Nutrigenomics for Global Health: Ethical Challenges for Underserved Populations

Nutrigenomics covers disparate fields of nutrition science and has been defined in many different ways. In fact, this emerging field of science has multiple facets, many of which do not generate the same ethical issues. In particular, different ethical issues emerge concerning the extent to which nutrigenomics may actually improve global health, i.e., in terms of worldwide improvement of health, reduction of disparities, and protection against global threats that disregard national borders. Nutrigenomics raises many hopes and expectations on that score. However it remains unclear and controversial whether nutrigenomics studies and their actual or potential applications will actually benefit developing countries and their populations. Different forces may drive the choice of research priorities and shape the claims that are made when communicating the goals or the results of nutrigenomics studies and applications. This article proposes to assess expectations and claims in nutrigenomics, with respect to their respective potential impact on global health and the ethical issues they raise. Nutrigenomics is and should be more than premature claims and much debated promises about personalized nutritional interventions on individuals. Beyond questionable commercial claims, nutrigenomics is also knowledge about and recognition of the considerable impacts of underfeeding and malnutrition on the genome (and epigenome) integrity and stability. As such, nutrigenomics research is a valuable opportunity to revive and give strength to the debate about the unacceptable consequences of hunger and malnutrition worldwide, and to support a newly and potentially significant convergence in research priorities that could benefit both developed and developing countries.

Researching from within: external and internal ethical engagement

This article examines the superficial and deep ethical and moral dilemmas confronting ‘insider’ researchers which we term external and internal ethical engagement. External ethical engagement refers to the traditional, easily identifiable ethical issues that insider researchers attend to by submitting their application for ethical approval to their institution’s internal review board. Internal ethical engagement relates to the deeper level ethical and moral dilemmas that insider researchers have to deal with once ‘in the field’ linked to on-going personal and professional relationships with participants, insider knowledge, conflicting professional and researcher roles, and anonymity. By reviewing the literature in this area and drawing on the authors’ experiences of undertaking interpretive studies at institutions where they were members of staff, we explore these concepts and examine the implications for insider researchers. Keywords: insider research; ethics; professional relationships; anonymity; access

Science and ethics : some issues for education

Ethical issues concerning pain and suffering of animals are necessarily a consideration when it comes to killing “pest” or “feral” species in Australia. Within a continent where there are no large predators, many introduced animal species such as rabbits, foxes, horses, donkeys, camels, goats, and mice have been able to thrive, competing with the interests of farmers and graziers, and livestock and food production. These species, thus, gain the label of “pest.” Many methods now exist to kill these species and, consequently, ethical issues arise concerning the possible pain and suffering caused as a direct result of these methods. Yet within government and scientific communities, ethical issues are reduced to a secondary consideration without serious debate or contention. Ethical issues appear to be at odds with scientific agendas. How can environmental ethics be incorporated as part of science-based decision making that appeals to objectivity and scientific evidence? Within educational institutions as well, the same dilemma exists: How can ethical issues be addressed within the science curriculum and in the classroom? A greater understanding of various perspectives on the subject of environmental ethics and the value positions advocated by proponents of these perspectives may help teachers consider ways of handling such issues in the science classroom.

Population dynamics and animal welfare issues raised by the culling of kangaroos in Puckapunyal

The culling of kangaroos at the Puckapunyal Army base (Australia) raises some intriguing ethical issues around animal welfare. After discussing the costs and benefits of the cull, this paper addresses the more general animal welfare issues related to population dynamics. Natural selection favours the maximization of the number of surviving offspring. This need not result in the maximization of the welfare of individuals in the species. The contrast between growth maximization and welfare maximization is first illustrated for a single population and then discussed in terms of competing populations. In the Lotka-Volterra model of competing species and its generalizations, the choice of different birthrates does not affect the population sizes at equilibrium. Welfare could be much higher at lower birthrates without even reducing numbers (at equilibrium)

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.

Designing ethical systems for online systems

Ethics is an important element in all aspects of Information Systems (IS), from the design, operation and delivery of such systems. Most research has focused upon traditional IS system design and the associated ethical issues. There are many aspects of ethics that can impact the design and operation of Information Systems, but online system design is often overlooked. The paper will focus upon a design approach that allows for the design on online systems and considers the ethical issues. The approach was developed and validated in regards to a tertiary environment.

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.

Ethical practice in sex offender assessment : consideration of actuarial and polygraph methods

The current generation of community protection laws represents a shift in priorities that may see the individual rights of sex offenders compromised for the goal of public safety. At the center of many judicial decisions under these laws are the risk assessment reports provided by mental health practitioners. The widespread enactment of laws allowing for additional sanctions for sex offenders, and a burgeoning research literature regarding the methods used to assess risk have served to heighten rather than resolve the ethical concerns associated with professional practice in this area. This article examines ethical issues inherent in the use of two assessment methods commonly used with sex offenders in the correctional context, focusing on actuarial measures and polygraph tests. Properly conducted and adequately reported actuarial findings are considered to provide useful information of sufficient accuracy to inform rather than mislead judicial decision makers, although careful consideration must be given to the limitations of current measures in each individual case. Despite its increasing use, polygraph testing is considered controversial, with little consensus regarding its accuracy or appropriate applications. On the basis of the current state of the professional literature regarding the polygraph, its use with sex offenders raises unresolved ethical concerns.

Developing a placebo-controlled trial in surgery : issues of design, acceptability and feasibility

Background: Surgical placebos are controversial. This in-depth study explored the design, acceptability, and feasibility issues relevant to designing a surgical placebo-controlled trial for the evaluation of the clinical and cost effectiveness of arthroscopic lavage for the management of people with osteoarthritis of the knee in the UK.
Methods: Two surgeon focus groups at a UK national meeting for orthopaedic surgeons and one regional surgeon focus group (41 surgeons); plenary discussion at a UK national meeting for orthopaedic anaesthetists (130 anaesthetists); three focus groups with anaesthetists (one national, two regional; 58 anaesthetists); two focus groups with members of the patient organisation Arthritis Care (7 participants); telephone interviews with people on consultant waiting lists from two UK regional centres (15 participants); interviews with Chairs of UK ethics committees (6 individuals); postal surveys of members of the British Association of Surgeons of the Knee (382 surgeons) and members of the British Society of Orthopaedic Anaesthetists (398 anaesthetists); two centre pilot (49 patients assessed).
Results: There was widespread acceptance that evaluation of arthroscopic lavage had to be conducted with a placebo control if scientific rigour was not to be compromised. The choice of placebo surgical procedure (three small incisions) proved easier than the method of anaesthesia (general anaesthesia). General anaesthesia, while an excellent mimic, was more intrusive and raised concerns among some stakeholders and caused extensive discussion with local decision-makers when seeking formal approval for the pilot. Patients were willing to participate in a pilot with a placebo arm; although some patients when allocated to surgery became apprehensive about the possibility of receiving placebo, and withdrew. Placebo surgery was undertaken successfully.
Conclusions: Our study illustrated the opposing and often strongly held opinions about surgical placebos, the ethical issues underpinning this controversy, and the challenges that exist even when ethics committee approval has been granted. It showed that a placebo-controlled trial could be conducted in principle, albeit with difficulty. It also highlighted that not only does a placebo-controlled trial in surgery have to be ethically and scientifically acceptable but that it also must be a feasible course of action. The place of placebo-controlled surgical trials more generally is likely to be limited and require specific circumstances to be met. Suggested criteria are presented.

Ethical considerations in synthesising research : whose representations?

Research syntheses play a powerful role in shaping further research, practice, policy and public perceptions. Accordingly, the ethical issues associated with how perspectives of different groups are included or censored in a research synthesis report must be paid adequate attention. Any research synthesis is inherently influenced by subjectivities associated with multiple layers of interpretation, selection and representation. In framing a research synthesis, it is vital that synthesists take into account: multiple interests and influences of different stakeholders; potential impact of the synthesis on different stakeholders; synthesists’ own multiple and shifting identities within the synthesis; synthesists’ methodological positioning within the synthesis; status accorded to authors and participants of the primary research studies included in the synthesis; influences of funding agencies; politics of who/what gets published; and biases introduced through common strategies for retrieving primary research studies. I have raised strategic questions and issues to structure and inform critical decision-making throughout a synthesis process. I hope this article will stimulate debate and discussion on various ethical considerations associated with the process of synthesising research.

The security, privacy, and ethical implications of social networking sites

© 2015, IGI Global. The chapter investigates the security and ethical issues relating to privacy and security. This chapter also examines the ethical issues of new forms of bullying that are being played out weekly in the media: cyber bulling, specifically on SNS such as Facebook. The traditional and direct forms of bullying are being replaced by consistent abuse via SNS due to the ease and accessibility of these new forms of communications.

The migration of health care workers in the Western Hemisphere: issues and impacts

Includes bibliography

Ubiquitous Computing: Any Ethical Implications?

In this article, the authors investigate, from an interdisciplinary perspective, possible ethical implications of the presence of ubiquitous computing systems in human perception/action. The term ubiquitous computing is used to characterize information-processing capacity from computers that are available everywhere and all the time, integrated into everyday objects and activities. The contrast in approach to aspects of ubiquitous computing between traditional considerations of ethical issues and the Ecological Philosophy view concerning its possible consequences in the context of perception/action are the underlying themes of this paper. The focus is on an analysis of how the generalized dissemination of microprocessors in embedded systems, commanded by a ubiquitous computing system, can affect the behaviour of people considered as embodied embedded agents.

Everyone is; should healthcare? Outsourcing: Issues in strategic planning, organizational culture, and organizational ethics

Expenditures for personal health services in the United States have doubled over the last decade. They continue to outpace the growth rate of the gross national product. Costs for medical care have steadily increased at an annual rate well above the rate of inflation and have gradually outstripped payers' ability to meet their premiums. This limitation of resources justifies the ongoing healthcare reform strategies to maximize utilization and minimize costs. The majority of the cost-containment effort has focused on hospitals, as they account for about 40 percent of total health expenditures. Although good patient outcomes have long been identified as healthcare's central concern, continuing cost pressures from both regulatory reforms and the restructuring of healthcare financing have recently made improving fiscal performance an essential goal for healthcare organizations. ^ The search for financial performance, quality improvement, and fiscal accountability has led to outsourcing, which is the hiring of a third party to perform a task previously and traditionally done in-house. The incomparable nature and overwhelming dissimilarities between health and other commodities raise numerous administrative, organizational, policy and ethical issues for administrators who contemplate outsourcing. This evaluation of the outsourcing phenomenon, how it has developed and is currently practiced in healthcare, will explore the reasons that healthcare organizations gravitate toward outsourcing as a strategic management tool to cut costs in an environment of continuing escalating spending. ^ This dissertation has four major findings. First, it suggests that U.S. hospitals in FY2000 spent an estimated $61 billion in outsourcing. Second, it finds that the proportion of healthcare outsourcing highly correlates with several types of hospital controlling authorities and specialties. Third, it argues that healthcare outsourcing has implications in strategic organizational issues, professionalism, and organizational ethics that warrant further public policy discussions before expanding its limited use beyond hospital “hotel functions” and back office business processes. Finally, it devises an outsourcing suitability scale that organizations can utilize to ensure the most strategic option for outsourcing and concludes with some public policy implications and recommendations for its limited use. ^