Should patients in a persistent vegetative state be allowed to die? Guidelines for a new standard of care in Australian hospitals

In this article we will be arguing in favour of legislating to protect doctors who bring about the deaths of PVS patients, regardless of whether the death is through passive means (e.g. the discontinuation of artificial feeding and respiration) or active means (e.g. through the administration of pharmaceuticals known to hasten death in end-of-life care). We will first discuss the ethical dilemmas doctors and lawmakers faced in the more famous PVS cases arising in the US and UK, before exploring what the law should be regarding such patients, particularly in Australia. We will continue by arguing in favour of allowing euthanasia in the interests of PVS patients, their families, and finally the wider community, before concluding with some suggestions for how these ethical arguments could be transformed into a set of guidelines for medical practice in this area.

The impact of ethics education in medical laboratory science.

Teachers and students were asked what ethics education is offered in their program. The survey of the teachers regarding ethics education revealed some differences between english and french schools. It was found that franch schools favoured ethics courses taught by philosophers while english schools favoured ethics courses taught by health care providers. Furthermore, case studies were reported to be used more often in english schools and more often in assignments. However, regarless of the differences, 87 % of teachers agreed that ethics training is a high priority and most teachers thought that ethics training in their programs was adequate. At same time, students were asked to answer some questions that involved ethical dilemmas wherein some moral decisions would have to be made. Their responses revealed their level of moral development, based on Kohlberg's theory of moral development. The impact of ethics courses in the curriculum on moral development was correlated taking into account what ethics education students actually received with what year-of-study they were in (1st year, end of program or two years post graduation). Students were presented scenarios about falsifying records, communication, student dishonesty and preanalytical impact on patient care. These are authentic issues that technologists face on a daily basis. In reply to multiple-choice questions, respondents chose, in order of personal preference, the three best answers out of six offered to complete a statement regarding ethics. Statistical analysis was performed using SPSS (Statistical Package for Social Studies), employing crosstabulations and Oneway Anova. Factors including respondents age range, mother tongue, gendre, and years of schooling were considered.

Investigating the dilemmas of ethical social research

The author’s work with a university ethics committee and field research in Pacific New Caledonia is used as a basis to problematise the biomedical research models used by universities in Australia for assessing social research as ethical. The article explores how culturally specific Western emotional bases for ethical decisions are often unexamined. It expresses concerns about gaps in biomedical models by linking the author’s description of field interactions with research participants to debates about the creation of knowledge.

VET and VET educators : understanding teacher dilemmas in providing quality educational experience to international students in Brisbane

In the past fifteen years, increasing attention has been given to the role of Vocational Education and Training (VET) in attracting large numbers of international students and its contribution to the economic development of Australia. This trend has given rise to many challenges in vocational education, especially with regard to providing quality education that ensures international students’ stay in Australia is a satisfactory experience. Teachers are key stakeholders in international education and share responsibility for ensuring international students gain quality learning experiences and positive outcomes. However, the challenges and needs of these teachers are generally not well understood. Therefore, this paper draws on the dilemmas faced by teachers of international students associated with professional, personal, ethical and educational aspects. This paper reports on a Masters Research project that is designed to investigate the dilemmas that teachers of international students face in VET in Australia, particularly in Brisbane. This study uses a qualitative approach within the interpretive constructivist paradigm to gain real-life insights through responsive interviewing and inductive data analysis. While the data collection has been done, the analysis of data is in progress. Responsive interviews with teachers of VET with different academic and national backgrounds, ages, industry experience have identified particular understandings, ideologies and representations of what it means to be a teacher in today's multicultural VET environment; provoking both resistances and new pedagogical understanding of teacher dilemmas and their work environment through the eyes of teachers of international students. The paper considers the challenges for the VET practitioners within the VET system while reflecting on the theme for the 2011 AVETRA conference, “Research in VET: Janus- Reflecting Back, Projecting Forward” by focusing particularly on “Rethinking pedagogies and pathways in VET work through the voice of VET workers”.

Rewriting the future? Biomedical advances and legal dilemmas

Developments in medical science have sparked public debate about the legal and ethical implications of new technologies. Within these debates a number of distinct discourses are evident, including discourses about the positive and negative implications of technological advances, the influence of globalisation on regulatory choice, and the challenges of articulating common values in a pluralistic society. This article argues that an understanding of these discourses is an essential part of understanding the nature of contemporary regulatory dilemmas.

The centrality of ethical leadership

Purpose The central argument in this paper is that ethical school leadership is imperative in a context of increasing performance-driven accountability. The purpose of this paper is to focus on school principals’ perceptions of how they understand ethical leadership and how they lead the ethical use of data. Design/methodology/approach This study utilises semi-structured interviews with six state school principals (one primary and six secondary) to explore their perceptions of ethical leadership practices; and how they balance current competing accountabilities in a context of performance-driven accountability. Findings There were four key findings. First, principals used data to inform and direct their practices and their conversations with teachers. Second, while ethics was a central consideration in how principals’ led, practising in an ethical manner was identified as complex and challenging in the current context. Third, Starratt’s (1996) ethical framework proved to be relevant for interpreting principals’ practices. Finally, all of the principals referred to dilemmas they faced as a result of competing priorities and all used a variety of strategies to deal with these dilemmas. Originality/value While there is a small body of research that explores school leaders’ understandings of ethical tensions and dilemmas, there is little research that has focused on school leaders’ understandings of the ethical use of data. This study, then, contributes to this area as it provides a discussion on school principals’ leadership practices in the current climate driven by data use.

Coercion in the Community: A Situated Approach to the Examination of Ethical Challenges for Mental Health Social Workers

Increasingly, mental health social workers in the United Kingdom and elsewhere in the world are employing coercive interventions with clients. This paper explores this trend in the context of community-based settings, using national and international research literature on this subject. It begins with a discussion about the complex, contested nature of ideas on coercion. The authors then explore debates about how coercion is perceived and applied in practice. They choose two forms of coercion*/informal types of leverage, and the legally mandated use of Community Treatment Orders*/to highlight the range of ethical problems and dilemmas that confront practitioners in this field. The authors conclude by developing a tentative, explanatory model to explain how and why mental health social workers should consider a more holistic, situated approach to help deal with ethical concerns about the use of coercion.

Communication, recognition and social work: Aligning the ethical theories of Habermas and Honneth

The modern world is replete with ethical challenges of Orwellian proportions. The violation of human rights and misrecognition of identities are two of the most pressing examples. In this paper, the ethical theories of Habermas and Honneth are aligned as a way of addressing these specific challenges within social work. It is suggested that these theories are complementary, mutually rectifying and concordant at the meta-ethical level of analysis. The alignment is also justified, pargmatically, through the construction of three hypothetical vignettes demonstrating different kinds of practice dilemmas. The need for egalitarian communication and the imperative to recognise human identity in all its dimensions subsequently emerge as the two foundation stones for ethical deliberation in social work.

Enjeux ethiques de la psychiatrie sous contrainte [Ethical issues in psychiatry under coercion].

Psychiatry is now subject to two apparently contradictory movements. On the one hand, the need to respect the autonomy and rights of patients is reinforced and coercive measures are strictly defined and limited. On the other hand, security concerns in our society leads to prosecution of psychiatric disorders, especially when accompanied by behavioral problems or criminal acts. In these situations of compulsory treatment or care provided in prisons, a number of dilemmas emerge. The place of the healthcare professional in treatments ordered by the Justice and problems related to administrative detention are discussed in more detail.

Dilemmas in Military Medical Ethics: A Call for Conceptual Clarity

Article

Researching from within: external and internal ethical engagement

This article examines the superficial and deep ethical and moral dilemmas confronting ‘insider’ researchers which we term external and internal ethical engagement. External ethical engagement refers to the traditional, easily identifiable ethical issues that insider researchers attend to by submitting their application for ethical approval to their institution’s internal review board. Internal ethical engagement relates to the deeper level ethical and moral dilemmas that insider researchers have to deal with once ‘in the field’ linked to on-going personal and professional relationships with participants, insider knowledge, conflicting professional and researcher roles, and anonymity. By reviewing the literature in this area and drawing on the authors’ experiences of undertaking interpretive studies at institutions where they were members of staff, we explore these concepts and examine the implications for insider researchers. Keywords: insider research; ethics; professional relationships; anonymity; access