The moral imperative of designating patient safety and quality care as a national nursing research priority

Since the early 1990s, research studies conducted respectively in the USA, UK and Australia have found that between 4 and 16.6 per cent of patients suffer from some kind of harm (including permanent disability and death) as a result of human errors and adverse events while in hospital. It has been further estimated that approximately 50 per cent of these human errors/adverse events resulting in harm could have been prevented. In response to the significant financial, social, and political implications of these figures, a range of processes have been put in place in an attempt to improve patient safety and quality care in Australia. Nonetheless, it is evident that more can be done to improve the status quo. One process that warrants consideration is that of peak health professional groups and organisations providing active leadership in the promotion of patient safety, such as by making a visible and recognisable commitment to patient safety as a strategic research priority area. In this paper it is contended that, given the moral importance of patient safety and quality care in nursing and related health care domains, the inseparable link between nursing practice and patient safety, and the central role that research has to play in driving safety improvements in these domains, it is morally imperative that the nursing profession gives sustained and focussed public attention to patient safety and quality care as a national research priority.

Metaphysics of love as moral responsibility in nursing and midwifery

This study used a qualitative research design incorporating principles of social constructionism, hermeneutic dialectic method, Neo-Socratic dialogue and philosophy for reporting the tacit and social knowledge constructions underlying particular ways of knowing that inform the experiential reality of love in the practice of nursing and midwifery. The philosophy of Emmanuel Levinas, that culminated in his magnum opus of the ‘metaphysics of otherness’, provided the theoretical underpinning for the interpretation of the experiences nurses and midwives believed were examples of love in their clinical practice in Australia, Singapore and Bhutan. What is love in nursing and midwifery? The answer is moral responsibility. The relational context has a nurse and midwife constantly exposed to patient situations that give rise to expressions of love as moral responsibility. It is a form of love that centres on the ability of our being, or at least the possibility of our being, to transcend its everyday form to a metaphysical state of being moral. It enables a nurse and midwife to transcend the isolation associated with their personal being as a self-project, to be ‘for’ the patient as a first priority. But while the ‘Goodness’ of the ‘Good’ assigns the nurse and midwife responsible and is expressed to their personal being in the form of the ‘urge to do’, ‘what to do’ in caring for the patient is a matter of living out the command to be responsible and will be different for each nurse and midwife. However, no matter the outcome, love as moral responsibility will always leave a nurse and midwife feeling there is still more to be done in being responsible.

On strangers, ‘moral panics’ and the neo-liberalization of teacher education

This paper explores the convergence of neo-liberal managerialism with the neo-conservative technologies of creating ‘moral panics’ about teacher education, English language and literacy curriculum and traditional values that allegedly fail to address the issues of public safety and cultural integration in the post- September 11th world. It problematises the neo-conservative vision of managing ‘strangers’ and public risks through dominant cultural literacy. The paper counters the neo-conservative backlash with a framework that emphasizes dialogical ethics in teaching for difference and conceptualizes transcultural literacy as an alternative model of education in multicultural conditions. This model is presented both as a way of resisting the subliminal infiltration of neo-conservative thinking in teacher education today and as a way of imagining a ‘cosmopolitan’ professional.

The moral reasoning abilities of Australian and Malaysian accounting students : a comparative analysis

If national culture is a significant determinant of ethical attitudes, it is not unreasonable to expect ethical decision-making to be influenced by one's culture. However, problems arise when the notion of right differs from one culture to another. The question addressed in this paper is whether the moral reasoning abilities of Australian and Malaysian accounting students in their final year of study differ because of their cultural upbringing. This study uses primary data collected from 34 final year accounting students (12 Australian and 22 Malaysian) enrolled in an Australian degree program. The test scores collected at the beginning and end of the academic year indicate that culture and other explanatory variables do not have an affect on students' moral judgment. The findings in this study suggest that culture as an independent variable does not influence the way accounting students analyse and resolve ethical dilemmas.

Media reports of heroin overdose spates: public health messages, moral panics or risk advertisements?

This article reports on an investigation of the public health utility of media messages concerning spates (temporal clusters) of heroin-related overdose (HOD) from the perspective of some injecting drug users (IDUs). In-depth qualitative interviews were carried out with a convenience sample of 60 IDUs, in the setting of two Needle and Syringe Programs in an Australian regional city (Geelong) between April and May 2000. Very few interviewees reported that they had personally experienced a spate of overdoses. None of the interviewees reported communicating the existence of a killer batch to other IDUs. No interviewees reported having changed either their injecting practices or the amount of heroin they used following such a media alert. Indeed, a substantial minority of the interviewees reported seeking out these stronger batches and participant narratives illustrate that, for a substantial group of interviewees, the media reporting of a hypothetical 'killer batch' of heroin may have implications for their drug-seeking and health-related behaviour. It was found that the accuracy of information available to IDUs is mixed and that the flow of information within this social network was slow. Findings demonstrate that media reporting of killer batches of heroin has little value as a public health strategy and provide an example of how some activities that are proposed as public health measures may in fact have the opposite effect.

Harmony in and between aesthetic experience and moral experience

The thesis finds that the notion of harmony has been integral to the concepts of beauty and goodness from the earliest times, in Eastern and Western philosophy. It also argues that the experience of beauty and the experience of goodness are related through the human propensity to avoid disorder.

Moral rights, heritage and Australian contemporary architecture : thoughts & designs of Peter Muller

Peter Muller is one of the most unique Australian architects of the 20th century possessing a passion for organic architecture realised in several significant Australian and Indonesian design exemplars. His inquiry in the organic style of architecture stylistically mirrors that of Frank Lloyd Wright whom wrote to Muller expressing his pleasure in his successful pursuit of this style in Australia.3 This paper considers the position of moral rights under the Australian Copyright Act 19684 having regard to the Australian exemplars of Muller. It considers recent Australian debates about moral rights and projects that implicate several architectural and landscape architecture projects, the interpretations the legal fraternity are taking in approaching this topic, and positions the ideas, values, and attitudes of Muller in this context. Muller’s personal opinion is expressed providing an insight into the thoughts of one senior contemporary Australia architect as to 'their' architecture and ‘heritage’.

About global leadership and global ethics, and a possible moral compass : an introduction to the special issue

This paper reviews a number of huge challenges to ethical leadership in the twenty-first century and concludes that the need for global ethical leadership is not merely a desirable option, but rather – and quite literally – a matter of survival. The crises of the recent past reveal huge, and in some cases criminal, failures of both ethics and leadership in finance, business and government. We posit that mainstream economic theory’s construct of ‘homo economicus’ and its faith in the ‘invisible hand’ of the market constitute deeply flawed foundations upon which alone policy may be built and, farthermore, that these problematic foundations exert substantial shaping power over the institutional and discursive landscapes in which international business is transacted. Analogously, we argue that dominant approaches to business ethics and corporate social responsibility are, if not incorrect, at least in need of revisiting in terms of questioning their basic assumptions. Instead of the smugness of Western (especially Anglo-American) attitudes towards other ways of thinking, valuing and organising, it appears clear that openness, cooperation and co-creation between the developed and developing worlds is a basic prerequisite for dealing with the global challenges facing not just leaders, but humanity as a whole. This objective of stimulating discussion between dominant and marginal voices has guided our selection of papers for this Special Issue. We have thus included not only representatives of research from within the parameters of mainstream business ethics, IB or leadership scholarship, but also innovative contributions from fields such as military history, information technology, regulation, spirituality and sociology.

Negotiating masculinities via the moral problematization of sport

Researchers have raised concerns about the construction of dangerous/problematic masculinities within sporting fratriarchies1. Yet little is known about how male sport enthusiasts—critical of hypermasculine performances—negotiate their involvement in sport. Our aim was to examine how males negotiated sporting tensions and how these negotiations shaped their (masculine) selves. We drew on Foucault (1992) to analyze how interviewees problematized their respective sport culture in relation to the sexualization of females, public drunkenness and excessive training demands. Results illustrated how the interviewees produced selves, via the moral problematization of sport, that rejected the values or moral codes of hypermasculinity in attempts to create ethical masculinities. We suggest that a proliferation of techniques of self that resist hypermasculine forms of subjection could be one form of ethical response to the documented problems surrounding masculinities and sport.

Moral repair with offenders : ethical issues arising From victimization experiences

In this article, the authors examine the relevance of the concept of moral repair for sex offenders who have been victims of sexual or physical abuse. First, they briefly review the literature on victimization rates and effects in sexual offenders. Second, the notion of moral repair and its constituent tasks is examined with particular emphasis given to Margaret Walker's recent analysis of the concept. Third, the concept of moral repair is applied to offenders and its implications and possible constraints discussed. Fourth, the authors outline a normative framework for addressing victimization issues with sexual offenders, drawing on the resources of human rights theory and strength-based treatment approaches. Finally, they conclude with a brief consideration of the ethical and clinical implications of their normative model.