can go about creating something new, caught in a tension between stasis and change. (shrink)

Objective: The field of clinical ethics is relatively new and expanding. Best practices in clinical ethics against which one can benchmark performance have not been clearly articulated. The first step in developing benchmarks of clinical ethics services is to identify and understand current practices.Design and setting: Using a retrospective case study approach, the structure, activities, and resources of nine clinical ethics services in a large metropolitan centre are described, compared, and contrasted.Results: The data yielded a unique and detailed account of (...) the nature and scope of clinical ethics services across a spectrum of facilities. General themes emerged in four areas—variability, visibility, accountability, and complexity. There was a high degree of variability in the structures, activities, and resources across the clinical ethics services. Increasing visibility was identified as a significant challenge within organisations and externally. Although each service had a formal system for maintaining accountability and measuring performance, differences in the type, frequency, and content of reporting impacted service delivery. One of the most salient findings was the complexity inherent in the provision of clinical ethics services, which requires of clinical ethicists a broad and varied skill set and knowledge base. Benchmarks including the average number of consults/ethicist per year and the hospital beds/ethicist ratio are presented.Conclusion: The findings will be of interest to clinical ethicists locally, nationally, and internationally as they provide a preliminary framework from which further benchmarking measures and best practices in clinical ethics can be identified, developed, and evaluated. (shrink)

Transnational reproductive travel is symptomatic of insufficient supplies of reproductive resources, including donor gametes and gestational surrogacy services, and inequities in access to these within domestic health-care jurisdictions. Here, we argue that an innovative approach to domestic policy making using the framework of the National Self-Sufficiency paradigm represents the best solution to domestic challenges and the ethical hazards of the global marketplace in reproductive resources.

The prevention, treatment and management of disease are closely linked to how the causes of a particular disease are explained. For multi-factorial conditions, the causal explanations are inevitably complex and competing models may exist to explain the same condition. Selecting one particular causal explanation over another will carry practical and ethical consequences that are acutely relevant for health policy. In this paper our focus is two-fold; the different models of causal explanation that are put forward within current scientific literature for (...) the high and rising prevalence of the common complex conditions of coronary artery disease and type 2 diabetes mellitus ; and how these explanations are taken up within national health policy guidelines. We examine the causal explanations for these two conditions through a systematic database search of current scientific literature. By identifying different causal explanations we propose a three-tier taxonomy of the most prominent models of explanations: evolutionary, lifecourse, and lifestyle and environment. We elaborate this taxonomy with a micro-level thematic analysis to illustrate how some explanations are semantically and rhetorically foregrounded over others. We then investigate the uptake of the scientific causal explanations in health policy documents with regard to the prevention and management recommendations of current National Service Frameworks for CAD and T2D. Our findings indicate a lack of congruence between the complexity and frequent overlap of causal explanations evident in the scientific literature and the predominant focus on lifestyle recommendations found in the mainstream health policy documents. (shrink)

The UK’s National Institute for Health and Care Excellence is responsible for conducting health technology assessment on behalf of the National Health Service. In seeking to justify its recommendations to the NHS about which technologies to fund, NICE claims to adopt two complementary ethical frameworks, one procedural—accountability for reasonableness —and one substantive—an ‘ethics of opportunity costs’ that rests primarily on the notion of allocative efficiency. This study is the first to empirically examine normative changes to NICE’s approach (...) and to analyse whether these enhance or diminish the fairness of its decision-making, as judged against these frameworks. It finds that increasing formalisation of NICE’s approach and a weakening of the burden of proof laid on technologies undergoing HTA have together undermined its commitment to EOC. This implies a loss of allocative efficiency and a shift in the balance of how the interests of different NHS users are served, in favour of those who benefit directly from NICE’s recommendations. These changes also weaken NICE’s commitment to AfR by diminishing the publicity of its decision-making and by encouraging the adoption of rationales that cannot easily be shown to meet the relevance condition. This signals a need for either substantial reform of NICE’s approach, or more accurate communication of the ethical reasoning on which it is based. The study also highlights the need for further empirical work to explore the impact of these policy changes on NICE’s practice of HTA and to better understand how and why they have come about. (shrink)

The distinctive security features of the Spanish electronic national identity card, known as Documento Nacional de Identidad electrónico, allow us to propose the usage of this cryptographic smart card in an authentication framework that can be used during the registration and login phases of internet services where the validation of the user’s age and real identity are key elements, as it is the case for example of the so-called social networks. Using this mechanism with NFC-capable devices, the identity (...) and age of the potential user can be determined, allowing or denying the access to the service based on that information. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:An Interesting Framework That Deserves to Be Developed and Used WidelyThe author reports no conflict of interests.Friesen's "Why Democratize Psychiatric Research?" is an important piece of work and makes a compelling epistemic and ethical case. As someone who has spent decades in the field of (in chronological order): survivor involvement, service user involvement, patient and public involvement and now lived experience; I am delighted when I see (...) a robust reminder of the reasons why we need to take this seriously. The author is right to stop us sleepwalking into an activity because funders expect it, psychiatry now prides itself on it, and academics write countless pieces on it. People who have not lived in a time when our involvement in research was entirely counter-cultural (or even symptomatic of a patient lacking insight) could be forgiven for thinking it was always like this.There are, however, three themes that could and should be developed from this thinking. They concern assumptions about general medicine, the institutional discrimination within psychiatry, and the significant cultural change that has occurred since the rise of the survivor movement as one of the later rights movements of the last century.Many years ago, I would have made the same argument about how psychiatry lacks the objectivity and testable biomarkers of general medicine. As I have spent more time with assorted medics, many at the top of their game, it is clear that there is much more subjectivity across much of medicine and rather than place psychiatry as uniquely needing more democratic research (a proposition I wholeheartedly endorse), I would love to see us take these arguments into medicine as a whole. Until we do this, we risk "othering" psychiatry as a whole rather than showing an area in which psychiatric patients (or survivors, or service users, or people with lived experience, as you wish) can become leaders in progressive medical thinking.A more important omission which needs significant addressing if we genuinely are to democratize psychiatric research is the racial inequality within psychiatric practice. There are many inequalities both within psychiatry and in broader society that contributes to mental health inequalities, but the experience of racialized communities, in our [End Page 139] psychiatric services has been a consistent theme. For those unfamiliar with the extent of difference between White and Black experience of UK psychiatry you need only look at the differential rates of detention under mental health legislation. National Health Service data show that people from minority ethnic groups are more likely to experience compulsory detention than their White counterparts. In 2020/21, rates of detention by ethnicity were Black or Black British: 309.4 per 100,000 people compared with White: 76.2 per 100,000 people (National Health Service Digital, 2021.)If we are to truly democratize research in psychiatry, we need to more actively engage racialized communities and ensure that they are leading and coproducing more of our research. Although this forms part of the argument in feature #3, it warrants being front and center of features #1 and #4 where the differences between Black and White are so marked.We as democratizing researchers should be carrying an anti-racist banner high and doing more to both improve our own practice and constantly challenge a psychiatry that has failed, review after review, to address this. The Whiteness and Race Equality Network, part of the Collaborating Centre for Values Based Practice1 is working hard on this theme but much more is needed.The final challenge which needs addressing, and one which certainly needs the analytical skill and clarity of thinking that Friesen has applied throughout, is the breadth and diversity of what now constitutes "lived experience" in mental health. Even if we restrict our scope to psychiatry, this is a much broader research field than when survivor research started to be taken seriously. The vast majority of survivor researchers would have spent considerable periods of time as inpatients in psychiatric hospitals, often as detained patients. None of us would have chosen to self-diagnose, most of us would have done all we could to shed our diagnostic labels, some of us find it hard to forget... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 12.1 (2002) 103-113 [Access article in PDF] Scope Note Update Searching Across Boundaries: National Information Resource on Ethics and Human Genetics* While indeed an historical moment, the announcement of the mapping of the human genome has been treated in the literature as a beginning—a new way to think about biology and the ways in which biological concepts are applied to medicine. Issues of (...) both Science and Nature magazines celebrated the event by establishing interdisciplinary websites where readers can access essays on aspects of genome mapping and directly link to databases to search for more information on the topics (IV. Genome Gateway 2001; The Human Genome 2001). Since 1994, the National Information Resource on Ethics and Human Genetics (NIREHG), a special project of the National Reference Center for Bioethics Literature (NRC), has been providing such an integrated information service on ethics and genetics. Designed to enable a wide range of users to go from annotated bibliographies (Scope Notes) and brief essays (called "enotes") to database searching, NIREHG fosters an interdisciplinary approach to research on ethics and genetics. Links are provided between and among Scope Notes and enotes to information maintained on the NIREHG site as well as to sources found throughout the Internet. In providing the following annotations added to NIREHG materials since 1997, the Kennedy Institute of Ethics Journal (in its online presence through Project Muse) becomes an additional forum for NIREHG links. "It is a rare and wonderful moment when success teaches us humility, and this, I argue, is precisely the moment at which we find ourselves at the end of the twentieth century" (IV. Keller 2000, p. 7). It is with both joy and humility that we celebrate the mapping of the human genome. [End Page 103] I. Genetic Testing Andrews, Lori B. Future Perfect: Confronting Decisions About Genetics. New York: Columbia University Press, 2001. 264 p.Noting the wide impact of genetic testing, Andrews discusses patient self concept, reproduction decisions, confidentiality, discriminations in health insurance and employment, the need for competent counseling, and the legal, ethical, and social regulations she deems important to help solve dilemmas arising from the tests and their ensuing ramifications. She describes three models, pointing out both advantages and problems: a medical model with physician gatekeepers, a public health model that could provide education as well some testing for those unable to afford tests, and a fundamental rights model that could give greater weight to individuals decisions about the use of health care services. The book has 85 pages of footnotes.American Society of Human Genetics. Social Issues Subcommittee on Familial Disclosure. Professional Disclosure of Familial Genetic Information. American Journal of Human Genetics 62 (2): 474-83, February 1998.The ASHG statement outlines points to consider: the general rule of confidentiality, exceptional circumstances that permit disclosure, and the ethical duty to inform patients about familial implications. Background discussion includes: ethical frameworks for disclosure of otherwise confidential information, the duty to warn under law, and international trends and positions.Boetzkes, Elisabeth. Genetic Knowledge and Third-Party Interests. Cambridge Quarterly of Healthcare Ethics 8 (4): 386-92, Summer 1999.Protection from the interests of insurers or prospective employers are discussed from the point of view of the ethical basis of the professional obligation to confidentiality as well as the right to privacy of those tested. However, the author supports family members, saying that "first-party resistance to disclosure may be overcome by weighty third-party claims."Chadwick, Ruth; Shickle, Darren; ten Have, Henk; and Wiesing, Urban, eds. The Ethics of Genetic Screening. Dordrecht, The Netherlands: Kluwer Academic Publishers, 1999. 255 p.Twenty-one chapters and 23 authors provide views of genetic testing/screening in different European countries and offer brief discussions of sociological perspectives, moral and philosophical issues, privacy, reconciling liberty and the common good, and questions raised in genetic testing of children.Clayton, Ellen Wright. Genetic Testing in Children. Journal of Medicine and Philosophy 22 (3): 233-51, June 1997.Clayton argues that there is room for... (shrink)

Nearly two decades of debate have not settled the definition of research misconduct. The literature provides four explanatory frameworks for misconduct. The paper examines these frameworks and maps them onto efforts by the U.S. Public Health Service to define research misconduct and subsequent responses to these efforts by the scientific community. The changing frameworks suggest that closure will not be achieved without an authoritative effort, which may occur through the Research Integrity Panel’s recent attempt to create a government-wide definition.

In the current era of the Sustainable Development Goals, many countries are attempting to strengthen their health system and achieving Universal Health Coverage. The Korean National Health Insurance system functions as a core element of health financing, contributing to achieving UHC by promoting public health and social security through insurance benefits for prevention, diagnosis, treatment, rehabilitation, childbirth, and health promotion. The Republic of Korea achieved 100% NHI coverage of the target population in 1989, 12 years after the introduction of (...) the social insurance system. However, poor coverage of health services and lack of financial protection are major obstacles to achieving UHC. Therefore, the Korean government announced and implemented ‘Moon Jae-in Care’ in August 2017 to enhance the coverage rate of NHI by 70%. First, this study reviews the existing health insurance system in Korea from the perspective of health financing and UHC. Second, it analyses ‘Moon Jae-in Care’, based on the main framework of UHC. Third, it considers the ethical implications of these developments, with focus on the principles of equity, fairness, autonomy, and solidarity. Although the NHI reform is expected to propel Korean health care closer to UHC, many ethical, social, and political issues remain. (shrink)

Public-private partnerships are established to specifically harness the potential of Big Data in healthcare and can include partners working across the data chain—producing health data, analysing data, using research results or creating value from data. This domain paper will illustrate the challenges that arise when partners from the public and private sector collaborate to share, analyse and use biomedical Big Data. We discuss three specific challenges for PPPs: working within the social licence, public antipathy to the commercialisation of public sector (...) health data, and questions of ownership, both of the data and any resulting intellectual property or products. As a specific example we consider the case of the UK National Health Service providing patient data to Google’s DeepMind AI program to develop a diagnostic app for kidney disease. This article is an application of the framework presented in this issue of ABR. Please refer to that article for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. We use four specific values to help analysis these issues: public benefit, stewardship, transparency and engagement. We demonstrate how the Deliberative Framework can support ethical governance of PPPs involving biomedical big data. (shrink)

Over the last 30 years, colleges of education across the nation have examined and deliberated how best to educate pre-service history teachers for the challenges of the modern classroom. Specifically, they sought to create and refine teacher preparation programs that foster within the pre-service history teacher the propensity to use authentic teaching practices once they are licensed and instructing independently in the classroom. Using a situated learning theoretical framework, this research study adds to the literature on this (...) topic by examining how a semester-long pre-service residency at a historic site, archive, library, or museum influences in-service history teacher pedagogy. Utilizing an ex post facto qualitative research methodology with a questionnaire, interviews, and analysis of lesson plans, this study pursued the objective of evaluating the nuances of a residency and how those experiences influence in-service pedagogical dispositions. The findings of the study conclude pre-service history teacher residencies offer valuable and unique learning spaces for the pedagogical development of pre-service history teachers by promoting authentic-based teaching models that participants carry into their in-service teaching. (shrink)

Increased awareness of the importance of mental health for global health has led to a number of new initiatives, including influential policy instruments issued by the World Health Organization (WHO) and the United Nations (UN). This policy brief describes two WHO instruments, the Mental Health Action Plan for 2013–2020 (World Health Organization, 2013) and the Mental Health Atlas (World Health Organization, 2015), and presents a comparative analysis with the Sustainable Development Goals (SDGs) of the UN’s 2030 Agenda for Sustainable Development (...) (United Nations, 2015). The WHO’s Action Plan calls for several specific objectives and targets, with a focus on improving global mental health governance and service coverage. In contrast, the UN’s SDGs include only one goal specific to mental health, with a single indicator tracking suicide mortality rates. The discrepancy between the WHO and UN frameworks suggests a need for increased policy coherence. Improved global health governance can provide the basis for ensuring and accelerating progress in global mental health. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.2 (2004) 165-173 [Access article in PDF] Professional Judgment, Critical Realism, Real People, and, Yes, Two Wrongs Can Make a Right! K.W.M. Fulford Anthony Colombo Keywords values, values-based practice, models of disorder, concept of mental illness, user-centred practice, patient-centred practice, multidisciplinary teamwork We are grateful to our four commentators for putting much-needed conceptual air and space around the models project. Published originally as an empirical (...) study of the different implicit models of disorder, held by users of services, carers, nurses, psychiatrists, and social workers (Colombo et al. 2003), our paper outlined the philosophical roots of the models project in linguistic analytic philosophy of the "Oxford school" (Fulford and Colombo 2004). Our four commentators provide extra dimensions of understanding, respectively from professional education (Williams 2004), sociology (Bendelow 2004), Heideggerian phenomenology (Heginbotham 2004), and mental health policy and practice (Williamson 2004).Since the original study, the models project has been taken forward as a key contribution to a range of philosophy-into-practice initiatives called, collectively, Values-Based Practice. In this brief response, we outline the key features of Values-Based Practice and indicate how these connect with some of the many thoughtful points about models made by our commentators. Values-Based Practice Values-Based Practice, then, is the theory and skills-base for effective health care decision making where different, and hence potentially conflicting, values are in play (Fulford 2004). Premised on the democratic meta-value of equal respect for all voices, Values-Based Practice relies, much as a political democracy relies, on good process rather than preset outcomes for its practical effectiveness. The ten pointers to good process in Values-Based Practice are summarized in Figure 1. We return to the implications of these for the work on models below.Relying on good process may be thought to be a recipe more for relativism and indecision in clinical decision making than for practical effectiveness. To the contrary, however, the 'values democracy' of Values-Based Practice, again like a political democracy, carries a number of clear and coherent implications for policy and practice in health care. [End Page 165] Click for larger viewFigure 1 10 Pointers to Good Process in VBP [End Page 166]Examples of the implications of Values-Based Practice for policy and practice are given in the Values Framework shown in Figure 2. This is a policy framework for the development of Values-Based Practice in mental health produced by a project group in the National Institute for Mental Health in England (NIMHE), the section of the UK's National Health Service (NHS) responsible for implementing government policy on mental health as embodied in the National Service Framework for Mental Health (Department of Health 1999) and subsequent policies. The framework gives three key principles of Values-Based Practice (the three Rs of recognition, raising awareness, and respect) and then summarizes some of the specific implications of the approach. Racism, for example, is incompatible with Values-Based Practice because racism is by definition intolerant of diversity. Again, we indicate some of the policy implications of Values-Based Practice for the points about models made by our commentators below.Training for mental health practitioners in Values-Based Practice will be rolled out from April 2005, through both voluntary and statutory bodies, in each of the eight regions of the National Health Service of England and Wales. This roll out will be supported by training methods developed and piloted in a unique joint venture between Warwick University's Department of Philosophy and Medical School, and an in-service training provider, the Sainsbury Centre for Mental Health (Fulford, Williamson, and Woodbridge 2002; Woodbridge and Fulford 2003). These training methods are the basis of a detailed workbook for Values-Based Practice (Woodbridge and Fulford 2004). The workbook will be launched in July 2004 at a conference in London by the Minister of State with responsibility for mental health, Rosie Winterton. Professional Training and Professional Judgment The models project has been central to the development of... (shrink)

This paper addresses whether, how, and to what extent social studies student teachers who have been introduced to inquiry-oriented teaching (as manifest in the National Council for the Social Studies C3 Framework) in their secondary social studies methods course incorporate this approach into the planning for their practicum experience. Based on analysis of lesson plans used in the practicum and follow-up interviews with a small subset of student teachers, this paper analyzes the factors that promote or inhibit use (...) of this approach to teaching in their practicum experience. Results indicate the C3-oriented teaching approach, as taught in the methods course, did appear in the student teachers’ lesson plans. A small subset of student teachers used the framework competently while two smaller subsets were less adept in their application. The degree of application was affected by student teachers’ perceptions of their school placements and students’ needs. (shrink)

ABSTRACTWidespread trade liberalization and economic integration characterize the current era of globalization. While this approach has resulted in significant job creation, improved living standards, and a wider variety of cheaper consumer goods and services, opponents question if globalization's benefits outweigh the dislocations and downsides that it causes. Protestors are intent on stalling or rolling back globalization's progression and our review of the history of globalization reveals that a backlash is not without precedent. The article carefully examines the myth and reality (...) of these two opposing positions on four key areas of the globalization debate: jobs; inequality and poverty; national sovereignty and cultural diversity; and the natural environment. This information is then utilized to derive a broad set of feasible policy recommendations that could help bring about a more sustainable form of globalization. (shrink)

Background Although the importance of clinical ethics in contemporary clinical environments is established, development of formal clinical ethics services in the Australia health system has, to date, been ad hoc. This study was designed to systematically follow and reflect upon the first 18 months of activity by a newly established service, to examine key barriers and facilitators to establishing a new service in an Australian hospital setting. Methods: how the study was performed and statistical tests used A qualitative (...) case study approach was utilised. The study gathered and analysed data using observations of service committee meetings, document analysis of agendas and minutes, and semi-structured interviews with committee members to generate semantic themes. By interpreting the thematic findings in reference to national capacity building resources, this study also aimed to provide practice-based reflections for other health agencies. Results: the main findings An overarching theme identified in the data was a strong commitment to supporting clinicians facing difficult patient care decisions and navigating difficult discussions with patients and families. Another key theme was the role of the new clinical ethics support service in providing clinicians with a pathway to raise system-wide issues with the organisation Executive. While there was strong clinical engagement, consumer and community participation remained a challenge, as did unresolved governance issues and a need for clearer policy relationship between the service and the organisation. Conclusions: brief summary and potential implications Considering these themes in relation to the national capacity building resources, the study identifies three areas likely to require ongoing development and negotiation. These are: the role of the clinical ethics support service as a link between the workforce and the Executive; the incorporation of consumers and patients; and ethical reasoning. To improve the effectiveness of the service, it is necessary to increase clarity on the service’s role at the governance and policy level, as well as develop strategies for engaging consumers, patients and families. Finally, the capacity of the service to reflect on complex cases may be enhanced through explicit discussions of various different ethical frameworks and ways of deliberating. (shrink)

For the last thirty years, the nation's mental health and social service systems have been under relentless assault, with dramatically rising costs and the fragmentation of service delivery rendering them incapable of ensuring the safety, security, and recovery of their clients. The resulting organizational trauma both mirrors and magnifies the trauma-related problems their clients seek relief from. Just as the lives of people exposed to chronic trauma and abuse become organized around the traumatic experience, so too have our (...) social service systems become organized around the recurrent stress of trying to do more under greater pressure: they become crisis-oriented, authoritarian, disempowered, and demoralized, often living in the present moment, haunted by the past, and unable to plan for the future.Complex interactions among traumatized clients, stressed staff, pressured organizations, and a social and economic climate that is often hostile to recovery efforts recreate the very experiences that have proven so toxic to clients in the first place. Healing is possible for these clients if they enter helping, protective environments, yet toxic stress has destroyed the sanctuary that our systems are designed to provide.This thoughtful, impassioned critique of business as usual begins to outline a vision for transforming our mental health and social service systems. Linking trauma theory to organizational function, Destroying Sanctuary provides a framework for creating truly trauma-informed services. The organizational change method that has become known as the Sanctuary Model lays the groundwork for establishing safe havens for individual and organizational recovery. The goals are practical: improve clinical outcomes, increase staff satisfaction and health, increase leadership competence, and develop a technology for creating and sustaining healthier systems. Only in this way can our mental health and social service systems become empowered to make a more effective contribution to the overall health of the nation.Destroying Sanctuary is a stirring call for reform and recovery, required reading for anyone concerned with removing the formidable barriers to mental health and social services, from clinicians and administrators to consumer advocates. (shrink)

For at least the past 15 years, food safety stakeholders across all levels of government have recognized the critical role that state and local agencies play in our nation's food safety system. State and local agencies are the first responders to foodborne outbreaks and have primary responsibility for keeping their residents safe from foodborne disease through effective surveillance and rapid response to outbreaks. They also conduct the vast majority of food safety inspections across the nation's restaurants, grocery stores, and other (...) food service and food retail establishments.Recent efforts among industry and government officials alike have focused on creating a more integrated, prevention-oriented food safety system. The Food Safety Modernization Act, the first major overhaul of the nation's food safety laws since the 1930s, now mandates that most sectors of the food industry put preventive controls in place, changing the emphasis of what the FDA does from response to prevention. (shrink)

Due to the innovative nature of the world economy and the continuity of scientific and technological progress, intellectualization becomes one of the world's leading trends. The article is aimed to evaluate the state of intellectualization of the national economy of Ukraine in the context of globalization. In the article the existing approaches are considered, which are used by international organizations and expert agencies to evaluate the intellectualization level of the countries around the world. The indicators of the state of (...) intellectualization, available in the publications of the State statistics service of Ukraine have been researched. The author's deductive description of the intellectualization state of the regions (on the basis of twenty four indicators) and of types of economic activity (three indicators) of the national economy has been presented. It has been determined, that in the today's circumstances, an increasing of intellectualization level of the Ukrainian economy could happen, on the one hand, by means of getting balanced the status of intellectualization of the regions, given their natural resource potential, the socio-economic situation and the international human resources movement. On the other hand, this can happen due to introduction of new forms of national economic policies for human resources development in the fields of IT-technologies, information services, sports, education, space industry, tourism. The scientific novelty and practical importance, as well as originality of the obtained results is represented by an elaborated methodological framework for evaluating the state of the intellectualization of the national economy plus a further projecting of mechanisms of intellectualization of Ukraine in the worldwide context. (shrink)

The American Society for Bioethics and Humanities poses a chal­lenge in Core Competencies for Healthcare Ethics Consultation: health care ethics consultation services “should be able to demonstrate their value to those who pay for the service, as well as to those whom the service is intended to serve.” To respond to this challenge, this article provides a brief review of the literature on evaluating ethics consultation in its traditional frameworks of quality outcomes. The author follows this discussion with (...) a new methodology to evaluate ethics consultation on the basis of the intrinsic good of the service. He ends with a novel risk-based assessment to complement the evaluation of clinical ethics services grounded in the Ethical and Religious Directives for Catholic Health Care Services. (shrink)

We commend the authors for their comprehensive discussion on consent and episiotomies.1 They correctly observe that informed consent for all proposed interventions in maternity care is always necessary. The claim that consent for maternity health services does not always have to be fully informed or explicit, however, is erroneous. We are especially concerned with, and surprised by, the endorsement of ‘opt-out consent’. ‘Opt-out consent’ (a.k.a. substitute decision making) is already standard practice in maternity healthcare, with obstetric violence a normalised response (...) to conclusive refusals or requests for explanations. Informed consent is based on the fundamental human rights to bodily autonomy and integrity, which healthcare providers are obliged to respect. Healthcare structured around human rights violations is not care. It is cruel and inhumane treatment—a violation of yet another fundamental human right—and a reflection of poor-quality care. To be valid, consent must always be informed, specific, timely, freely given and reversible. The provider must provide information specific to each and every proposed intervention in a timely manner. The consumer has the right to consider, freely accept or refuse before providers can act. They can also change their mind at any time. Provider attempts to substitute consumer decision-making rights constitute assault and battery. Whether the infraction was major or minor is of no consequence to human rights law. National courts create artificial …. (shrink)

When research concludes, post-trial access to the trial intervention or standard healthcare can be crucial for participants who are ill such as those in resource-poor countries with inadequate healthcare, British participants testing ‘last-chance drugs’ unavailable on the National Health Service and underinsured US participants. Yet, many researchers are unclear about their obligations regarding the post-trial period, and many research ethics committees do not know what to require of researchers. Consequences include participants who reasonably expect but lack PTA to (...) the trial intervention, unplanned financial liabilities for NHS Trusts forced to fund this, negative press and potential to undermine public trust.1–3,iOne reason for the lack of clarity is controversy over whether and when participants should have access, after the study, to the study intervention. At one extreme is the view that continued access should be ensured when the intervention has benefited the participant or when it has proven safe and effective for the participant population, irrespective of the cost and burden of ensuring continued access. At the other extreme is the view that continued access need never be provided so long as non-availability of the study intervention post-trial was adequately disclosed when participants were invited to participate.6 There is also disagreement about when poststudy access to the study intervention should be considered beneficial for participants. The spectrum ranges from the view that the intervention should be regarded as beneficial for a proposed use only after the …. (shrink)

The requirement by the National Science Foundation (NSF) that research proposals include plans for “broader impact” activities to foster connections between Science, Technology, Engineering, and Math (STEM) research and service to society has been controversial since it was first introduced. A chief complaint is that the requirement diverts time and resources from the focus of research and toward activities for which researchers may not be well prepared. This paper describes the theoretical framework underlying a new strategy to (...) pair NSF-funded nano research centres with science museums in order to achieve greater success in the broader impact mission, and to transform the perceived burden of the requirement into an opportunity to provide enhanced value to the constituencies of the partnering organizations, as well as to the larger community. This partnership approach is presented as a model that also can be applied to NSF-funded research centres in other STEM fields, and to non-NSF-funded STEM research centres nevertheless looking to pursue broader impacts types of activities. The model also provides an opportunity to stretch the typical spectrum of broader impacts activities to include citizen engagement in science, technology and societal concerns. (shrink)

This contribution asks how to approach the question of whether the European Union should – replacing or supplementing member states – also be a locus of social justice‐based duties to provide welfare state services. The contribution scrutinizes two important theories of global justice (cosmopolitan and relational theories) and finds that their normative assumptions hinder them from adequately addressing this question. A new theory is proposed, inspired by Immanuel Kant's political philosophy. The core idea is that social justice requires public authorities (...) to protect citizens against private forms of coercion; and that the level (national, European, global) at which such authority needs to be exercised depends on which arrangement best protects citizens' rights to independence. The paper outlines several duties of global justice to give specificity to this general principle, and then applies them to the case of integrating European welfare states. (shrink)

Verbal autopsy presents the opportunity to understand the disease burden in many low-income countries where vital registration systems are underdeveloped and most deaths occur in the community. Advances in technology have led to the development of software that can provide probable cause of death information in real time, and research considering the ethical implications of these advances is necessary to inform policy. Our research explores these ethical issues in rural Nepal using a public health ethics framework. We considered the (...) burdens and benefits of VA and giving cause of death information to families of the deceased through qualitative research with VA interviewers, community members, national policy stakeholders and international academics. Burdens can be experienced differently, and it is important to balance the emotional burden of VA with utilization of the data to inform planning and increased access to health services. The training, support and supervision of VA interviewers should be prioritized if VA is taken to scale. Initial and ongoing community engagement is recommended in addition to engaging ethical, legal, health and policy personnel in developing protocols and systems. Integrating rigorous research while cautiously moving forward is recommended to ensure systems and responses to concerns are relevant to contexts. (shrink)

The National Institute for Health and Clinical Excellence (hereafter NICE) was created in 1998 to give guidance on which treatments should be provided by the British National Health Service, and to whom. So it has a crucial role as an agent of distributive justice. In this paper I argue that it is failing to adequately explain and justify its decisions in the public arena, particularly in terms of distributive justice; and that this weakens its legitimacy, to the (...) detriment of the National Health Service as a whole. I argue that this failure arises from the fact that NICE works within the frameworks of positivist science and liberal ethics, largely to the exclusion of other perspectives. This narrowness of view prevents NICE from properly connecting with the range of moral concerns represented in the population. I argue for NICE’s deliberations to become more inclusive, both in terms of epistemology, and also in terms of ethical perspectives. And I suggest a range of perspectives that could usefully be included. Finally I offer a framework of structures, philosophies and discussion process that will enable competing perspectives to be debated fairly and productively in this process. (shrink)

Working as a clinician within the National Health Service (NHS) in England is described along with the difficulty of identifying a role for the humanities within the organisational framework. The author argues that the humanities are both marginalised and required and that the humanities can provide a means to redefine values within medical practice.

Public benefit corporations are National Health Service, that is, state, entities whose function to provide healthcare in discharge of public duties. If we regardvalue as the output of such organisations, it seems logical to connect the values of the organisation to thevalue produced by such organisations. But, on closer examination there are competing underlying logics in play: (1) those based on promoting organisational efficiency and efficacy; and (2) those based on the idea of building service provision around (...) the clinician–patient relationship. Underlying these logics are differing value sets. These clash. Because of the clashing of underlying moral frameworks the connection between values andvalue becomes hard, if not impossible. This paper argues that (1) the clash in these moral frameworks must be addressed by the organisation rather than between individuals or groups of individuals within the organisation; (2) alloying duties within hybrid professionals submerges but does not resolve these conflicts; (3) one approach could be to impose on the organisation itself an ethical imperative to promote, enhance and protect from deterioration the welfare of the patients; (4) a board ethics committee is a possible organisational structure that could transparently and fairly balance clashes within the competing moral frameworks in a way that could reconcile the competing logics and (5) if such conflicts can be better resolved at the organisational level what the organisation must do to achieve its objectives will become clearer because what needs to be valued would naturally emerge connecting values,value and what is valued. (shrink)

The national ethical guidelines relevant to assisted reproductive technology have recently been reviewed by the National Health and Medical Research Council. The review process paid particular attention to the issue of non-medical sex selection, although ultimately, the updated ethical guidelines maintain the pre-consultation position of a prohibition on non-medical sex selection. Whilst this recent review process provided a public forum for debate and discussion of this ethically contentious issue, the Victorian case of JS and LS v Patient Review (...) Panel [2011] VCAT 856 provides a rare instance where the prohibition on non-medical sex selection has been explored by a court or tribunal in Australia. This paper analyses the reasoning in that decision, focusing specifically on how the Victorian Civil and Administrative Tribunal applied the statutory framework relevant to ART and its comparison to other uses of embryo selection technologies. The Tribunal relied heavily upon the welfare-of-the-child principle under the Assisted Reproductive Treatment Act 2008. The Tribunal also compared non-medical sex selection with saviour sibling selection. Our analysis leads us to conclude that the Tribunal’s reasoning fails to adequately justify the denial of the applicants’ request to utilize ART services to select the sex of their prospective child. (shrink)

Jews and Arabs in Israel often agree that there is a reciprocal relation between rights and duties, though they derive opposing conclusions from it. Jews infer that Arabs are not entitled to the same rights and privileges as Jews are, since they do not shoulder an equal share of the duties. Arabs, by contrast, argue that they are under no duty to share the burdens, particularly military or national service, since their rights are not fully respected. The Paper (...) assesses these opposing claims and ends up rejecting both. It argues that the rights to which citizens are entitled do not depend on citizens carrying out all their social or legal duties, while the citizens’ duty to contribute to the welfare of their countries by national service or other means is generally not contingent on the countries’ fulfillment of its duties towards them. The Paper focuses on national service by Israeli Arabs and suggests that that there is nothing wrong in making such service mandatory though there are practical considerations against doing so and that making such service optional is an excellent alternative, one that should be encouraged as much as possible. (shrink)

The Republic of Macedonia has been a part of the Bologna process since 2003. The Ministry of Education, law and policy makers and higher education institutions have actively engaged with its main concepts. In parallel with this, since the adoption of the law on higher education in 2008 and the reform of the Accreditation and Evaluation Board, there have been numerous changes and amendments culminating in the fast-tracked adoption of a new law at the beginning of 2015. Some of its (...) solutions created a huge debate among the academic community, other intellectuals and students themselves, resulting in the postponement of that law and a kind of legal vacuum. In such turbulent circumstances, individual higher education institutions had to consider how and to what extent to adopt and develop relevant standards and guidelines, comply with the legal framework and promote good practice. The aim of this paper is to present how these three aspects, Bologna standards and guidelines for Quality Assurance, a national legal framework and an institutional approach are being reflected, merged and implemented at a relatively young higher education institution. It questions the impact of these three elements on each other and how one institution’s drive for improvement is affected. This is done through a qualitative analysis of the three-fold perspectives. The conclusions and recommendations are expected to be of use to policy makers in the country and region as they evaluate how international trends and good practice fit into the socio-economic and political conditions of RM and similar countries. At the same time, it can demonstrate how far institutional quality assurance and progress can be implemented and recognized in the country itself and by some international stakeholders. It can also prove that the South East European University is a national leader in this field as RM has no functioning QA evaluation system, while SEEU has managed to create a well structured and operating one, based on international and institutional experiences. (shrink)

Corruption has traversed all lengths and breadth of the Nigerian nation. The corrupt practice is mostly ornamented with language. The present study aims to ascertain the linguistic codings used to mask corruption in educational, civil service, political and social settings. Data for the study were collected from notable online newspaper and media sources, which include: _The Vanguard, The Guardian, The Punch, This Day, The Nation, The Premium, Sahara Reporters, Naira land_ and others published between 2015 and 2021. The data (...) from online sources were complemented by focused group discussions, unstructured interviews and participant’s observation method. The study adopted a qualitative research design and a random sampling method in selecting a total of hundred respondents from the five states that make up the southeast zone in Nigeria. The paper anchored its analyses on the conceptual model of Sapir-Whorf relativity framework and the analyses were done using interpretative textual analysis model. Findings from the study reveal that using words, phrases and expressions which are reflected in coinages, code-mixing, reduplication, metonymy, metaphor, slang, borrowing, pidginization, lexical reversals and creative usages to mask corruption have far-reaching effects on national development. The paper recommends that in considering the fight against corruption, the government should pay attention to the linguistic embellishments that act as the lifeline of the negative practice. (shrink)

The article aims at studying the economic processes of developing national market of resort services in a historical perspective. The theoretical conceptualization of the market of resort services has been conducted, the basic economic backgrounds of its formation has been defined basing on a comprehensive assessment of researches of Ukrainian and foreign scientists. The article has analyzed the institutional framework of a resort services market in the realities of a mixed model of the national economy. The issues (...) of financial security of resort treatment and rehabilitation in the conditions of a market and anti-market of Ukrainehave been studied. The problem of economic inefficiency of planning and distribution system to ensure the proper level of reproduction of human capital has been outlined. It has been established that the spa and resort sector of Ukraine is characterized by the transformation of the economy reflecting the changes of public vectors of a state-formationthat affect differently entrepreneurship, private and state property, principles and ways of funding spa treatment and rehabilitation of the population. The results of the study enable to formulate the basic economic conditions of formation of the national market of spa and resort services: a significant level of economic utilization of natural recreational resources, development of infrastructure for spa treatment and rehabilitation of people; revival of institutional norms of sanatorium and resort business on the principles of private property, entrepreneurship and competition. Further research should be conducted as to develop anti-crisis trends in a governmental regulation of the national market of resort services in Ukraine, transformation of quasi-marketsystem of spa and resort services into a socially oriented system of market relations that meet the demands of a modern Ukrainian society. (shrink)

Source: Author: Leonila C. Crisostomo, Ma. Teresa G. Generales, Amelita L. de Guzman The primary purpose of this study is to ascertain the benefits of the National Service Training Program implementation and to identify the problems encountered by its implementers. Results showed that the benefits derived from the program were topped by enhancement of skills on basic leadership with emphases on the ability to listen and ability to communicate which were rated very important and very much benefited among (...) other training aspects of the program. Results also revealed that students are aware of the importance of physical, mental and social health as well as the observance of proper hygiene for overall sense of well-being. Although recreation is one aspect that the respondents find important, appreciation of it underscores the need to have more time for assignments and projects as most of the respondents are enrolled in their respective courses with 29 units, making them unable to appreciate the perks of involving themselves into various recreational activities. Problems in the implementation showed lack of provision of materials and equipment and of budgetary allocation which rendered full implementation weak as students and faculty involved in the community immersion have to rely on their own resources, in addition to the indifference and passivity of the local government officials. Based on the findings, the researchers recommended that: the school administrators need to allocate adequate budget for materials and equipment; periodic faculty development trainings and; to look into the passive attitude of the local officials to ensure that implementation NSTP projects will benefit both clients and implementers. ]]>. (shrink)

The LBS National Academy of Administration, Government of India, had invited the authors to present before 30 officers of the Indian Administrative Service their views regarding the role of ethics in public administration as part of a five-day training programme on the subject. The participants' experience ranged from 12 to 31 years. The paper seeks to bring home to administrators that for carrying out the responsibilities that the Constitution of India has entrusted to the civil services there is (...) no option but to subscribe to a sound ethical framework of reference. (shrink)