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.

Ethical structures and processes of corporations operating in Australia, Canada and Sweden : A longitudinal and cross-cultural study

Based on the ‘Partnership Model of Corporate Ethics’ (Wood, 2002), this study examines the ethical structures and processes that are put in place by organizations to enhance the ethical business behavior of staff. The study examines the use of these structures and processes amongst the top companies in the three countries of Australia, Canada, and Sweden over two time periods (2001–2002 and 2005–2006). Subsequently, a combined comparative and longitudinal approach is applied in the study, which we contend is a unique approach in the area of business ethics. The findings of the study indicate that corporations operating in Sweden have utilized ethical structures and processes differently than their Canadian and/or Australian counterparts, and that in each culture the way that companies fashion their approach to business ethics appears congruent with their national cultural values. There does, however, appear to be a convergence of views within the organizations of each culture, as the Swedish companies appear to have been more influenced in 2005–2006 by an Anglo-Saxon business paradigm than they have been in the past.

International standards of business conduct: framework and illustration

Purpose: – The purpose of this paper is to describe the insights and a proposal into the structure of standards of business conduct and its intended applications.

Design/methodology/approach: – The case study is based upon an inductive content analysis of corporate ethics artefacts.

Findings: – It is concluded that the standards of business conduct may be highly prescriptive in world wide corporations, but that there should be an explicit commitment to a flexible and dynamic approach to the application of standards of business conduct.

Research limitations/implications: – An examination of the actual behaviour of a corporation's operations was beyond the scope of the present research, but such a study has potential for future research. This would open up the wider question of how corporations can minimise the gap between corporate intentions and actual outcomes in business operations across national and cultural boundaries.

Practical implications: – These diverse national and cultural contexts that world wide corporations encounter must be taken into consideration in the content of their standards of business conduct.

Originality/value: – The authors emphasise the concern of recognising that the contexts surrounding standards of business conduct are dynamic. Corporate codes of ethics should be regarded as dynamic artefacts. A framework of application is proposed.

No limits : exploring the psychology of unsolicited credit card limit increase offers

The issue of credit card debt has become an increasing concern in recent years. In Australia, for example, there is currently $42.5 billion worth of outstanding debt on credit cards, with $30 billion (over 70 per cent) bearing interest. Further, in 2001, Visa reported that 32 per cent of consumers had not paid their card off in the previous 12 months, which suggests that interest-bearing debt in Australia is held by approximately only 113 of credit card borrowers. An important element of credit card marketing is the use of psychological manipulations to encourage consumers to take-up credit. In this article, we examine the use of language and imagery in unsolicited credit card limit increase offers, and how these might influence consumers' decisions to increase their credit card limit. The analysis found that the use of terms that focused on the benefits of credit card use, such as "choice", "freedom", and "peace of mind" were used consistently to convince consumers to increase their credit card limit, whereas the use the of terms that could be considered more pragmatic and with direct reference to the nature of the product, such as "debt", "repayment" and "loan", were rarely used. Similarly, the use of colour, text changes, and images, were used which may have an influence over a consumer's ability to rationally consider whether the increase is appropriate for them. The paper concludes by recommending that government and representative bodies need to take into account the psychological manipulations used by credit card providers when developing consumer policy and codes of ethics.

Ethical practice from the perspective of the forensic psychologist : commentary on the uses and value of the Australian Psychological Society (2007) code of ethics

Forensic practice in Australia and around the world attracts a high level of public and judicial scrutiny. The way in which the forensic psychologist conducts him or herself in ethically challenging situations is important not only to the reputation of the individual practitioner, but to the profession more widely. This paper outlines some of the ethical issues that commonly arise in forensic psychology practice and discusses these in relation to the recently published Australian Psychological Society (2007) Code of Ethics. Four ethically challenging scenarios are described and discussed in terms of how the Code might be used to offer guidance to psychologists about how they might best respond.

The influence of need-for-cognition on ethical decision-making in marketing

The research established that the work-related norms of marketers and their socialisation into the marketing profession are influenced beneficially by their need-for-cognition. The research revealed contradictions between corporate codes of ethics and the values espoused by professional associations. Better ways of managing corporate ethical standards and behaviour are suggested.

Code of ethics quality : an international comparison of corporate staff support and regulation in Australia, Canada and the United States

The objective of this paper is to examine the ‘Code of Ethics Quality’ (CEQ) in the largest companies of Australia, Canada and the United States. For this purpose, a proposed CEQ construct has been applied. It appears from the empirical findings that while Australia, Canada and the United States are extremely similar in their economic and social development, there may well be distinct cultural mores and issues that are forming their business ethics practices. A research implication derived from the performed research is that the construct provides a selection of observable and measurable elements in the context of CEQ. The construct of CEQ consists of nine measures divided into two dimensions (i.e. staff support and regulation). They should not be seen as a complete list. On the contrary, it is encouraged that others propose and elaborate revisions and extensions. A practical implication of this paper is a structure of what and how to examine the CEQ in a managerial setting. It may assist companies in their efforts to establish, maintain and improve their ethical culture, norms and beliefs within the organization and supporting them in their ethical business practices with different stakeholders in the marketplace and society. The dimensions and measures of the construct may be used as a frame of reference for further research. They may be useful and applicable across contexts and over time using similar samples when it comes to large companies, as small- or medium-sized ones may not have considered all areas nor have the elements in place. This is a research limitation, but it provides an opportunity for further research.

Commitment to business ethics in UK organizations

Purpose – The purpose of this research is to determine the commitment to business ethics in UK corporations. This study reports on the responses of those organizations that participated in the survey and possessed a code of ethics.

Design/methodology/approach – An unsolicited questionnaire was sent to the top 500 private sector organizations by market capitalization in the UK. A total of 92 companies responded, of which 56 possessed a code of ethics.

Findings – The empirical findings indicate that the processes involved in developing business ethics commitment have begun to be recognized and acted upon at an organizational level. The supporting measures of business ethics commitment appear to be under-utilized by many of these UK organizations. This suggests that many organizations have not so far developed a strong organizational commitment to embedding their codes of ethics into organizational practices.

Research limitations/implications – While the responses provided a rich picture of organizational actions, further research exploring internal culture and attitudes would add to an understanding of organizational commitment.

Practical implications – It is found that in order to influence practice, it is not enough to have the artefacts of an ethical culture, such as codes, without ensuring that all employees are assisted in understanding what is required of them.

Originality/value – Despite a history of business ethics research, there are a limited number of studies seeking to understand UK companies' commitment to ethical codes. The paper provides guidance on steps that organizations can take to develop a higher level of commitment.