Research ethics, reconciliation, and strengthening the research relationship in Indigenous health domains : an Australian perspective

Australia has one of the best health care systems in the world. Despite this, the health of Indigenous Australians remains poor in comparison to non-Indigenous Australians and in comparison to other Indigenous peoples in other developed countries, such as Canada, the USA and New Zealand. Although the disparities in Indigenous health are the result of a complex array of interacting social and political processes, the historical failings of the nation's research endeavours to directly benefit the health status of Indigenous peoples are bring increasingly implicated in the status quo. Because of their shared memories of past bad experiences, Indigenous communities are profoundly distrustful of non-Indigenous health researchers. As a result of this distrust, opportunities to improve the performance, accountability and benefits of health research in Indigenous health domains are being lost—to the further detriment of the health of Indigenous peoples. In an attempt to redress this distrust and strengthen the research relationship in Indigenous health domains, various national research ethics guidelines and frameworks have been developed. It is evident, however, that if the research relationship in Indigenous health domains is to be improved, researchers need to do much more than merely uphold prescribed rules and guidelines. This article contends that if the research relationship in Indigenous health is to be strengthened, health researchers must also engage in the distinctive political processes of ‘recognition’ and ‘reconciliation’. In support of this contention, the processes of recognition and reconciliation are described, and their importance to improving the overall performance, accountability and benefits of Indigenous health research explained.

Ethics and advance care planning in a culturally diverse society

Emerging international research suggests that in multicultural countries, such as Australia and the United States, there are significant disparities in end-of-life care planning and decision making by people of minority ethnic backgrounds compared with members of mainstream English-speaking background populations. Despite a growing interest in the profound influence of culture and ethnicity on patient choices in end-of-life care, and the limited uptake of advance care plans and advance directives by ethnic minority groups in mainstream health care contexts, there has been curiously little attention given to cross-cultural considerations in advance care planning and end-of-life care. Also overlooked are the possible implications of cross-cultural considerations for nurses, policy makers, and others at the forefront of planning and providing end-of-life care to people of diverse cultural and language backgrounds. An important aim of this article is to redress this oversight.

Ethics in nursing

This chapter will :
- define nursing ethics
- outline the development of mainstream bioethics
- explore a range of 'everyday' ethical issues that nurses might face in the course of providing nursing care to clients/patients; and
- discuss five areas in which a re-examination of the ethical issues faced by the nursing profession is warranted

An anthology of codes of ethics

Purpose – Corporate codes of conduct originated around 1900 in the USA gaining further momentum in the 1950s in relation to anti-trust legislation. Subsequently, the adoption of codes of ethics has spread throughout the world and they now feature extensively in many organisations. The literature relating to codes of ethics, therefore, spans many decades and is undoubtedly comprehensive. The purpose of the paper is to provide an appropriate anthology of codes of ethics.
Design/methodology/approach – A descriptive, historical, anthological approach has been taken.
Findings – This paper examines the motivations for the adoption of codes of ethics, which naturally also includes international codes, their frequency of use and content. Codes are also not without critique and it is appropriate to highlight the criticisms of codes, to provide an assessment of their potential effectiveness, the issues surrounding implementation and enforcement and the relationship to organisational culture and leadership.
Research limitations/implications – As noted, the literature on codes of conduct is extensive and while effort has been made to capture the key themes the review is not necessarily exhaustive.
Originality/value – The literature is characterised by the means of institutionalising ethics in organisations and the paper concludes with a summative reflection on the key dimensions that appear to be paramount for improving the efficacy of codes of conduct.

New work ethics? The corporate athlete's back end index and organisational performance

Drawing on Michel Foucault’s later genealogies of the Self the paper will illustrate particular dimensions of the increasingly powerful individualizing and normalizing processes shaping the lifeworlds of worker-citizens in a globalizing risk society. Processes that require those who wish to be positively identified as professional, entrepreneurial, resilient, effective, athletic to do particular sorts of work on themselves. Here the paper argues that we can identify the emergence of what we call New Work Ethics. We illustrate this more general argument via an analysis of the ways in which a large Information Technology (IT) organization seeks to produce—via a workplace health and fitness program—employees who imagine themselves as embodying the behaviours and dispositions that mark the person as a corporate athlete. Knowledge of the Self in these terms can, it is promised, enhance the performance of the Self, and the organization.

Ethical practice from the perspective of the forensic psychologist : commentary on the uses and value of the Australian Psychological Society (2007) code of ethics

Forensic practice in Australia and around the world attracts a high level of public and judicial scrutiny. The way in which the forensic psychologist conducts him or herself in ethically challenging situations is important not only to the reputation of the individual practitioner, but to the profession more widely. This paper outlines some of the ethical issues that commonly arise in forensic psychology practice and discusses these in relation to the recently published Australian Psychological Society (2007) Code of Ethics. Four ethically challenging scenarios are described and discussed in terms of how the Code might be used to offer guidance to psychologists about how they might best respond.

Ethics and self-knowledge in corruption related decision making

The nature of corruption in international business is briefly considered and several types of bribes are distinguished. Two managerial decision-models are then proposed, in order to assist international managers faced with corruption-related situations. The first model is based upon an ethical analysis and it conditionally endorses some types of facilitating-payment. The second is based upon a psychological analysis and it involves identification and classification of the generic consequences of bribe payments. The two models are intended to form part of a wider and multifaceted approach to reducing corruption.

Corporate codes of ethics in Australia, Canada and USA : measurement and structural properties of a cross-cultural model

The objective is to test the consistency of measurement and structural properties in a model of corporate codes of ethics (CCE) on an aggregated level and across multiple samples derived from three countries, namely Australia, Canada and the USA. The properties of four constructs of CCE are described and tested, these being: surveillance/training, internal communication, external communication, and guidance. The conclusion is that the measurement and structural models on an aggregated level have a satisfactory fit, validity and reliability. Furthermore, they are consistent when tested on each of the three samples (i.e. cross-validated). The cross-cultural model makes a contribution in addition to previous mostly descriptive studies and theory in the field using confirmatory factor analysis and structural equation modeling.

Property transactions : a note on ethics

Some activities that are applied in the property market to facilitate transactions have the potential to lead to unethical behaviour. Two conditions required for a sale price to be acceptable as market value are that the transaction is at arm’s length and the parties to the transaction are knowledgeable and prudent. The well-known difficulties associated with access to market pricing information are exacerbated by several of these activities including dummy bidding at auctions, two-tier marketing and the provision of lease incentives. Added to these is a common requirement that any negotiation be commercial-in-confidence. The lack of information has the potential to distort the market and this has been well publicised in recent times particularly in the residential market.
The definition of market value is visited and the nature of ethics in property transactions is outlined. Several examples of activities that could lead to unethical behaviour are described. It is concluded that unethical behaviour is hard to identify. Some recommendations are included for consideration and discussion.

The ethics and practical importance of defining, distinguishing and disclosing nursing errors : a discussion paper

Nurses globally are required and expected to report nursing errors. As is clearly demonstrated in the international literature, fulfilling this requirement is not, however, without risks. In this discussion paper, the notion of ‘nursing error’, the practical and moral importance of defining, distinguishing and disclosing nursing errors and how a distinct definition of ‘nursing error’ fits with the new ‘system approach’ to human-error management in health care are critiqued. Drawing on international literature and two key case exemplars from the USA and Australia, arguments are advanced to support the view that although it is ‘right’ for nurses to report nursing errors, it will be very difficult for them to do so unless a non-punitive approach to nursing-error management is adopted.

Patient safety ethics and human error management in ED contexts part I : development of the global patient safety movement

In recent years there has been increasing recognition internationally that health care is not as safe as it ought to be and that patient safety outcomes need to be improved. To this end patient safety has become the focus of a world-wide endeavour aimed at reducing the incidence and impact of preventable human errors and related adverse events in health care domains. The emergency department has been identified as a significant site of preventable human errors and adverse events in the health care system, raising important questions about the nature of human error management and patient safety ethics in rapidly changing environments. In this article (the first of a two-part discussion on the subject) an overview of the incidence and impact of preventable adverse events in ED contexts is explored. The development of a ‘culture of safety’ in other hazardous industries and the ‘lessons learned’ and applied to the health care industry are also briefly examined. In a second article (to be presented as Part II), some of the ethical tensions that have arisen in the context of implementing patient safety processes and their possible implications for ED contexts are explored.

Patient safety ethics and human error management in ED contexts Part II : Accountability and the challenge to change

In recent years there has been increasing recognition internationally that health care is not as safe as it ought to be and that patient safety outcomes need to be improved. To this end, patient safety has become the focus of a world-wide endeavour – endorsed by the World Health Organisation – to reduce the incidence and impact of preventable human errors and related adverse events in health care domains. The emergency department has been identified as a significant site of preventable human errors and adverse events in the health care system, raising important questions about the nature of human error management and patient safety ethics in rapidly changing environments, of which the Emergency Department is a prime example. In Part I of this article series, an overview of the incidence and impact of preventable adverse events in Emergency Department contexts and the development of the global patient safety movement was presented. In this second article brief attention is given to examining some of the ethical tensions that have arisen in response to the patient safety movement and their possible implications for Emergency Department contexts and staff.

Implementation, communication and benefits of corporate codes of ethics : an international and longitudinal approach for Australia, Canada and Sweden

This paper examines the implementation, communication and benefits of corporate codes of ethics by the top companies operating in Australia, Canada and Sweden. It provides an international comparison across three continents. It is also based on a longitudinal approach where three national surveys were performed in 2001–2002 and replications of the same surveys were performed in 2005–2006. The empirical findings of this research show in all three countries that large organisations indicate a substantial interest in corporate codes of ethics. There are, however, differences in the ways that the companies in each country implement and communicate their corporate codes of ethics and the benefits that they see being derived from them. The longitudinal comparison between 2001–2002 and 2005–2006 indicates changes in the implementation, communication and benefits of corporate codes of ethics in the three countries.

A construct of the 'ethos of codes of ethics' (ECE) : the case of private and public Sweden

Purpose – The objective of this paper is to develop and describe a construct of the “ethos of the codes of ethics” (i.e. an ECE construct) in the private and public sectors of Sweden.

Design/methodology/approach – The paper takes a cross-sector approach to codes of ethics amongst the top private sector companies and the top public sector organisations. The paper then examines the measures put in place by the dual sample in order to describe the ethos of their codes of ethics.

Findings – The multivariate techniques used in the statistical analysis indicated that the ECE-construct consists of five dimensions: ethical bodies, ethical tools, ethical support procedures, internal ethics usage, and external ethics usage.

Research limitations/implications – It should be noted that the ECE construct has been derived from large companies and organisations in private and public Sweden, which may indicate less applicability to smaller operations. Another limitation may be the validity and reliability across other cultural samples. The dual sample contains a variety of different types of operations, but it may not be transferable to other countries.

Practical implications – The outcome is based on data from private companies and public organisations that indicated they had corporate codes of ethics. Therefore, a suggestion for further research is to examine the ECE construct in other countries/cultures that differ from the ones in this research effort performed in the private and public sectors of Sweden.

Originality/value – The ECE construct introduced makes a contribution to theory and practice in the field as it is based upon a dual sample. It makes a contribution to theory as it outlines a construct for the benefit of other researchers working in both the private and the public sectors. The authors also believe that it may be of managerial interest as it provides a grounded framework of areas to be considered in the implementation of the codes of ethics in both private companies and public organisations.