Ethics in nursing practice: a guide to ethical decision making

Every day nurses are required to make ethical decisions in the course of caring for their patients. Ethics in Nursing Practice provides the background necessary to understand ethical decision making and its implications for patient care. The authors focus on the individual nurse’s responsibilities, as well as considering the wider issues affecting patients, colleagues and society as a whole. This third edition is fully updated, and takes into account recent changes in ICN position statements, WHO documents, as well as addressing current issues in healthcare, such as providing for the health and care needs of refugees and asylum seekers, bioethics and the enforcement of nursing codes.

Confidentiality and disclosure : assessment and intervention issues

This portfolio addresses the moral, ethical and legal issues that impact upon decisions to maintain or disclose confidential communications. The tensions and moral dilemmas that are created when a conflict between these aspects arises are considered. Risk assessment procedures that inform decisions to maintain or disclose confidential information are discussed, as are issues related to the practical implementation of planned interventions. The topic is addressed by firstly reviewing professional codes of conduct and legal requirements to maintain confidentiality. The limits of confidentiality and privileged communication are then reviewed together with legal requirements of “duty to warn” or “duty of care”. These requirements are then related to risk assessment procedures and relevant interventions. Four case studies that illustrate the practical application of assessment techniques in the decision process and planned interventions are presented. They cover such diverse topics as disclosure and suicidal intent, threat of harm to a third party, risk of transmission of the AIDS virus and “duty to warn” and maintenance of a minor’s confidential communications. The ways in which these issues were addressed and the outcome is presented. NOTE: All names and details that have the potential to identify the people whose cases are presented here have been changed to protect their anonymity.

The regulation of research by funding bodies : an emerging ethical issue for the alcohol and other drug sector?

The degree to which funding bodies can and do control the content and dissemination of research products raises important issues which need to be openly debated by the alcohol and other drug (AOD) sector. Current policies relating to censorship and other means of controlling research topics or output are explored alongside an examination of how some institutions, particularly some academic journals, deal with such issues. We argue that regulation of research by funding bodies clearly contravenes the scientific ideal of freedom of information and open access to knowledge. Using international ethical guidelines, we also demonstrate that regulation raises concerns in relation to the ethical concept of beneficence. A number of examples specific to harm reduction strategies are presented in order to demonstrate how censorship might conceivably increase the harms associated with drug use. The commentary closes with recommendations concerning the establishment the prevalence of censorship and other forms of control over research in the AOD sector, and the role that ethics committees, journal editorial boards and professional societies might play in resisting the imposition of unacceptable conditions on publication of findings.

Dignity, virtue and punishment : the ethical justification of disciplinary segregation in prisoners

In this paper I reflect on Bersot and Arrigo’s argument that virtue ethics provides a sound ethical theory to guide judicial decisions concerning the legitimacy of subjecting mentality disordered offenders to long-term disciplinary solitary confinement. I expand on three issues evident in the Bersot and Arrigo paper: (1) the nature and justification of punishment; (2) the concept of dignity and its relevance to mentally disordered offenders placed in disciplinary solitary confinement, and (3) the nature and scope of virtue theory in the criminal justice context.

Ethical discriminations? Representing the reprehensible

This paper reflects upon the ‘goodness’ or ‘ethics’ of Critical Management/ Critical Organisation Studies (COS) research practices. I argue that academic representations of others entail an ethical responsibility to the researched, a responsibility that COS is, as yet, insufficiently exploring. Reflecting upon my own research with those who have colluded in discrimination and Stanley and Wise’s (1979) research on obscene telephone callers, I explore the nature and limits of responsibility when researching those who have acted reprehensibly. I end by arguing that COS “owe(s) some responsibility to ‘the researched’ of all kinds, whether we morally approve of them or not” (Stanley and Wise 1993:177).

Cloud computing services : theoretical foundations of ethical and entrepreneurial adoption behaviour

Clouicomputing is an emerging service technology that has ethical and entrepreneurial implications. Due to technological innovations increasing the attention placed on cloud computing services, more people are focusing on the security and privacy issues determined by ethical guidelines and how the technology is evolving as an entrepreneurial service innov.ation. This paper presents a theoretical perspective on how a person adopts cloud computing. The literature on technology innovation and adoption behaviour is examined with a focus on social cognitive theory. A theoretical framework is then presented, which indicates a number of propositions to describe the intention of a person to adopt cloud computing services. The role of technology marketing capability, sustained learning and outcome expectancy are included in helping to understand the role of cloud computing applications. Suggestions for future research and practical implications are stated.

Issues in assessing students in the clinical workforce : an exploratory study

The Monash Mini Case Record (MCR), based on Norcinis mini CEX, is an observed interaction between a student and a real patient in an authentic clinical setting. The assessor rates the students competence in history taking or physical examination and clinical reasoning on eight point scales. Professional / ethical behaviour within the encounter is evaluated on a four point scale. The assessor also grades the complexity of the case as low, medium or high. On completion of the student patient interaction, or her performance, and the assessor provides verbal and written feedback. Students complete both formative and summative MCRs across the academic year.

The ethical difference of Organization

Noting that from its very inception Organization laid claim to having a central interest in the ethics and politics of organization, in this article we review contributions to the Journal over the past 20 years in order to consider the ethical thinking that has developed. We suggest that there is a common thread of ethical interest that characterizes much of this work—one that clearly differentiates it from more conventional approaches to business ethics. While business ethics has as its locus of interest the ethicality of organizations themselves, central issues that have emerged in Organization concern how individuals might (or might not) maintain a valued experience of themselves as ethical subjects despite the behaviour of organizations, and how organizational arrangements might be politically contested in the name of ethics. We explore this in relation to a question that unites much of the study of ethics in Organization: how do we live (and work) together in a world beset by difference? We consider this question in terms of the issue of ethical subjectivity and the relation between an ethics of consensus and an ethics of difference. The article concludes much as the Journal started—with the proposal that ethics remains a pressing challenge for critical scholarship and practice.

An investigation of the differences in ethical perceptions among construction managers and their peers

Previous research on ethical perceptions of managers and their peers show a consistent result, managers think they have higher ethical standards than their peers. The aim of this paper is to study the ethical perceptions of construction managers and their peers. The method for conducting the study is through a questionnaire survey among UK construction managers. Three hundred and seven questionnaires were distributed; ninety-three completed questionnaires were completed and returned. The overall results show that the construction mangers believe they have higher ethical standards than their peers. The ethical perceptions which are exceptions to this are cooperation between firms to establish common prices is an unfair act and whistleblowing, the respondents think their peers have higher ethical standards on these two issues. The managers in the current and previous studies think they are more ethical than their peers on dealing with the issue such as having low level of personal honesty. The difference between the current and previous studies is that the construction mangers think they have much higher ethical standards than their peers on the issue providing trade secrets in order to exchange for personal benefits.

A pilot, multisite, randomized controlled trial of a self-directed coping skills training intervention for couples facing prostate cancer : accrual, retention, and data collection issues

PURPOSE: To examine the acceptability of the methods used to evaluate Coping-Together, one of the first self-directed coping skill intervention for couples facing cancer, and to collect preliminary efficacy data. METHODS: Forty-two couples, randomized to a minimal ethical care (MEC) condition or to Coping-Together, completed a survey at baseline and 2 months after, a cost diary, and a process evaluation phone interview. RESULTS: One hundred seventy patients were referred to the study. However, 57 couples did not meet all eligibility criteria, and 51 refused study participation. On average, two to three couples were randomized per month, and on average it took 26 days to enrol a couple in the study. Two couples withdrew from MEC, none from Coping-Together. Only 44 % of the cost diaries were completed, and 55 % of patients and 60 % of partners found the surveys too long, and this despite the follow-up survey being five pages shorter than the baseline one. Trends in favor of Coping-Together were noted for both patients and their partners. CONCLUSIONS: This study identified the challenges of conducting dyadic research, and a number of suggestions were put forward for future studies, including to question whether distress screening was necessary and what kind of control group might be more appropriate in future studies.