Finding a way through the ethical and legal maze : withdrawing medical treatment and euthanasia

This article examines Finnis' and Keown's claim that the intention/foresight distinction should be used as the basis for the lawfulness of withholding and withdrawing medical treatment, rather than the act/omission distinction which is currently used. I argue that whilst the intention/foresight distinction is sound and can apply to palliative pain relief hastening death, it cannot be applied to withholding and withdrawing medical treatment. Instead, the act/omission distinction remains the better basis for the lawfulness of withholding and withdrawal, and law reform is consequently unnecessary.

Household type and structure, time-use pattern, and trip-chaining behavior

In order to examine time allocation patterns within household-level trip-chaining, simultaneous doubly-censored Tobit models are applied to model time-use behavior within the context of household activity participation. Using the entire sample and a sub-sample of worker households from Tucson's Household Travel Survey, two sets of models are developed to better understand the phenomena of trip-chaining behavior among five types of households: single non-worker households, single worker households, couple non-worker households, couple one-worker households, and couple two-worker households. Durations of out-of-home subsistence, maintenance, and discretionary activities within trip chains are examined. Factors found to be associated with trip-chaining behavior include intra-household interactions with the household types and their structure and household head attributes.

Treating an unhealthy organisational culture : the implications of the Bundaberg Hospital inquiry for managerial ethical decision making

This paper explores the interplay between individual values, espoused organisational values and the values of the organisational culture in practice in light of a recent Royal Commission in Queensland, Australia, which highlighted systematic failures in patient care. The lack of congruence among values at these levels impacts upon the ethical decision making of health managers. The presence of institutional ethics regimes such as the Public Sector Ethics Act 1994 (Qld) and agency codes of conduct are not sufficient to counteract the negative influence of informal codes of practice that undermine espoused organisational values and community standards. The ethical decision-making capacity of health care managers remains at the front line in the battle against unethical and unprofessional practice. What is known about the topic? Value congruence theory focusses on the conflicts between individual and organisational values. Congruence between individual values, espoused values and values expressed in everyday practice can only be achieved by ensuring that such shared values are an ever-present factor in managerial decision making. What does this paper add? The importance of value congruence in building and sustaining a healthy organisational culture is confirmed by the evidence presented in the Bundaberg Hospital Inquiry. The presence of strong individual values among staff and strong espoused values in line with community expectations and backed up by legislation and ethics regimes were not, in themselves, sufficient to ensure a healthy organisational culture and prevent unethical, and possibly illegal, behaviour. What are the implications for practitioners? Managers must incorporate ethics in decision making to establish and maintain the nexus between individual and organisational values that is a vital component of a healthy organisational culture.

Multiple Health Behavior Changes and Co-variation in a Telephone Counseling Trial

Background Delivering effective multiple health behavior interventions to large numbers of adults with chronic conditions via primary care settings is a public health priority. Purpose Within a 12-month, telephone-delivered diet and physical activity intervention with multiple behavioral outcomes, we examined the extent and co-variation of multiple health behavior change. Methods A cluster-randomized trial with 434 patients with type 2 diabetes or hypertension were recruited from 10 general practices, which were randomized to receive telephone counseling or usual care. Results Those receiving telephone counseling were significantly more likely than those in usual care to make greater reductions in multiple behaviors after adjusting for baseline risk behaviors (OR 2.42; 95%CI 1.43, 4.11). Controlling for baseline risk and group allocation, making changes to either physical activity, fat, vegetable, or fiber intake was associated with making significantly more improvements in other behaviors. Conclusions For patients with chronic conditions, telephone counseling can significantly improve multiple health behaviors, with behavioral changes tending to co-vary.

Factors contributing to ethical issues in project procurement planning : a case study in Malaysia

The construction industry plays a substantial role in a country’s national economy, irrespective of the country’s levels of economic development. The Malaysian Government has given a much needed boost to the country’s construction projects under the 9th Malaysian Plan where a total of 880 projects worth RM15billion (US$48billion) is to be tendered (The Star, 2006). However, Malaysia has not escaped the problems of project failure. In 2005, 17.3% of 417 Malaysian government contracts projects were considered “sick”. Project procurement is one of the most important stages of project delivery. Even though ethics in project procurement has been identified as one of the contributors to project failure, it has not been systematically studied before from the perspective of client in Malaysia. The aim of this paper is to present an exploration to the ethical issues in project procurement in Malaysian public sector projects. By exploring ethical issues from client perspective, this could provide an ethical standpoint for the project life cycle and could maintain a good affiliation between the clients and the customers. It is expected that findings from this review will be somewhat representative of other developing countries.

“Entrepreneurial management” as a strategic choice in firm behavior : linking it with performance

Establishing the core principals of “entrepreneurial management” within an organization describes a certain strategic choice that affects a company in six dimensions, according to Stevenson (1983). Our aim is to empirically measure entrepreneurial management (it’s existence and degree) and to link this measured strategic choice (for or against) entrepreneurial management with firm performance. Our argument here is that companies that follow core principals of entrepreneurial management should outperform other more administrative firms in certain measures of strategic performance. This paper builds on an empirical investigation published by Brown, Davidson & Wiklund (2001), who have developed and tested a reliable measurement instrument for Stevenson’s definition of “entrepreneurial management” (Stevenson 1983, Stevenson & Jarillo 1990). In the first part of our paper we aim to replicate and to some extent improve this study. In the second part we link the measured degree of “entrepreneurial management” with firm performance. To our knowledge, even so Stevenson’s definition of entrepreneurial management is commonly acknowledged and Brown et al. (2001) developed a reliable instrument to empirically capture this behavioral approach to management, the construct of entrepreneurial management never before has been linked to firm performance in an empirical study. Since most papers on corporate entrepreneurship and firm performance are based on Covin & Slevin’s (1991) or Miller’s (1983) concept of entrepreneurial orientation, we contribute to the literature on corporate entrepreneurship in a novel way, given the fact that the entrepreneurial management dimensions measured in our study can theoretically and empirically be clearly distinguished from the construct of entrepreneurial orientation as defined by Covin & Selvin (1991).

Photo-cross-linked poly(D,L-lactide)-based networks. Structural characterization by HR-MAS NMR spectroscopy and hydrolytic degradation behavior

To date, biodegradable networks and particularly their kinetic chain lengths have been characterized by analysis of their degradation products in solution. We characterize the network itself by NMR analysis in the solvent-swollen state under magic angle spinning conditions. The networks were prepared by photoinitiated cross-linking of poly(dl-lactide)−dimethacrylate macromers (5 kg/mol) in the presence of an unreactive diluent. Using diffusion filtering and 2D correlation spectroscopy techniques, all network components are identified. By quantification of network-bound photoinitiator fragments, an average kinetic chain length of 9 ± 2 methacrylate units is determined. The PDLLA macromer solution was also used with a dye to prepare computer-designed structures by stereolithography. For these networks structures, the average kinetic chain length is 24 ± 4 methacrylate units. In all cases the calculated molecular weights of the polymethacrylate chains after degradation are maximally 8.8 kg/mol, which is far below the threshold for renal clearance. Upon incubation in phosphate buffered saline at 37 °C, the networks show a similar mass loss profile in time as linear high-molecular-weight PDLLA (HMW PDLLA). The mechanical properties are preserved longer for the PDLLA networks than for HMW PDLLA. The initial tensile strength of 47 ± 2 MPa does not decrease significantly for the first 15 weeks, while HMW PDLLA lost 85 ± 5% of its strength within 5 weeks. The physical properties, kinetic chain length, and degradation profile of these photo-cross-linked PDLLA networks make them most suited materials for orthopedic applications and use in (bone) tissue engineering.

News produsage in a pro-am mediasphere : why citizen journalism matters

The rise to prominence of citizen journalism is usually described as a paradigm shift in the relationship between news organizations and their audiences – ‘citizen’ or ‘amateur’ journalists are positioned as inherently different from, and possibly in competition with, ‘professional’ journalists. Some journalists in the industry have taken up this theme, and are at pains to distinguish their professional, supposedly objective and accountable practices from what they describe as the opinionated and partisan ‘armchair journalism’ of amateurs, while some citizen journalists, in turn, give as good at they get and describe the professionals as lackeys of their corporate masters who (willingly or unwittingly) fall prey to political and commercial spin. In fact, the very terminology we use to describe both sides creates the impression that professionals are not also citizens, and that citizen journalists are incapable of having professional skills and knowledges; in reality, of course, the lines between them are much less clear.

Exploring the Pro‐Am interface between production and produsage

This conference celebrates the passing of 40 years since the establishment of the Internet (dating this, presumably, to the first connection between two nodes on ARPANET in October 1969). For a gathering of media scholars such as this, however, it may be just as important not only to mark the first testing of the core technologies upon which much of our present‐day Net continues to build, but also to reflect on another recent milestone: the 20th anniversary of what is today arguably the chief interface through which billions around the world access and experience the Internet – the World Wide Web, launched by Tim Berners‐Lee in 1989.

The international search for ethics norms : which consumer behaviors do consumers consider (un)acceptable?

Purpose: Businesses cannot rely on their customers to always do the right thing. To help researchers and service providers better understand the dark (and light) side of customer behavior, this study aims to aggregate and investigate perceptions of consumer ethics from young consumers on five continents. The study seeks to present a profile of consumer behavioral norms, how ethical inclinations have evolved over time, and country differences. ---------- Design/methodology/approach: Data were collected from ten countries across five continents between 1997 and 2007. A self-administered questionnaire containing 14 consumer scenarios asked respondents to rate acceptability of questionable consumer actions. ---------- Findings: Overall, consumers found four of the 14 questionable consumer actions acceptable. Illegal activities were mostly viewed as unethical, while some legal actions that were against company policy were viewed less harshly. Differences across continents emerged, with Europeans being the least critical, while Asians and Africans shared duties as most critical of consumer actions. Over time, consumers have become less tolerant of questionable behaviors. ---------- Practical implications: Service providers should use the findings of this study to better understand the service customer. Knowing what customers in general believe is ethical or unethical can help service designers focus on the aspects of the technology or design most vulnerable to customer deviance. ---------- Multinationals already know they must adapt their business practices to the market in which they are operating, but they must also adapt their expectations as to the behavior of the corresponding consumer base. Originality/value: This investigation into consumer ethics helps businesses understand what their customer base believes is the right thing in their role as customer. This is a large-scale study of consumer ethics including 3,739 respondents on five continents offering an evolving view of the ethical inclinations of young consumers.

The importance of project governance framework in project procurement planning

Project Procurement is a ‘great’ environment for ethical issues with its low-price state of mind and competition. It has many opportunities that could contribute to illegal activities or unethical behavior especially in the construction industry. In 2006 alone, 17.3% of 417 Malaysian government contract projects were considered sick due to the poor performance by the contractors. Therefore it is important to govern the project procurement, especially the plan procurement stage to ensure the accountability and transparency of the decision made in awarding the right contract to the best contractor. This is where project governance framework (PGF) is really needed in project procurement planning. Project governance is a subset of corporate governance focusing on the areas of corporate governance related to project activities, including: portfolio direction, project sponsorship, project and program management and efficiency and disclosure and reporting. This paper highlights the importance of implementing project governance framework (PGF) to ensure that the decision makers are answerable and accountable to the stakeholders, and the decision making is transparent to avoid any ethical issues arises. A comprehensive preliminary literature is carried out to discover the importance of executing PGF in project procurement in Malaysian public sector. By understanding the important of PGF, it is hoped that this will bring a signal to other developing countries to implement the similar method in ensuring the transparency of the decision making in project procurement planning in their countries.

A conceptual framework for ethical decision making in project procurement

There is a lack of research which identifies the role of the public-sector client in relation to ethical practice in plan procurement. This paper discusses a conceptual framework for ethical decision making in project procurement, focusing on public sector clients within the Malaysian construction industry. A framework is proposed to ensure that effective ethical decision making strategies are deployed to ensure that plan procurement is carried out with a transparent process so that the public sector clients are able to adopt. The conceptual framework adopts various factors that contribute to ethical decision making at the early stage of procurement and consists of the procurement system, individual factors, project characteristics, and organizational culture as the internal factors and professional code of conduct and government policies as the external factors. This framework rationalizes the relationships between systems, psychology and organizational theory to form an innovative understanding of making ethical decisions in plan procurement. It is expected that this proposed framework will be useful as a foundation for identifying the factors that contribute to ethical decision making focusing on the planning stage of procurement process.

Longitudinal investigation of wandering behavior in department of veterans affairs nursing home care units

Objectives To explore the extent of and factors associated with male residents who change wandering status post nursing home admission. Design Longitudinal design with secondary data analyses. Admissions over a 4-year period were examined using repeat assessments with the Minimum Data Set (MDS) to formulate a model understanding the development of wandering behavior. Setting One hundred thirty-four Veterans Administration (VA) nursing homes throughout the United States. Participants: Included 6673 residents admitted to VA nursing homes between October 2000 and October 2004. Measurements MDS variables (cognitive impairment, mood, behavior problems, activities of daily living and wandering) included ratings recorded at residents’ admission to the nursing home and a minimum of two other time points at quarterly intervals. Results The majority (86%) of the sample were classified as non wanderers at admission and most of these (94%) remained non wanderers until discharge or the end of the study. Fifty one per cent of the wanderers changed status to non wanderers with 6% of these residents fluctuating in status more than two times. Admission variables associated with an increased risk of changing status from non-wandering to wandering included older age, greater cognitive impairment, more socially inappropriate behavior, resisting care, easier distractibility, and needing less help with personal hygiene. Requiring assistance with locomotion and having three or more medical comorbidities were associated with a decreased chance of changing from non-wandering to wandering status. Conclusion A resident’s change from non-wandering to wandering status may reflect an undetected medical event that affects cognition, but spares mobility.

Towards an integrated model of information behavior

Information behavior models generally focus on one of many aspects of information behavior, either information finding, conceptualized as information seeking, information foraging or information sense-making, information organizing and information using. This ongoing study is developing an integrated model of information behavior. The research design involves a 2-week-long daily information journal self-maintained by the participants, combined with two interviews, one before, and one after the journal-keeping period. The data from the study will be analyzed using grounded theory to identify when the participants engage in the various behaviors that have already been observed, identified, and defined in previous models, in order to generate useful sequential data and an integrated model.

Reading nineteenth century schoolbooks online : user behavior in a digitized special collection

Special collections, because of the issues associated with conservation and use, a feature they share with archives, tend to be the most digitized areas in libraries. The Nineteenth Century Schoolbooks collection is a collection of 9000 rarely held nineteenth-century schoolbooks that were painstakingly collected over a lifetime of work by Prof. John A. Nietz, and donated to the Hillman Library at the University of Pittsburgh in 1958, which has since grown to 15,000. About 140 of these texts are completely digitized and showcased in a publicly accessible website through the University of Pittsburgh’s Library, along with a searchable bibliography of the entire collection, which expanded the awareness of this collection and its user base to beyond the academic community. The URL for the website is http://digital.library.pitt.edu/nietz/. The collection is a rich resource for researchers studying the intellectual, educational, and textbook publishing history of the United States. In this study, we examined several existing records collected by the Digital Research Library at the University of Pittsburgh in order to determine the identity and searching behaviors of the users of this collection. Some of the records examined include: 1) The results of a 3-month long user survey, 2) User access statistics including search queries for a period of one year, a year after the digitized collection became publicly available in 2001, and 3) E-mail input received by the website over 4 years from 2000-2004. The results of the study demonstrate the differences in online retrieval strategies used by academic researchers and historians, archivists, avocationists, and the general public, and the importance of facilitating the discovery of digitized special collections through the use of electronic finding aids and an interactive interface with detailed metadata.