This study explores how qualitative health researchers navigate the demands of medical research ethics committees in Germany where qualitative research is subject to approval only when it is conducted in medical contexts. We present the results of a grounded theory study to investigate qualitative health researchers’ experiences with procedural ethics and the strategies they adopt to navigate its demands. Our analysis revealed six dimensions of experience and three strategies adopted by researchers to navigate the demands of medical (...) research ethics committees. All participants agreed that research ethics is of high importance in qualitative health research, but strategies to navigate the demands of medical research ethics committees ranged from avoiding, and adapting, to transforming the procedures of ethics review. Based on our findings, we provide recommendations for improving the ethics review of qualitative health research. (shrink)

Fundamental questions in value sensitive design include whether and how high-tech products/artefacts could embody values and ethical ideals, and how plural and incommensurable values of ethical and social importance could be chosen rationally and objectively at a collective level. By using a humanitarian cargo drone study as a starting point, this paper tackles the challenges that VSD’s lack of commitment to a specific ethical theory generates in practical applications. Besides, it highlights how mainstream ethical approaches usually related to VSD are (...) incapable of solving main ethical dilemmas raised by technological design for well-being in democratic settings. Accordingly, it is argued that VSD’s ethical-democratic import would substantially be enhanced by the espousal of a procedural ethics stance and the deliberative approach to value and welfare entailed by Amartya Sen’s capability approach. Differently from rival ethical–political theories, its normative and meta-ethical foundations better handle human diversity, value-goal pluralism, conflicting vested interests as well as the epistemic-moral disagreements typical of contemporary complex democracies. Particularly, Sen’s capability approach procedural-deliberative tenets result in an “objective-impartial” choice procedure selecting a “hierarchy” of plural incommensurable values and rational goals thus, suitable to validate an applied science such as welfare-oriented technological design in concrete social environments. Conclusions suggest that refining VSD with a capability-based procedural approach to ethics fosters the concern for democracy and social justice while preserving vital scientific-technical standards. Major advantages are at an applied level to delivering ethically and socially justified, but yet highly functional technologies and high-tech products/artefacts. (shrink)

The article analises from the perspective of the concept of ‘processuality’ proposed by Andrew Smirnov, as well as in comparison with Kant’s categorical imperative, the concept of ‘reflection’ and its role in the ethical teaching of the outstanding Iraqi Sufi al-Haris al-Muhasibi (VIII-IX centuries). Reflection is an integral component of the mystic’s continuous observation of his thoughts and intentions. The latter is the main tool for cleansing the soul and heart on a person’s path to God. The ‘additional’ tools used (...) in the study are Smirnov’s logical-semantic theory and Kant’s ethical teaching goal is to show the fundamental difference between the ideological paradigm of al–Muhasibi as a representative of Afro-Asian civilization from the paradigm of Kant as a representative of Western European civilization. The contrast of two ethics – ‘procedural’ (al-Muhasibi) and ‘substantial’ (Kant) – leads us to the theory of four types of civilization-specific mentality developed by Andrew Paribok. This article can and should be considered as a demonstration of how the method of Pskhu’ ‘situational hermeneutics’ works, according to which the researcher has the right to use those intellectual theories (sometimes irrelevant to each other) that help him in a concise form to clearly and unambiguously convey to the reader the meaning of the phenomenon under study (concept / text). (shrink)

Hazardous operational consequences of unethical behavior in high-risk projects can be traced back to inadequate relationships between businesses and the insurance industry. The communication of blame, as a consequence of major industrial accidents like the explosion of the Deepwater Horizon drilling rig in the Gulf of Mexico in April 2010, and the relevance of this communication of blame for subsequent insurance litigation, show that the awareness of the relationship between unethical behavior resulting in irresponsible procedural action and deficient loss-prevention (...) practices is a significant component of risk consciousness. The awareness of ethical origins of project risks could alter the methods of design and monitoring of insurance contracts for risky techno-organizational ventures. (shrink)

Knowledge about human wellbeing is a central part of ethical knowledge. But it is a neglected topic not only in ethics in general, but also in wellbeing theorizing, which has focused on enumerating the basic elements of wellbeing rather than on how to gauge, foster and maintain wellbeing in actual human lives. I consider the prospects for a procedural approach to wellbeing that sees it as depending on a process of continual adjustment between values, preferences, actions and emotions. (...) The value-fulfilment theory of Valerie Tiberius provides a model for such an approach, but needs to be corrected and supplemented in certain respects. I propose a version of the approach that is only partly, but still significantly procedural, and which does not privilege higher-order mental states. Considering the relevance of such an approach for ethics, I finally suggest that (certain forms of) moral agency may be best analyzed as an intersubjective process of adjustment and fulfilment of values and desires (etc.), and as a process of acquiring and exercising collective moral knowing how. (shrink)

This paper reports on an investigation of issues surrounding the use of ethical codes/codes of conduct in Irish based companies. Using a comprehensive questionnaire survey, the paper examines the incidence, content and enforcement of codes of conduct among a sample of the top 1000 companies based in Ireland. The main findings indicate that the overall usage of codes of conduct amongst indigenous Irish companies has increased significantly from 1995 to 2000. However, in line with prior research, these codes focus primarily (...) on issues surrounding company and employee protection as opposed to society protection. Almost half of all codes are written by company personnel or provided by head office. Revisions of codes are common but formal ongoing methods of instructing new staff about codes are not prevalent. Less than one-third of companies with codes have formal channels for reporting violations but a high percentage have formal disciplinary procedures in place for breaches of codes. (shrink)

In this paper I focus on the discussion between Rawls and Habermas on procedural justice. I use Rawls’s distinction between pure, perfect, and imperfect procedural justice to distinguish three possible readings of discourse ethics. Then I argue, against Habermas’s own recent claims, that only an interpretation of discourse ethics as imperfect procedural justice can make compatible its professed cognitivism with its proceduralism. Thus discourse ethics cannot be understood as a purely procedural account of (...) the notion of justice. Finally I draw the different consequences that follow from this reading. (shrink)

The procedures for structuring clinical ethics case reflections in a childhood cancer care setting are presented, including an eight-step model. Four notable characteristics of the procedures are: members of the inter-professional health care team, not external experts, taking a leading role in the reflections; patients or relatives not being directly involved; the model explicitly addressing values and moral principles instead of focussing exclusively on the interests of involved parties; using a case-based (inductive) rather than principle-based (deductive) method. By discusing (...) the advantages and disadvantages of the proposed procedures, our paper aims to contribute to the literature on models and procedures for ethical analysis that can be used in clinical settings. It is suggested that our proposed procedures have some advantageous features when it comes to promoting health care staff’s learning to structure their thinking about ethical issues. (shrink)

As cognitive enhancement research advances, important ethical questions regarding individual autonomy and freedom are raised. Advocates of cognitive enhancement frequently adopt a procedural approach to autonomy, arguing that enhancers improve an individual’s reasoning capabilities, which are quintessential to being an autonomous agent. On the other hand, critics adopt a more nuanced approach by considering matters of authenticity and self-identity, which go beyond the mere assessment of one’s reasoning capacities. Both positions, nevertheless, require further philosophical scrutiny. In this paper, we (...) investigate the ethics of cognitive enhancement through the lenses of political and philosophical arguments about autonomy and freedom. In so doing, we contend that a substantive, relational account of individual autonomy offers a more holistic understanding of the ethical concerns of cognitive enhancement. (shrink)

Adults who are incapacitated and alone, having no surrogates, may be known as “unbefriended.” Decision-making for these particularly vulnerable patients is a common and vexing concern for healthcare providers and hospital ethics committees. When all other avenues for resolving the need for surrogate decision-making fail, patients who are incapacitated and alone may be referred for “public guardianship” or guardianship of last resort. While an appropriate mechanism in theory, these programs are often under-staffed and under-funded, laying the consequences of inadequacies (...) on the healthcare system and the patient him or herself. We describe a qualitative study of professionals spanning clinical, court, and agency settings about the mechanisms for resolving surrogate consent for these patients and problems therein within the state of Massachusetts. Interviews found that all participants encountered adults who are incapacitated and without surrogates. Four approaches for addressing surrogate needs were: work to restore capacity; find previously unknown surrogates; work with agencies to obtain surrogates; and access the guardianship system. The use of guardianship was associated with procedural challenges and ethical concerns including delays in care, short term gains for long term costs, inabilities to meet a patient’s values and preferences, conflicts of interest, and ethical discomfort among interviewees. Findings are discussed in the context of resources to restore capacity, identify previously unknown surrogates, and establish improved surrogate mechanisms for this vulnerable population. (shrink)

Pediatric cancer is accompanied by many ethical challenges, particularly those related to respecting the child's opinion and parental responsibility and consent.Questionnaires were collected from 400 participants, from four equal groups: doctors, nurses, parents and medical students, from three cities in Saudi Arabia, about three problematic issues which revolve around the mandatory consent of one or both parents, the extent of a child’s assent, and the acceptable form of consent and assent.Despite the diversity of the participants' cultural backgrounds, most preferred both (...) parents to give consent, followed by either parent without differentiation between parents, which reinforced a trend towards more gender equality. The majority of participants preferred that parental consent forms be detailed enough to obtain the maximum information, while others chose medium‐size consent forms; a large majority preferred that the form seeking to obtain the assent of the child with cancer be short, reflecting their desire not to increase the burden on the child, in addition to the fact that the final decision belongs to the parents rather than the child. Most participants preferred to rely on a child's level of maturity rather than having reached a certain age so that they could give assent, while the rest considered the age of 13‐14 as a suitable age.These findings reflect an increasing ethical awareness regarding parental consent and child assent, and they can be formulated in a recommendation for a more ethical practice in the field of childhood cancer and pediatrics in general. (shrink)

Originally applied on domestic and lab animals, assisted reproduction technologies (ARTs) have also found application in conservation breeding programs, where they can make the genetic management of populations more efficient, and increase the number of individuals per generation. However, their application in wildlife conservation opens up new ethical scenarios that have not yet been fully explored. This study presents a frame for the ethical analysis of the application of ART procedures in conservation based on the Ethical Matrix (EM), and discusses (...) a specific case study—ovum pick-up (OPU) procedures performed in the current conservation efforts for the northern white rhinoceros (Ceratotherium simum cottoni)—providing a template for the assessment of ART procedures in projects involving other endangered species. (shrink)

The current coronavirus disease 2019 pandemic has led to essential adjustments in clinical research involving human subjects. The pandemic is substantially affecting most procedures of ongoing, as well as new clinical trials related to diseases other than COVID-19. Procedural changes and study protocol modifications may significantly impact ethically salient fundamentals, such as the risk-benefit profile and safety of clinical trial participants, which raise key ethical challenges the subject-matter experts must face. This article aims to acquaint a wide audience of (...) clinical research professionals, ethicists, as well as the general public interested in this topic with the legal, ethical and practical considerations in the field of clinical trials during the COVID-19 pandemic and to support the clinical researchers and study sponsors to fulfil their responsibilities in conducting clinical trials in a professional way that does not conflict with any legal or ethical obligations. (shrink)

Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (eg, junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of (...) ways. One possible solution to this clinical dilemma is through the use of conversational artificial intelligence using large language models (LLMs). There is considerable interest in the potential benefits of such models in medicine. For delegated procedural consent, LLM could improve patients’ access to the relevant procedural information and therefore enhance informed decision-making.In this paper, we first outline a hypothetical example of delegation of consent to LLMs prior to surgery. We then discuss existing clinical guidelines for consent delegation and some of the ways in which current practice may fail to meet the ethical purposes of informed consent. We outline and discuss the ethical implications of delegating consent to LLMs in medicine concluding that at least in certain clinical situations, the benefits of LLMs potentially far outweigh those of current practices. (shrink)

Organ transplant shortages are ubiquitous in healthcare systems around the world. In response, several commentators have argued for the adoption of an opt-out policy for organ transplantation, whereby individuals would by default be registered as organ donors unless they informed authorities of their desire to opt-out. This may potentially lead to an increase in donation rates. An opt-out system, however, presumes consent even when it is evident that a significant minority are resistant to organ donation. In this article, we defend (...) a mandated choice framework for consent to deceased organ donation. A mandated choice framework, coupled with good public education, would likely increase donation rates. More importantly, however, a mandated choice framework would respect the autonomous preferences of people who do not wish to donate. We focus in particular on the Australian healthcare context, and consider how a mandated choice system could function as an ethical means to increase the organ donation rate in Australia. We make the novel proposal that all individuals who vote at an Australian federal election be required to state their organ donation preferences when voting. (shrink)

Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. ‘Fertility preservation’ for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion (...) about whether it is ethical to offer such ‘experimental’ procedures. The question addressed in this paper is: when, if ever, is it ethically justifiable to offer fertility preservation surgery to prepubertal children? We present the ethical concerns about prepubertal fertility preservation, drawing both on existing literature and our experience discussing this issue with clinicians in clinical ethics case consultations. We argue that offering the procedure is ethically justifiable in certain circumstances. For many children, the balance of benefits and burdens is such that the procedure is ethically permissible but not ethically required; when the procedure is medically safe, it is the parents’ decision to make, with appropriate information and guidance from the treating clinicians. We suggest that clinical ethics support processes are necessary to assist clinicians to engage with the ethical complexity of prepubertal fertility preservation and describe the framework that has been integrated into the pathway of care for patients and families attending the Royal Children’s Hospital in Melbourne, Australia. (shrink)

This article argues that an ethic applying the technology assessment (TA)-method is only feasible as a risk ethic, since the consequences of technical action are ambivalent and uncertain. It first distinguishes possible strategies of justification for a risk ethic, that is (a) deontological, (b) teleological and (c) procedural approaches. On the basis of the critique of both (a) and (b), a central problem for the integration of discourse ethics in the TA-method is highlighted by reverting to a game (...) theory modeling: As it turns out, mechanisms of self-selection undermine the representativity of discourses and thus its legitimation. In view of this dilemma, the article pledges for a complementary approach selectively integrating (a)-(c) into a “provisional moral”. (shrink)

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

BackgroundWe describe our experience from a multi-national application of a European Union-funded research-driven paediatric trial (DEEP-2, EudraCT 2012-000353-31; NCT01825512). This paper aims to evaluate the impact of the local and national rules on the trial authorisation process in European and non-European countries. National/local provisions and procedures, number of Ethics Committees and Competent Authorities to be addressed, documentation required, special provisions for the paediatric population, timelines for completing the authorisation process and queries received were collected; compliance with the European provisions (...) were evaluated. Descriptive analysis, Wilcoxon Rank-Sum test and General Linear Model analysis were used to determine factors potentially influencing the timelines. The Cluster Analysis procedure was used to identify homogenous groups of cases.ResultThe authorisation process was completed in 7.7 to 53.8 months in European countries and in 17.1 to 27.1 months in non-European countries. The main factors influencing these timelines were the requests for changes/clarifications in European countries and the different national legislations in non-European countries.ConclusionThis work confirms that the procedures and requirements for the clinical trial application of a paediatric trial are different. In the European Union, the timeframes for submission were generally harmonised but longer. In non-European countries, delays were caused by national dispositions but the entire authorisation process resulted faster with less requests from ECs/cas. The upcoming application of Regulation (EU) 536/2014 is expected to harmonise practices in Europe and possibly outside. Networks on paediatric research acting at international level will be crucial in this effort. (shrink)

The prophylactic use of antibiotics has become a routine procedure in many areas of medicine. In neurosurgery, however, there is considerable debate over their use in the prevention of postoperative infection. We pose several ethical questions about antibiotic prophylaxis in a neurosurgical setting. These questions are discussed under the following categories: responsible usage of antibiotics; the ethical dilemmas of controlled, antibiotic clinical trials, and some problems inherent in not using prophylactic antibiotics.

I argue that the Universal Law formulation of the Categorical Imperative is best interpreted as a test or decision procedure of moral rightness and not as a criterion intended to explain the deontic status of actions. Rather, the Humanity formulation is best interpreted as a moral criterion. I also argue that because the role of a moral criterion is to explain, and thus specify what makes an action right or wrong, Kant's Humanity formulation yields a theory of relevant descriptions.

Committees established for the ethical review of research involving animals have become a widespread legal standard around the world. Despite many differences in their composition, powers, and institutional settings, they share many common problems related to the well-established standards of procedural justice in administrative practice. The paper adapts the general theory of procedural justice to the specific context of ethical review committees. From this perspective, the main concerns over the procedural aspects of the ethical evaluation of research (...) projects are identified and examined. They include in particular the standards of the committees’ composition, impartiality, fair hearing, appeal, transparency, and benevolence. Their proper reflection in the regulatory regimes of animal ethics committees is necessary to secure the standards of fairness of the ethical review itself. This, in turn, is a condition of the moral and social legitimacy of all administrative and quasi-administrative procedures, including the committees’ operations. (shrink)

In this paper I aim to lay out the major aspects of a procedural, pragmatist account of objectivity in ethics. This account is “procedural” insofar as it holds that the objectivity of inquiry depends not on what the results of that inquiry are, but rather whether the proper procedure of inquiry was followed to generate the results. The account is “pragmatic” insofar as it coheres with a broader approach to ethics that conceives of ethical inquiry and (...) progress in terms of resolving problems (Roth 2010a, 2012). Why should we want this sort of account of ethical objectivity? In addition to its contribution to a larger pragmatist conception of ethical inquiry, this account has two desirable features. First .. (shrink)

W. D. Ross’s ethical theory requires us somehow to compare the metaphorical “weights” of different prima facie duties, but it leaves mysterious how this might be done. The formulation of a procedure to achieve such a comparison would be desirable on practical, theoretical, and pedagogical grounds. I formulate a procedure that is congenial to Ross’s theory. Central to my procedure are instructions to characterize the weight of each prima facie duty with respect to (a) the general stringency of this kind (...) of duty, (b) the stringency of this particular duty relative to other duties of its own kind, and (c) the degree to which the duty specifically demands the particular action that it favors in a given case. The procedure leads to a determination of one’s actual, all-things-considered duty in some cases but not in all. (shrink)

The purpose of this study was to extend the knowledge about why procedural justice has behavioral implications within organizations. Since prior studies show that PJ leads to legitimacy, the author suggests that, when formal regulations are unfairly implemented, they lose their validity or efficacy. This “rule deactivation,” in turn, leads to two proposed destructive work behaviors, namely, workplace deviance and decreased citizenship behaviors. The results support this mediating role of RD, thus suggesting that it forms part of the generative (...) mechanism through which unfair procedures influence ethical behavior within organizations. The author ends the article by discussing behavioral ethics and managerial implications as well as suggestions for future research. (shrink)

The research ethics committee is a key element of university administration and has gained increasing importance as a review mechanism for those institutions that wish to conduct responsible...

El prodigioso desarrollo de la ciencia y la tecnología médicas tiene una vertiente negativa que se expresa en la crisis de la atención de salud y de la relación médico-paciente. Los cambios en dicha relación, la mayor especialización y las nuevas posibilidades de tecnologías médicas llevan a reflexionar sobre las consecuencias y los efectos a largo alcance desde el punto de vista ético. Se realizó una revisión bibliográfica utilizando la base de datos EBSCO para determinar cómo repercute el proceso tecnológico (...) en el declinar de la relación médico-paciente en la especialidad de Neurología. Además se revisaron las revistas de Ética y Bioética en su formato impreso de los últimos 10 años. El prodigioso desarrollo de la ciencia y la tecnología médicas tiene una vertiente negativa que se expresa en la crisis de la atención de salud y de la relación médico-paciente. Los cambios en dicha relación, la mayor especialización y las nuevas posibilidades de tecnologías médicas llevan a reflexionar sobre las consecuencias y los efectos a largo alcance desde el punto de vista ético. Se realizó una revisión bibliográfica utilizando la base de datos EBSCO para determinar cómo repercute el proceso tecnológico en el declinar de la relación médico-paciente en la especialidad de Neurología. Además se revisaron las revistas de Ética y Bioética en su formato impreso de los últimos 10 años. (shrink)

The aim of this paper is to highlight an interdependence between procedural and agential norms that undermines their neat separation when appraising argumentation. Drawing on the munāẓara tradition, we carve a space for sequencing in argumentation scholarship. Focusing on the antagonist’s sequencing of critical moves, we identify each sequence’s corresponding values of argumentation: coalescence, reliability, and efficacy. These values arise through the mediation of virtues and simultaneously underpin procedural as well as agential norms. Consequently, an ambiguity between procedure (...) and agent becomes apparent. This ambiguity hints at the potential for a virtue theory of argumentation that draws on procedural norms. (shrink)

Background Research is fundamental to improving the quality of health care. The need for regulation of research is clear. However, the bureaucratic complexity of research governance has raised concerns that the regulatory mechanisms intended to protect participants now threaten to undermine or stifle the research enterprise, especially as this relates to sensitive topics and hard to reach groups. Discussion Much criticism of research governance has focused on long delays in obtaining ethical approvals, restrictions imposed on study conduct, and the inappropriateness (...) of evaluating qualitative studies within the methodological and risk assessment frameworks applied to biomedical and clinical research. Less attention has been given to the different epistemologies underlying biomedical and qualitative investigation. The bioethical framework underpinning current regulatory structures is fundamentally at odds with the practice of emergent, negotiated micro-ethics required in qualitative research. The complex and shifting nature of real world settings delivers unanticipated ethical issues and (occasionally) genuine dilemmas which go beyond easy or formulaic ‘procedural’ resolution. This is not to say that qualitative studies are ‘unethical’ but that their ethical nature can only be safeguarded through the practice of ‘micro-ethics’ based on the judgement and integrity of researchers in the field. Summary This paper considers the implications of contrasting ethical paradigms for the conduct of qualitative research and the value of ‘empirical ethics’ as a means of liberating qualitative (and other) research from an outmoded and unduly restrictive research governance framework based on abstract prinicipalism, divorced from real world contexts and values. (shrink)

MORAL THEORY is by no means unique in its dependence upon judgment for its application. Judgment is a creative faculty that stands as the active link between any theory and its application, whether it be a theory of science, morality, or aesthetics.

This study examines the procedural ethical considerations surrounding religious exemptions to Covid vaccine mandates, specifically focusing on immigrant healthcare personnel (HCP) and HCPs of color. It emphasizes communication issues with applicants by investigating exemption applications and their accompanying guidelines. While there is extensive literature on the ethical implications of religious exemptions, a notable gap remains in addressing the procedural aspects of religious exemption applications and their reviewing processes. The study scrutinized religious exemption application forms and accompanying guidelines from (...) 32 selected non-teaching and teaching hospitals for the years 2022–2023. The findings highlight significant variability in exemption application criteria and processes across institutions. Importantly, many application forms lacked comprehensive procedural information, which may result in subjective evaluations and potential misinterpretations of non-Western and non-mainstream religious beliefs, especially those of immigrant HCPs and HCPs of color. The study proposes various strategies to advocate for more equitable and transparent procedures, underlining the significance of diversity, equity, and inclusion in the religious exemption review process for vaccine mandates. (shrink)

Despite the prevailing discourses on the importance of top management ethical leadership, related theoretical and empirical developments are lacking. Drawing on institutional theory, we propose that top management ethical leadership contributes to organizational outcomes by promoting firm-level ethical and procedural justice climates. This theoretical framework was empirically tested using multi-source data obtained from 4,468 employees of 147 Korean companies from various industries. The firm-level analysis shows that top management ethical leadership significantly predicts ethical climate, which then results in (...) class='Hi'>procedural justice climate that fully mediates the effects of top management ethical leadership on two organizational outcomes, namely, firm-level organizational citizenship behavior and firm financial performance. The present study provides a plausible theoretical account and empirical validation of a mechanism through which top management ethical leadership enhances organizational performance. (shrink)

This study examines the relationship between procedural justice and employee job insecurity, and the boundary conditions of this relationship. Drawing upon uncertainty management theory and ethical leadership research, we hypothesized that procedural justice is negatively related to job insecurity, and that this relationship is moderated by ethical leadership. We further predicted that the moderating relationship would be more pronounced among employees with a low power distance orientation. We tested our hypotheses using a sample of 381 workers in Macau (...) and Southern China. The results support all of our hypotheses. The implications of these results for research and practice are discussed. (shrink)

A patient is not always told when a student is performing a procedure for the first time. Withholding this information is a form of deception. It is justified on paternalistic grounds (it is in the patient's interest not to know), or on public policy grounds (given the choice, patients would refuse, thus compromising the training of future physicians). Using the spinal tap procedure (lumbar puncture) as a paradigm, 173 patients were surveyed to determine how they felt about first time procedures (...) by medical students, interns, and residents. The patients indicated that they would be willing to be the subject for a student's (52%), intern's (62%), or resident's (66%) first spinal tap. This paper reassesses the ethics of consent for first time procedures based on responses to this survey. (shrink)

There have been many attempts during the history of applied ethics that have tried to develop a theory of moral reasoning. The goal of this paper is to explicate one aspect of the debate between various attempts of offering a specific method for resolving moral dilemmas. We contrast two kinds of deliberative methods: deliberative methods whose goal is decision-making and deliberative methods that are aimed at gaining edifying perspectives. The decision-making methods assessed include the traditional moral theories like utilitarianism (...) and Kantianism, as well as second order principles, such as principlism and specified principlism. In light of this assessment, we suggest taking a closer look at two perceptive models, casuistry and particularism. These models are used for dealing with moral dilemmas that provide for edifying perspectives rather than decision-making. These perceptive models, though less scientific and not as good at prescribing an action, are more human in the sense that they enrich our moral sensibilities and enhance our understanding of the meaning of the situation. (shrink)

This paper analyzes ethical issues relating to lawyer mobility.

Thus far, little work in bioethics has specifically focused on global health research priority-setting. Yet features of global health research priority-setting raise ethical considerations and concerns related to health justice. For example, such processes are often exclusively disease-driven, meaning they rely heavily on burden of disease considerations. They, therefore, tend to undervalue non-biomedical research topics, which have been identified as essential to helping reduce health disparities. In recognition of these ethical concerns and the limited scholarship and dialogue addressing them, we (...) convened an international workshop in September 2015. The workshop aimed to initiate discussion on the appropriate relationship between global and national levels of health research priority-setting and to begin exploring what might be ethically required for priority-setting at each of those levels. This paper comprises our reflections following the workshop. Its main objective is to launch a research agenda for the ethics of global health research priority-setting. We identify three domains of global health research priority-setting—scope, underlying values and substantive requirements, and procedural considerations. For each domain, specific research questions are highlighted and why they need to be explored is explained. Some preliminary thoughts and normative arguments as to how the research questions might be answered are also offered. For example, we provide initial ideas about the appropriate relationship between different priority-setting levels and what values and substantive considerations should guide or underpin global health research priority-setting as a matter of justice. We anticipate that framing a new research agenda for the ethics of global health research priority-setting will spur ethicists, researchers, and policymakers to refocus their efforts on developing more rigorous and ethically sound approaches to priority-setting. (shrink)

In this dissertation, I argue that we should reframe the presentation and defense of the program of discourse ethics and deliberative democracy (DEP) in such a way that we make clear its connection to the substantive moral ideas of solidarity, equality and freedom. This program basically says that we should, when we can, determine the validity of the norms regulating our social life through practices of public deliberation. If we want to understand why engaging in public deliberation makes moral (...) sense, or is obligatory, we need to make explicit the connection between the formal procedures of deliberation and our most basic substantive moral ideas of freedom, equality and solidarity. In order to unpack this claim, I construct what I call an expressive-elaboration model of the relation between substance and procedure in public deliberation. According to this model, we should see the two dimensions as working in tandem, in such a way that deliberative procedures are understood as the medium of expression and elaboration of our basic substantive ideas of solidarity, equality and freedom. The three ideas are expressed in the fact and form of deliberation, and elaborated in their changing and specific interpretations as topics and consequences of deliberative practices. To develop this model, I start with a consideration of certain insights of Kant's moral theory, and proceed to bridge the gap between Habermas's more formalistic and Rawls's more substantive neo-Kantian accounts of practical reason. The result is a straightforwardly substantive articulation and defense of the dialogic procedures of DEP based on the recognition of the fact of widespread moral disagreement and a fundamental project of justice demanding that we deal with that condition of disagreement by constructing social arrangements in which we include each other, solidaristically, as free and equal members. This morally substantive defense of DEP referring to the fact of widespread moral disagreement and the fundamental project of justice is different from, and more compelling than, other common, formalistic and prudential defenses of DEP. (shrink)

This critical reflection on the ethical concerns of current practice is underpinned by a systematic synthesis of current evidence focusing on why and how children are held or restrained for clinical procedures within acute care and the experiences of those present when a child is held against their wishes. Empirical evidence from a range of clinical settings internationally demonstrates that frequently children are held for procedures to be completed; younger children and those requiring procedures perceived as urgent are more likely (...) to be held. Parents and health professionals express how holding children for procedures can cause feelings of moral distress expressed as uncertainty, guilt and upset and that this act breaches the trusting and protective relationship established with children. Despite this, children's rights and alternatives to holding are not always respected or explored. Children's experiences and perceptions are absent from current literature. Children and young people have a moral right to have their voice and protests heard and respected and for these to inform judgements of their best interests and the actions of health professionals. Without robust evidence, debate and recognition that children are frequently held against their wishes in clinical practice for procedures which may not be urgent, children's rights will continue to be compromised. (shrink)

The case "Caprica Energy and Its Choices" concerns a fictionalized energy corporation choosing between three potential drilling sites. According to the published Teaching Note, the case is an exercise in the stakeholder approach to business: it requires balancing profit considerations with potential harm to those who live near those drilling sites. Though unintended, the case raises a further question not addressed in the case or in the Teaching Note: what gives Caprica Energy the right to impose risk on members of (...) the communities surrounding its drilling sites? The first section of the present article argues that, in such cases, manage- ment can only justify imposing risk on the local community by securing those stakeholders' consent. The second section outlines the implications for stakeholder theory and stake- holder management. The third section outlines one con- nection between this material and recent literature on the imposition of risk and moral theory; that section offers an account of what make this particular instance of imposing risk morally problematic, with reference to the directedness of the imposition. (shrink)

The Faculty of Medicine and Health Sciences of the University of Sherbrooke has observed year after year, that certain students have not started and or completed their immunizations for common infectious diseases, which in effect makes them inadmissible for their clinical internships in healthcare establishments. The program administrators have posed a series of questions on the best way to proceed with these students as, a certain number remain reluctant to vaccination. They are often confronted with ethical dilemmas, are not necessarily (...) comfortable with their rights and responsibilities and wish to be guided throughout the process. This article aims to put forth a procedure that would be put in place to support the administrators in a way for them to obtain a more favorable vaccination level for all of their students in the most reasonable amount of time possible. The interest of the procedure is to move forward in a few simple and well defined steps that are supported by a rigorous legal framework, while respecting the rights and freedoms of the students. It is also designed so that it could be replicated in other faculties of medicine. (shrink)