La prise de décision d’urgence chez les pompiers premiers répondants : Une illustration de la pertinence d’une approche empirique en éthique professionnelle

Article

Moral Masculinities: Ethical Self-fashionings of Professional Chinese Men in London

Through qualitative interviews and examination of textual sources, this essay investigates the gendered, class and cultural subjectivities of transnational, highly-educated Chinese men living and working in London. Narrative analysis of the interviews of two participants suggests that they exhibit hybrid “bricolage masculinities,” which incorporate elements from Western educational and corporate cultures, and also appropriate concepts and practices from the Confucian tradition of moral self-cultivation. A discussion of contemporary texts that support the revival of Confucian masculinities illuminates the discursive context in which the participants’ ethical self-fashionings take place. The study argues that the cosmopolitan yet culturally embedded masculinities of the participants are suggestive of how professional Chinese men, as they step onto the world stage, seek to insert themselves more advantageously into local and global power relations of gender, class and nation.

Law, Rights and Reproduction: Reproductive Autonomy in Ethical Rationalism

As medical technology has advanced, so too have our attitudes towards the level of control we can expect to hold over our procreative capacities. This creates a multi-dimensional problem for the law in terms of access to services which prevent conception, access to services which terminate a pregnancy and recompensing those whose choices to avoid procreating are frustrated. These developments go to the heart of our perception of autonomy. In order to evaluate these three issues in relation to reproductive autonomy, I set out to investigate how the Gewirthian theory of ethical rationalism can be used to understanding the intersection between law, rights, and autonomy. As such, I assert that it is because of agents’ ability to engage in practical reason that the concept of legal enterprise should be grounded in rationality. Therefore, any attempt to understand notions of autonomy must be based on the categorical imperative derived from the Principle of Generic Consistency (PGC). As a result, I claim that (a) a theory of legal rights must be framed around the indirect application of the PGC and (b) a model of autonomy must account for the limitations drawn by the rational exercise of reason. This requires support for institutional policies which genuinely uphold the rights of agents. In so doing, a greater level of respect for and protection of reproductive autonomy is possible. This exhibits the full conceptual metamorphosis of the PGC from a rational moral principle, through an ethical collective principle, a constitutional principle of legal reason, a basis for rights discourse, and to a model of autonomy. Consequently, the law must be reformed to reflect the rights of agents in these situations and develop an approach which demonstrates a meaningful respect of autonomy. I suggest that this requires rights of access to services, rights to reparation and duties on the State to empower productive agency.

The recent development and performance of ethical investments

In this chapter, we assess the recent development and performance of ethical investments around the world. Ethical investments include both socially responsible investments (following Environmental, Social and Governance criteria) and faith-based investments (following religious principles). After presenting the development of each type of funds in a historical context, we analyse their ethical screening process, highlighting similarities and differences across funds and regions. This leads us to investigate their characteristics in terms of return and risk, and finally evaluate their historical performance using various risk-adjusted performance measures on a small sample of US funds. Hence we are able to not only compare the performance of each fund with each other and with traditional investments, but also assess their relative resilience to the 2007-08 financial crisis.

Ethical reasoning through simulation: a phenomenological analysis of student experience

Background
Medical students transitioning into professional practice feel underprepared to deal with the emotional complexities of real-life ethical situations. Simulation-based learning (SBL) may provide a safe environment for students to probe the boundaries of ethical encounters. Published studies of ethics simulation have not generated sufficiently deep accounts of student experience to inform pedagogy. The aim of this study was to understand students’ lived experiences as they engaged with the emotional challenges of managing clinical ethical dilemmas within a SBL environment.

Methods
This qualitative study was underpinned by an interpretivist epistemology. Eight senior medical students participated in an interprofessional ward-based SBL activity incorporating a series of ethically challenging encounters. Each student wore digital video glasses to capture point-of-view (PoV) film footage. Students were interviewed immediately after the simulation and the PoV footage played back to them. Interviews were transcribed verbatim. An interpretative phenomenological approach, using an established template analysis approach, was used to iteratively analyse the data.

Results
Four main themes emerged from the analysis: (1) ‘Authentic on all levels?’, (2)‘Letting the emotions flow’, (3) ‘Ethical alarm bells’ and (4) ‘Voices of children and ghosts’. Students recognised many explicit ethical dilemmas during the SBL activity but had difficulty navigating more subtle ethical and professional boundaries. In emotionally complex situations, instances of moral compromise were observed (such as telling an untruth). Some participants felt unable to raise concerns or challenge unethical behaviour within the scenarios due to prior negative undergraduate experiences.

Conclusions
This study provided deep insights into medical students’ immersive and embodied experiences of ethical reasoning during an authentic SBL activity. By layering on the human dimensions of ethical decision-making, students can understand their personal responses to emotion, complexity and interprofessional working. This could assist them in framing and observing appropriate ethical and professional boundaries and help smooth the transition into clinical practice.

Economics of Ethical and Prosocial Behavior: Experiments on Social Responsibility, Ignorance, and Cheating

In this thesis I experimentally investigate prosocial and ethical behavior in economic interactions. The thesis consists of three experimental research papers that have a broad range of research questions on social responsibility, ignorance and cheating. With these experiments I aim to better understand when and why people behave ethically and/or prosocially and which consequences it has on their own and other players’ payoffs, and on overall efficiency. The results from the three experimental studies suggest that (i) donations to charity by employees are rewarded in an experimental setting, and the effect is driven by reciprocal concerns; (ii) there is a significant fraction of people who decide not to know about negative consequences of own actions, and the sorting of social agents of a low type into ignorance drives self-interested behavior of ignorant agents; and (iii) if the possibility of being exposed as a liar is small, the tendency to lie increases with incentives, indicating that some people have positive and finite costs of lying. Furthermore, when the participants lie, they lie to the full extent, which suggests that the intrinsic cost of lying is fixed.

Australian professional standards for teachers and the ethical dimension of policies

Do Editorial Policies Support Ethical Research? A Thematic Text Analysis of Author Instructions in Psychiatry Journals

Introduction: According to the Declaration of Helsinki and other guidelines, clinical studies should be approved by a research ethics committee and seek valid informed consent from the participants. Editors of medical journals are encouraged by the ICMJE and COPE to include requirements for these principles in the journal's instructions for authors. This study assessed the editorial policies of psychiatry journals regarding ethics review and informed consent. Methods and Findings: The information given on ethics review and informed consent and the mentioning of the ICMJE and COPE recommendations were assessed within author's instructions and online submission procedures of all 123 eligible psychiatry journals. While 54% and 58% of editorial policies required ethics review and informed consent, only 14% and 19% demanded the reporting of these issues in the manuscript. The TOP-10 psychiatry journals (ranked by impact factor) performed similarly in this regard. Conclusions: Only every second psychiatry journal adheres to the ICMJE's recommendation to inform authors about requirements for informed consent and ethics review. Furthermore, we argue that even the ICMJE's recommendations in this regard are insufficient, at least for ethically challenging clinical trials. At the same time, ideal scientific design sometimes even needs to be compromised for ethical reasons. We suggest that features of clinical studies that make them morally controversial, but not necessarily unethical, are analogous to methodological limitations and should thus be reported explicitly. Editorial policies as well as reporting guidelines such as CONSORT should be extended to support a meaningful reporting of ethical research.

Dilemas éticos en niños con enfermedades neuromusculares y dependencias tecnológicas: Ethical dilemmas in children with neuromuscular diseases and technological dependencies

En los últimos años, los cuidados respiratorios especializados, y en particular los cuidados respiratorios no invasivos y otros avances tecnológicos han contribuido a una mejor calidad de vida y sobrevida de los pacientes con enfermedades neuromusculares. La naturaleza de las opciones terapéuticas (como ser la ventilación invasiva versus ventilación no invasiva, las cargas psicológicas, sociales y financieras) tienen ramificaciones éticas. Por lo tanto resulta esencial que los médicos comprendan todas las opciones terapéuticas y los factores psicosociales al informar a sus pacientes, en lo que tiene que ver con sus ventajas y desventajas y sus costos asociados, de modo que los padres puedan tomar decisiones informadas. Los nuevos desarrollos incluyen exámenes prenatales y neonatales más precisos, nuevas terapias genéticas y soporte respiratorio no invasivo para evitar episodios de fallas respiratorias y vías aéreas invasivas. Al empoderar a los pacientes y sus familias para educar y capacitar servicios personales de cuidados para que no deban depender de las instituciones y servicios de enfermería constante, y los recientes avances tecnológicos facilitan su permanencia en el hogar y dejan de estar atados a una vida dependiendo de la institución y los servicios de enfermería. Estos últimos infantilizan a los pacientes en lugar de promover su autonomía. Las consideraciones financieras, las terapias genéticas, el screening prenatal y las distintas opciones terapéuticas que promueven la autonomía, todos tienen implicancias éticas. Algunos de los avances discutidos en este artículo requieren un cambio de paradigma en la forma en que los médicos ven y tratan a estos individuos.

Ethical addresses and Ethical record

Vols. 3-7 have neither title-page nor index.

An ethical philosophy of life presented in its main outlines,

Autobiographical introduction.--Philosophical theory.--Applications: the three shadows, sickness, sorrow and sin, and the right to life, property and reputation.--Applications: the ethics of the family, the state, the international relations, etc.

Ethical aspects of children’s perceptions of information-giving in care

The aim of this study was to identify key aspects in the exchange of information and to determine how nurses communicate news to hospitalised children. For this study, we applied the critical incident technique with 30 children aged between 8 and 14 years. Data were collected in paediatric units in a hospital in Alicante (Spain) using participant observation and semi-structured interviews. The analysis yielded three main categories: the children’s reaction to the information, nursing staff behaviour as a key aspect in the exchange of information and communication of news as well as children’s experience. This article emphasises the need to promote children’s consent and participation in nursing interventions. An analysis of these aspects will verify whether children’s rights are being respected and taken into account in order to promote children’s well-being and adaptation to hospitalisation.