Investigating socio-economic status and chronic illness: directions and dilemmas

In Australia, chronic illness is increasing being recognised as more important. Yet there is relatively little discussion of the nature of the role played by socio-economic status (SES) plays in its prevalence. This paper argues there are two effects of SES. The first is that lower SES can lead to an increase in chronic illness, as evidenced by a number of epidemiological studies. The second is that chronic illness can contribute to lower SES. Examples are provided of the different types of relationships. Difficulties associated with SES analyses and its relationship to chronic illness are discussed, and specific conditions such as HIV/AIDS are referred to as examples. In addition the work of Marmot on SES and chronic illness is drawn on. The authors identify a number of areas that require further research, and recommend that in studies of chronic illness, SES may be a contributing variable, and outcome, or both.

Ethical performance evaluation (EPE) in business practices: framework and case illustrations

Purpose – A set of principal parameters (i.e. time, context, gap, outcome, and consequence) influences the ethical performance evaluation (EPE) of business practices in the marketplace and society. The purpose of this paper is to describe a managerial framework of EPE based upon these parameters.

Design/methodology/approach – Case illustrations are used to underpin the introduced managerial framework of EPE.

Findings – The EPE of business practices is not only dependent upon the ethical values and principles of today, but those principles of tomorrow may be equally, or even more, crucial. The EPE of business practices is also dependent upon the surrounding context and its specific ethical values and principles. Furthermore, it is dependent upon the gap between different perceptions of ethical values and principles and if the outcome of the corporation's ethical values and principles are proactive or reactive in relation to the reigning ethical values and principles in the marketplace and society. Finally, it is also dependent upon the potential and eventual consequences of ethical values and principles.

Research limitations/implications – The only way that we can “objectively” evaluate past ethical values and principles is through the use of ethical values and principles at the time and in respect to the context at hand. Research tends to fail when considering the longitudinal and evolutionary dimensions in the exploration of ethical values and principles in business practices. There is too much focus upon on-the-spot-accounts in the past and in current research efforts. An important area for further research is how to deal with the durability and variability of ethical values and principles in business practices in the marketplace and society. The key may be a stronger emphasis on longitudinal research efforts that may explore them over time and as contexts evolve. Ethical values and principles are connected and re-connected over time and across contexts in one way or another. They have a past, a current status and a future.

Practical implications – The decision as to whether business practices are ethical or unethical is – relatively speaking – easy to determine from a narrow perspective, however, the decision whether business practices are ethical or unethical becomes complicated as the perspective is widened and deepened. An introduced managerial framework of EPE provides a generic foundation and structure to examine the acceptability versus unacceptability of business practices.

Originality/value – The paper introduces a managerial framework of EPE, followed by case illustrations. It addresses the impact of time on ethical values and principles in any context on the potential and eventual gaps, outcomes and consequences in business practices. The managerial framework of EPE may also be used in non-business areas whenever found applicable and convenient to use.

Engaging practitioners with critical reflection: issues and dilemmas

This paper presents a reflective account of my teaching practice with health practitioners who work as school nurses in the secondary education system in regional Victoria, Australia. It highlights some of the issues and dilemmas that emerged during my experiences, as a social work educator, facilitating workshops about critically reflective learning as a cross-disciplinary  enterprise. Using critical reflection, this paper also raises questions  regarding how we might respond to some of the challenges to improve  future approaches to teaching critical reflection.

Spirituality and sexual abuse: issues and dilemmas for survivors

Sexual abuse profoundly affects survivors to the extent that they are unable to maintain previously held viewpoints or ways of being, including those relating to their spirituality. Certainly the experience has considerable potential to complicate the spiritual lives of survivors. For Christian survivors, this may include how they perceive and relate to both themselves and God as well as affect participation in sacraments such as eucharist and reconciliation. Spiritual traditions often promote the embracing of silence, but this may be problematic for survivors who have been silenced and unable to give expression to their experiences. Similarly, socialization resulting in beliefs that Christians should always forgive and/or never be angry needs to be overcome. While negotiating these pitfalls may result in explorations of spirituality being even less straightforward for survivors of sexual abuse than it is for others, a transformative spirituality within a Christian framework can be realized.

Impact of social expectations on ethical governance of sport organisations

Sport business is different; one of these differences is the significant and important cultural role that sport plays in society. This paper investigates the social expectations of sport, and how these expectations impact on the management and governance of sport organisations. Interviews were undertaken with the directors and CEOs of the Australian Football League and its clubs, to examine the concept of social expectations and ethical governance. Five key themes of the social expectations of sport were found: scrutiny, sport business, sport context, social investment, and the historical development of the club. Each of these themes was identified through the data analysis as having a potential impact on the management and ethical governance of sport organisations. A clearer understanding of the social and cultural context within which sport organisations operate, enables sport organisations to implement sound policy and practices for ethical governance.

The effects of accounting students` ethical reasoning and personal factors on their ethical sensitivity

Purpose – Rest posited that to behave morally, an individual must have performed at least four basic psychological processes: moral sensitivity; moral judgment; moral motivation; and moral character. Though much ethics research in accounting has been focused on component two, ethical judgment, less research has been undertaken on the other three components. The purpose of this study is to focus on component one, ethical sensitivity, of Rest's four-component model.
Design/methodology/approach – A sample of 156 accounting undergraduates was employed to investigate the ethical sensitivity of accounting students and the effects of their ethical reasoning and personal factors on their ethical sensitivity.
Findings – Results of this study show that accounting students vary in their ability to detect the presence of ethical issues in a professional scenario. There is no significant relationship between accounting students' ethical sensitivity and their ethical reasoning (P-score). Accounting students characterized as “internals” are more likely to show an ability to recognize ethical issues than those characterized as “externals.” The results also indicate that an accounting ethics intervention may have positive effect on accounting students' ethical sensitivity development. Hence, an individual who possesses the ability to determine what is ethically right or wrong (high ethical reasoning) may fail to behave ethically due to a deficiency in identifying ethical issues (low ethical sensitivity) in a situation.
Originality/value – Whilst much research has concentrated on ethical reasoning and ethics education to enhance the ethical conduct of accountants, it is important that the profession and researchers also direct their attention and efforts to cultivating the ethical sensitivity of accountants. The findings of this study provide additional evidence to support Rest's theory of a more comprehensive cognitive model of ethical decision-making and suggest a more balanced research effort in evaluating the ethical development of individuals.

Life and Death: The Religious, Philosophical and Moral Dilemmas in Medicine

Religious beliefs often play a major role in the decisions that are made in the home and the hospital concerning issues at the beginning and end of life. Only recently, however, due to rapidly advancing medical technology, have religious, moral, and philosophical beliefs taken such a controversial role. One of the major questions that has arisen from these various controversies is whether or not we have the right to posses control over the biological functions of our bodies. The answer is a difficult one, and it may be one that cannot be answered, but the attempt at an answer is what is at the heart of medical ethics.

Medical treatment and the good death: an ethical analysis of euthanasia, physician assisted suicide, and the right to die

Frequent advances in medical technologies have brought fonh many innovative treatments that allow medical teams to treal many patients with grave illness and serious trauma who would have died only a few years earlier. These changes have given some patients a second chance at life, but for others. these new treatments have merely prolonged their dying. Instead of dying relatively painlessly, these unfortunate patients often suffer from painful tenninal illnesses or exist in a comatose state that robs them of their dignity, since they cannot survive without advanced and often dehumanizing forms of treatment. Due to many of these concerns, euthanasia has become a central issue in medical ethics. Additionally, the debate is impacted by those who believe that patients have the right make choices about the method and timing of their deaths. Euthanasia is defined as a deliberate act by a physician to hasten the death of a patient, whether through active methods such as an injection of morphine, or through the withdrawal of advanced forms of medical care, for reasons of mercy because of a medical condition that they have. This study explores the question of whether euthanasia is an ethical practice and, as determined by ethical theories and professional codes of ethics, whether the physician is allowed to provide the means to give the patient a path to a "good death," rather than one filled with physical and mental suffering. The paper also asks if there is a relevant moral difference between the active and passive forms of euthanasia and seeks to define requirements to ensure fully voluntary decision making through an evaluation of the factors necessary to produce fully informed consent. Additionally, the proper treatments for patients who suffer from painful terminal illnesses, those who exist in persistent vegetative states and infants born with many diverse medical problems are examined. The ultimate conclusions that are reached in the paper are that euthanasia is an ethical practice in certain specific circumstances for patients who have a very low quality of life due to pain, illness or serious mental deficits as a result of irreversible coma, persistent vegetative state or end-stage clinical dementia. This is defended by the fact that the rights of the patient to determine his or her own fate and to autonomously decide the way that he or she dies are paramount to all other factors in decisions of life and death. There are also circumstances where decisions can be made by health care teams in conjunction with the family to hasten the deaths of incompetent patients when continued existence is clearly not in their best interest, as is the case of infants who are born with serious physical anomalies, who are either 'born dying' or have no prospect for a life that is of a reasonable quality. I have rejected the distinction between active and passive methods of euthanasia and have instead chosen to focus on the intentions of the treating physician and the voluntary nature of the patient's request. When applied in equivalent circumstances, active and passive methods of euthanasia produce the same effects, and if the choice to hasten the death of the patient is ethical, then the use of either method can be accepted. The use of active methods of euthanasia and active forms of withdrawal of life support, such as the removal of a respirator are both conscious decisions to end the life of the patient and both bring death within a short period of time. It is false to maintain a distinction that believes that one is active killing. whereas the other form only allows nature to take it's course. Both are conscious choices to hasten the patient's death and should be evaluated as such. Additionally, through an examination of the Hippocratic Oath, and statements made by the American Medical Association and the American College of physicians, it can be shown that the ideals that the medical profession maintains and the respect for the interests of the patient that it holds allows the physician to give aid to patients who wish to choose death as an alternative to continued suffering. The physician is also allowed to and in some circumstances, is morally required, to help dying patients whether through active or passive forms of euthanasia or through assisted suicide. Euthanasia is a difficult topic to think about, but in the end, we should support the choice that respects the patient's autonomous choice or clear best interest and the respect that we have for their dignity and personal worth.

Defining ethical investment and its demography in Australia

While ethical investment is relatively new in Australia, it is a well defined phenomenon in the United States and United Kingdom, subject to variations in interpretation in its practical implementation. Characteristics of ethical investment decision-making suggest ethical investors may be demographically different from "ordinary" investors. This descriptive paper reports on a survey of equity investors in Australia, comparing the average investor and an ethical investor. The main findings are that there is evidence of a strong gender effect, with females predominating among ethical investors, and that these investors are relatively young, highly educated and possessing small portfolios.