Reintegrative and Disintegrative Shaming:Legal and Ethical Issues

Abstract
This chapter considers a range of legal and ethical issues raised by the use of reintegrative and disintegrative shaming techniques (Braithwaite, 1989) with sex offenders. ‘Disintegrative shaming’ labels and stigmatises offenders, ostracises them from the local community and may result in violence directed towards offenders (McAlinden, 2005, 2007). ‘Reintegrative shaming’, on the other hand, focuses on rehabilitating the offender within a supportive community environment and assisting the offender in their efforts to change. The former is evident in the range of recent legislative responses designed to protect the community from sex offenders such as notification as well as the popular demand for measures which ‘name and shame’ known sex offenders. The latter is more clearly related to restorative measures such as circles of support and accountability. This chapter argues that although traditionally at opposite ends of the intervention spectrum, each type of mechanism gives rise to potentially difficult legal and ethical considerations.

Using debate to teach pharmacy students about ethical issues

Objective. To create, implement, and evaluate debate as a method of teaching pharmacy undergraduate students about ethical issues.

Design. Debate workshops with 5 hours of contact with student peers and facilitators and 5 hours of self-study were developed for second-year pharmacy students. Student development of various skills and understanding of the topic were assessed by staff members and student peers.

Assessment. One hundred fifty students completed the workshops. The mean score for debating was 25.9 out of 30, with scores ranging from 23.2 to 28.7. Seventy percent of students agreed that the debates were a useful teaching method in the degree program.

Conclusion. A series of workshops using debates effectively delivered course content on ethical issues and resulted in pharmacy students developing skills such as teamwork, peer assessment, communication, and critical evaluation. These findings suggest that pharmacy students respond favorably to a program using debates as a teaching tool.

Ethical issues experienced by healthcare workers in nursing homes: Literature review

BACKGROUND: Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress.

OBJECTIVES: The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home and to explore staffs' experiences of ethical issues.

METHODS: Using a systematic approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home.

FINDINGS: The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work.

CONCLUSIONS: The review highlighted a need for improved ethics education for care-providers.

Research with children: methodological issues and innovative techniques

In the past few decades, a growing body of literature examining children’s perspectives on their own lives has developed within a variety of disciplines, such as sociology, psychology, anthropology and geography. This article provides a brief up-to-date examination of methodological and ethical issues that researchers may need to consider when designing research studies involving children; and a review of some of the methods and techniques used to elicit their views. The article aims to encourage researchers to critically reflect on these methodological issues and the techniques they choose to use, since they will have implications for the data produced.

'Murder or Mercy?' an innovative module helping UK medical students to articulate their own ethical standpoints regarding end-of-life decisions

Objectives This student selected component (SSC) was designed to equip United Kingdom (UK) medical students to respond ethically and with sensitivity to requests they might receive as qualified doctors in regard to euthanasia and assisted dying. The aim was to expose students to relevant opinions and experiences and to provide opportunities to explore and justify their own views and rehearse ethical decision making in a safe learning environment. Method The module is delivered by specialists from a number of disciplines including law, theology, medicine and nursing, each providing students with a working knowledge allowing them to actively discuss cases, articulate their own views and practise ethical reasoning through group and individual study. Visits to local intensive care units, palliative care wards and hospices are integrated effectively with theory. Student assessment comprises a dissertation, student-led debate and reflective commentary. Module impact was evaluated by analysis of student coursework and a questionnaire. Results Students found the content stimulating and relevant to their future career and agreed that the module was well-structured and that learning outcomes were achieved. They greatly appreciated the clinical context provided by the visits and opportunities to apply ethical reasoning to real cases and to debate ethical issues with peers. Students reported an increased discernment of the ethical and legal position and practical considerations and a greater awareness of the range of professional and lay viewpoints held. Student perceptions were confirmed on analysis of their submitted coursework. Many participants were less strongly in favour of euthanasia and assisted dying on module completion than at the outset but all felt better equipped to justify their own viewpoint and to respond appropriately to patient requests. Conclusions The multi-disciplinary nature of this course is helpful in preparing students to deal effectively and sensitively with ethical dilemmas they will encounter in their medical career. Use of an integrated, learner-centred approach equips students to actively engage with their peers in discussion of such issues and to formulate and defend their own position.