Les conflits d’intérêts en médecine : un exemple vétérinaire

Étude de cas / Case study

Om lärarskapets moraliska dimension : ett perspektiv och en studie av lärarstuderandes nätbaserade seminariesamtal

In this dissertation, an educational perspective called the moral dimension of teaching is developed. The work includes a theoretically informed discussion from a pragmatist point of view in which the concept of pedagogical rhythm is introduced. The concept captures the need for teachers to regularly shift their intentions and occasionally act in contradictory ways as a consequence of the moral which emerges from interaction in pedagogical situations. Using this perspective, criteria are developed for the characteristics of discussions of the work of teachers, which are desirable in order for students in pre-service teacher education to have opportunities to develop their teachership. Secondly, the educational perspective as it is conceptualised serves as a theoretical framework for a study of discussions taking place in net-based seminars among students in teacher education. The study consists of 14 recorded seminars in which discussions of the work of teachers are analysed in terms of content and direction for reflection. The result of the analysis is a construction of four different focal points for processes of making judgements: existential, performative, critical and professional. Mainly the performative, and to some extent the critical, focal points appear to be supported by the net-based environment, although potential for the professional focal point is found when available tools in net-based settings are used in deliberate ways. Finally, based on these four focal points, possible future predispositions among student teachers are deliberated. Student teachers’ future opportunities to develop a moral and epistemological authority are discussed, as well as teachers’ general opportunities to exercise professional responsibility. The conclusion emphasises that a perspective such as the one developed in the dissertation is important, as it creates an understanding for the need to educate student teachers to exercise a form of responsibility that goes beyond being accountable to society.

Key stakeholders' expectations of educational outcomes from Australian critical care nursing courses: a Delphi study

Background
Educational preparation for critical care nursing in Australia varies considerably in terms of the level of qualification resulting in a lack of clarity for key stakeholders about student outcomes.

Objectives
The study aim was to identify and reach consensus regarding the desired learning outcomes from Australian post-registration critical care education programs as demonstrated through the graduate's knowledge, skills and attitudes.

Design
A Delphi technique was used to establish consensus between educators, managers, clinicians and students regarding learning outcomes expected of graduates with a Graduate Certificate, Graduate Diploma and Master level qualification in critical care nursing.

Participants
A total of 164 critical care nurses (66 clinicians, 48 educators, 32 managers and 18 students) participated and 99 questionnaires were returned in the first round (response rate 60%). Fifty-seven questionnaires were returned for Round 2 (response rate 58%).

Methods
Learning outcomes were obtained from the Australian College of Critical Care Nurses Competency Standards for Specialist Critical Care Nurses. Some statements included more than one characteristic, and these were split to create learning outcomes with one characteristic per item. A survey of Australian higher education providers of critical care education provided additional learning outcomes, for a total of 73 learning outcomes for the first Delphi round.

Results
Findings suggest that patient comfort, safety, professional responsibility and ethical conduct are deemed most important for all three levels of educational preparation. There was a lack of emphasis on clinical practice issues for all levels. Participants placed higher emphasis on learning outcomes related to complex decision-making, leadership, supervision, policy development and research for Graduate Diploma and Master level programs.

Conclusion
The findings have implications for curriculum development and the profession with regards to the level of educational preparation required of critical care nurses and suggest that further work is required before clear recommendations can be made for desired educational outcomes from critical care nursing programs in Australia.

I’m not like everybody else - online forums and PLT

This paper reports some of the findings from a study undertaken as part of the research component for a master of professional education and training degree.
The objectives of the study were to investigate students’ perceptions and satisfaction regarding CMC activities, including community of inquiry framework elements and self-system factors, and to frame recommendations that might improve the use of online discussions as a teaching medium in practical legal training.
A literature review identified themes arising from previous studies concerning the use of CMC in adult learning. The elements of the Community of Inquiry framework and Marzano and Kendall’s concept of students’ Self System were used as reference points to frame the study.
An online questionnaire was used to collect data from students who had undertaken online discussion activities as part of their practical legal training in the professional responsibility in New South Wales, Queensland and Victoria. The data included the students’ opinions, attitudes and perceptions regarding the online discussions. The data was analysed using descriptive statistics that tended to indicate the participants were satisfied with online discussions as teaching medium for PLT. Tests for association between certain variables conducted using Barnard’s Exact Test disclosed 30 possible associations.
This paper focuses on part of the findings, namely associations between the participants’ attributes and contexts, student-student interactions, and satisfaction with the learning experience.
Further research specifically concerning the design and delivery of blended programs of practical legal training would be beneficial. Further study involving quantitative and qualitative methods and regarding the use of computer-mediated communications in PLT is recommended.

The legal profession and the business of law

‘Professional Responsibility and Ethics’ is one of the ‘Priestley 11’ law subjects compulsorily undertaken by Australian law students who aspire to be admitted to practice. Many of the brightest join the major corporate law firms. Nevertheless, there is little theoretical analysis of how those firms are functioning to affect the professional and ethical conduct of their practitioners in the neoliberal state. In this article it is argued that in the mature and highly competitive marketplace for legal services, rather than working as autonomous professionals, corporate lawyers are now finding themselves working more and more as functionaries subservient to the dictates of their corporate clients. Drawing on interviews with Australian major law firm corporate lawyers and Charles Derber’s theory on the proletarianisation of professional workers, it is argued that corporate lawyers are losing key elements of their professional identity in the impetus to maintain the client list and the profit motive. Furthermore, as the balance of power in the corporate legal sector is shifting from law firms to clients, the professional ethics of law firm lawyers are at risk of being compromised as they find themselves being reduced to little more than ‘flush’ factory fodder for the major corporations.

Bioética e odontologia: um perfil dos problemas éticos vividos por cirurgiões-dentistas

Bioethics studies human behavior in the fields ofbiological sciences and health care. Tt strives for humanization in health services along with promoting the rights of patients. In view of the lack of dental research dealing with this topic, the present study was undertaken to identify, from the viewpoint of dental surgeons, ethical problems experienced in dental practice,understand how they occur and how professionals deal with them. It is a descriptive exploratory investigation within a qualitative approach. Empirical material was collected through semi-structured interviews performed with 15 dental surgeons who work both in private and public practice in the state of Rio Grande do Norte, Brazil. The content of the interviews was systemized and organized, resulting in the identification of topics, from which were grouped the ethical problems reported by the participants. The resu1ts indicate that many of the ethical problems coincide with infringements of the norms and mIes of the Dental Code of Ethics, confirming a dental ethic acquired during professional formation and therefore, inadequate for solving the problems that emerge in professional practice. Other questions stand out such as low salaries, competition and poor working conditions. Associated to these problems are lack of commitment and professional responsibility with the patients. Concem with maintaining user autonomy, guaranteeing access to specialized services, and the need for performing only procedures for which they are technically qualified arise in the responses, leading to difficulties in consolidating the principIes proclaimed by bioethics: autonomy, justice, nonmaleficence and beneficence. We concluded that the ethical problems identified in professional practice need to be understood beyond the dental dimension, towards a human approach. It is therefore necessary to incorporate health care management technologies into health practices, including dentistry, which implies recognizing the difTerent dimensions that surround individuaIs, that is, social, economic, political and cultural

Aspectos médico-legais da cirurgia para hérnia inguinal

Professional responsibility is an inherent factor to the medical activity. Therefore, the adoption of a healthy conduct based on good relationship between the physician and the patient, as well as the understanding of this professional of the several aspects involved in the inguinal hernia repairs, are considered the better means to protect himself against possible litigations with its patients. This issue provides a complete evaluation of medical and legal problems related to the inguinal hernia surgery, and discusses the care that surgeon must exercise during preoperative, intraoperative and postoperative periods. That authors also comment about medical error and its conception from the point of the new Civil Code.

A profissionalização docente: identidade e crise

Pós-graduação em Educação Escolar - FCLAR

Percepção e atitudes de estudantes de odontologia sobre a pobreza

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Reclamações éticas contra cirurgiões dentistas que deram entrada no CRO-SP durante o ano de 2007

Pós-graduação em Odontologia Preventiva e Social - FOA

Carcinoma de lábio com prognóstico sombrio devido conduta médica inadequada

The Squamous Cell Carcinoma is what more happens among the oral cancers, being considered sweats incidence in more than 90%. As important prognostic factor competes the early diagnosis and the immediate institution of the treatment, that it can involve radiotherapy and chemotherapy besides the surgery. The initial lesions don’t offer great diagnostic difficulties and now complemental laboratory exams define the diagnosis quickly, In the present report, the initial medical conduct was inadequate, with incomplete interpretation of the laboratorial result and adoption of inadequate therapeutic conduct, what resulted in constant evolution of the lesion. The patient came to the consultation with that medical history, after six months of the first attendance accomplished in another center. To the physical exam, infiltrative ulcerated lesion was observed in the lower lip, with having accentuated tissue loss superficially. The patient accused spontaneous pain and she did use an ointment, recommended six months ago for occasion of the first attendance. As diagnostic conduct was indicated the accomplishment of cytology and biopsy, being defined the diagnosis of Squamous Cell Carcinoma. The patient was immediately guided to the medical service of its municipal district for manegement of the specialized oncologic treatment. The patient was submitted the surgery followed by radiotherapy, being verified involvement of another structures by contiguity. Now, the patient meets abed, without viable perspectives of cure. The present report emphasizes the importance of the clinical knowledge and professional responsibility in attendance of cases of that nature.

¿En dónde ubican su atención los niños desatentos? Herramientas psicoanalíticas para abordar la problemática desatencional en la clínica y la institución escolar

El presente trabajo está basado en el recorte de algunos resultados y conclusiones de la investigación que desarrollé en el marco de la beca doctoral UBACyT (2003-2007) acerca de los "Aspectos histórico-libidinales en niños y niñas con problemas en sus aprendizajes que manifiestan dificultades atencionales". Se partió de la idea de que no existen niños que no atiendan en lo absoluto, que de lo que se tratará es de ubicar en qué tienen puesta su atención los niños desatentos. Las conclusiones principales fueron: La necesidad de plantear las dificultades atencionales como resultante de múltiples determinaciones y no tan sólo a causa de un supuesto déficit neurológico. La responsabilidad profesional de diferenciar diagnósticos descriptivos, de diagnósticos estructurales de sujetos en constitución. Se cuestionó la dicotomía cuerpo - mente, se propuso pensar la intersección entre “vulnerabilidad genética" y “potencialidad traumática". Se encontró una estrecha ligazón de las dificultades atencionales con las historias libidinales. Se hallaron situaciones silenciadas en todas las historias analizadas, modalidades a predominio de la desinvestidura y la preponderancia de situaciones traumáticas vivenciadas por las diferentes generaciones que el psiquismo prefiere mantener desligadas, incluso a costa del empobrecimiento subjetivo y las dificultades para simbolizar. A partir de este recorrido se proponen algunas herramientas para abordar la problemática tanto desde el espacio clínico, como escolar.

Consentimiento informado

La profesión de odontólogo se ejerce a través de numerosos actos que requieren de la responsabilidad del profesional, relacionado con distintos problemas que ocurren en el quehacer diario en relación a la aprobación por parte del paciente. El consentimiento informado constituye un acto jurídico que debe reunir características propias.

A Case Study in Crisis Management: Le Petit Gourmet Catering

The skills of crisis management are more and more valuable in the food service industry. How a manager handles a crisis can spell the difference between success and failure. Finding a good model for crisis management is difficult. The author offers a case study to introduce one such model.

Hotel Managers Identify Ethical Problems: A Survey of their Concerns

This study identified and examined the concerns of hotel general managers regarding ethics in the hospitality industry. Thirty-five managers were interviewed during and immediately following the economic recession to determine which ethical issues in the hotel industry and at their own properties concerned them the most. Results showed that more people and organizations attempted to renegotiate hotel rates, which actions, in turn, led to some lapses in ethical behavior. Managers said that because of the economic downturn, they felt pressure from both private owners and corporate headquarters. They also said a lack of work ethic, low motivation, and low pay caused many workers to underperform in ways that raised ethical issues. Managers also mentioned diversity issues and theft by both guests and employees as ethical issues of concern, and shared stories about their experiences.