The Development of an Ethical Strategy for Managers of International Hotels in Third World Countries

This article discusses some of the dilemmas of conscience that greet the international hotel manager in the Third World. It offers realistic and ethical guidelines for decision-making and problem-solving. Some of these guidelines require only common sense and good will to implement; others require a great deal of creativity, sensitivity, effort, and care; and a few will demand the courage to stand up for what is right in the face of competitive pressure.

Using ‘think aloud’ as a strategy for learning clinical reasoning in high fidelity case-based simulation for undergraduate nursing students

AIMS This paper reports on the implementation of a research project that trials an educational strategy implemented over six months of an undergraduate third year nursing curriculum. This project aims to explore the effectiveness of ‘think aloud’ as a strategy for learning clinical reasoning for students in simulated clinical settings. BACKGROUND Nurses are required to apply and utilise critical thinking skills to enable clinical reasoning and problem solving in the clinical setting [1]. Nursing students are expected to develop and display clinical reasoning skills in practice, but may struggle articulating reasons behind decisions about patient care. For students learning to manage complex clinical situations, teaching approaches are required that make these instinctive cognitive processes explicit and clear [2-5]. In line with professional expectations, nursing students in third year at Queensland University of Technology (QUT) are expected to display clinical reasoning skills in practice. This can be a complex proposition for students in practice situations, particularly as the degree of uncertainty or decision complexity increases [6-7]. The ‘think aloud’ approach is an innovative learning/teaching method which can create an environment suitable for developing clinical reasoning skills in students [4, 8]. This project aims to use the ‘think aloud’ strategy within a simulation context to provide a safe learning environment in which third year students are assisted to uncover cognitive approaches that best assist them to make effective patient care decisions, and improve their confidence, clinical reasoning and active critical reflection on their practice. MEHODS In semester 2 2011 at QUT, third year nursing students will undertake high fidelity simulation, some for the first time commencing in September of 2011. There will be two cohorts for strategy implementation (group 1= use think aloud as a strategy within the simulation, group 2= not given a specific strategy outside of nursing assessment frameworks) in relation to problem solving patient needs. Students will be briefed about the scenario, given a nursing handover, placed into a simulation group and an observer group, and the facilitator/teacher will run the simulation from a control room, and not have contact (as a ‘teacher’) with students during the simulation. Then debriefing will occur as a whole group outside of the simulation room where the session can be reviewed on screen. The think aloud strategy will be described to students in their pre-simulation briefing and allow for clarification of this strategy at this time. All other aspects of the simulations remain the same, (resources, suggested nursing assessment frameworks, simulation session duration, size of simulation teams, preparatory materials). RESULTS Methodology of the project and the challenges of implementation will be the focus of this presentation. This will include ethical considerations in designing the project, recruitment of students and implementation of a voluntary research project within a busy educational curriculum which in third year targets 669 students over two campuses. CONCLUSIONS In an environment of increasingly constrained clinical placement opportunities, exploration of alternate strategies to improve critical thinking skills and develop clinical reasoning and problem solving for nursing students is imperative in preparing nurses to respond to changing patient needs. References 1. Lasater, K., High-fidelity simulation and the development of clinical judgement: students' experiences. Journal of Nursing Education, 2007. 46(6): p. 269-276. 2. Lapkin, S., et al., Effectiveness of patient simulation manikins in teaching clinical reasoning skills to undergraduate nursing students: a systematic review. Clinical Simulation in Nursing, 2010. 6(6): p. e207-22. 3. Kaddoura, M.P.C.M.S.N.R.N., New Graduate Nurses' Perceptions of the Effects of Clinical Simulation on Their Critical Thinking, Learning, and Confidence. The Journal of Continuing Education in Nursing, 2010. 41(11): p. 506. 4. Banning, M., The think aloud approach as an educational tool to develop and assess clinical reasoning in undergraduate students. Nurse Education Today, 2008. 28: p. 8-14. 5. Porter-O'Grady, T., Profound change:21st century nursing. Nursing Outlook, 2001. 49(4): p. 182-186. 6. Andersson, A.K., M. Omberg, and M. Svedlund, Triage in the emergency department-a qualitative study of the factors which nurses consider when making decisions. Nursing in Critical Care, 2006. 11(3): p. 136-145. 7. O'Neill, E.S., N.M. Dluhy, and C. Chin, Modelling novice clinical reasoning for a computerized decision support system. Journal of Advanced Nursing, 2005. 49(1): p. 68-77. 8. Lee, J.E. and N. Ryan-Wenger, The "Think Aloud" seminar for teaching clinical reasoning: a case study of a child with pharyngitis. J Pediatr Health Care, 1997. 11(3): p. 101-10.

Meta-regulation approach of law : a potential legal strategy to develop socially responsible business self-regulation in least developed common law countries

In the corporate regulation landscape, 'meta-regulation' is a comparatively new legal approach. The sketchy role of state promulgated authoritative laws in pluralized society and scepticism in corporate self-regulation's role have resulted in the development of this legal approach. It has opened up possibilities to synthesize corporate governance to add social values in corporate self-regulation. The core of this approach is the fusion of responsive and reflexive legal strategies to combine regulators and regulatees for reaching a particular goal. This paper argues that it is a potential strategy that can be successfully deployed to develop a socially responsible corporate culture for the business enterprises, so that they will be able to acquire social, environmental and ethical values in their self-regulation sustainably. Taking Bangladeshi corporate laws as an instance, this paper also evaluates the scope of incorporating this approach in laws of the least developed common law countries in general.

A strategy to advance the evidence base in palliative medicine: formation of a palliative care research cooperative group.

BACKGROUND: Palliative medicine has made rapid progress in establishing its scientific and clinical legitimacy, yet the evidence base to support clinical practice remains deficient in both the quantity and quality of published studies. Historically, the conduct of research in palliative care populations has been impeded by multiple barriers including health care system fragmentation, small number and size of potential sites for recruitment, vulnerability of the population, perceptions of inappropriateness, ethical concerns, and gate-keeping. METHODS: A group of experienced investigators with backgrounds in palliative care research convened to consider developing a research cooperative group as a mechanism for generating high-quality evidence on prioritized, clinically relevant topics in palliative care. RESULTS: The resulting Palliative Care Research Cooperative (PCRC) agreed on a set of core principles: active, interdisciplinary membership; commitment to shared research purposes; heterogeneity of participating sites; development of research capacity in participating sites; standardization of methodologies, such as consenting and data collection/management; agile response to research requests from government, industry, and investigators; focus on translation; education and training of future palliative care researchers; actionable results that can inform clinical practice and policy. Consensus was achieved on a first collaborative study, a randomized clinical trial of statin discontinuation versus continuation in patients with a prognosis of less than 6 months who are taking statins for primary or secondary prevention. This article describes the formation of the PCRC, highlighting processes and decisions taken to optimize the cooperative group's success.

Geoengineering : the ethical and social issues

Tese de doutoramento, Filosofia (Filosofia da Natureza e do Ambiente), Universidade de Lisboa, Universidade Nova de Lisboa, 2015

Relationship Building with Aboriginal Elders in the Publicly Funded Secondary School Classroom: A Study of Ethical Space from an Aboriginal Persepective

This is a current story of ethical space in education that is often neglected in the design of educational experiences for Aboriginal students. This story is told through an Aboriginal lens rooted in the structured Two Row Wampum Belt relational agreement between Aboriginal peoples and Settlers. Through ethnographic narrative based on an extensive literature review, individual in-depth interviews, and a personal journal, this study documents the processes of acceptance, silence, complications, and then rejection to position Aboriginal Elders as inclusive bodies of knowledge in publicly funded secondary school classrooms. Aboriginal Elders are valued as Knowledge Holders, as Aboriginal teachers, guides, and mentors. Yet, the complexities of colonial rights, politics, and policies continue to intrude deeply into the lives of Aboriginal peoples to cause silence, confusion, and struggle rather than an evolution of new knowledge amongst two co-existing solitudes under the original terms of the Two Row Wampum Belt. The study was delayed and then came to an end when the school boards and local schools scrutinized its operating policies and unresolved funding issues. This study demonstrated that despite the Two Row Wampum Belt agreement that promised a co- existent relationship between Aboriginal peoples and Settlers, the strategy of inviting Aboriginal Elders to work alongside teachers in the classroom was viewed as being in conflict with the Settler’s institutional/educational objectivities, and, as such, was denied to Aboriginal students.

Anticipated Guilt and Ethical Consumption: The Moderating Role of Consumers’ Socially Responsible Consumption Behaviour

Recent research in the marketing literature has indicated that, while consumers’ interests in ethical products are growing, demand for such products still remains weak. Previous research has indicated that anticipated guilt can have a positive effect on ethical consumption. Thus, the objective of the current study is to investigate the moderating role of consumers’ socially responsible consumption behaviour (SRCB) on the relationship between anticipated guilt and ethical consumption. Specifically, the current study hypothesizes that, when viewing a guilt ad, high (vs. low) SRCB individuals will generate higher, ethical purchase intentions, willingness to pay an ethical premium, and attitudes toward an ethical brand. The findings from the two experimental studies indicate that, when viewing a guilt ad for an ethical product, high SRCB individuals are willing to pay a higher ethical premium and generate more favourable brand attitudes than low SRCB individuals. However, when viewing a non-guilt ad, high SRCB individuals did not differ from low SRCB individuals in their willingness to pay an ethical premium or brand attitudes. Further, consumers’ socially conscious self-identity was explored as a mediator of these effects. By understanding the moderating role that SRCB plays in the relationship between anticipated guilt and ethical consumption, this paper intends to assist marketers in understanding for which consumers a guilt appeal is an appropriate strategy in marketing ethical products.

The Bomb: Nuclear Weapons in their Historical, Strategic and Ethical Context

This book examines to what extent the invention and first use of nuclear weapons was a turning point in the history of warfare and strategy(to what extent was it a mere continuation or perfection of air power strategy? Were the casualty numbers really unprecedented?), the ethics of war (was this form of war against civilians unprecedented?), and it asks whether it was an expression of total war or did it create total war

The mediating effect of environmental and ethical behaviour on supply chain partnership decisions and management appreciation of supplier partnership risks

Green supply chain management and environmental and ethical behaviour (EEB), a major component of corporate responsibility (CR), are rapidly developing fields in research and practice. The influence and effect of EEB at the functional level, however, is under-researched. Similarly, the management of risk in the supply chain has become a practical concern for many firms. It is important that managers have a good understanding of the risks associated with supplier partnerships. This paper examines the effect of firms’ investment in EEB as part of corporate social responsibility in mediating the relationship between supply chain partnership (SCP) and management appreciation of the risk of partnering. We hypothesise that simply entering into a SCP does not facilitate an appreciation of the risk of partnering and may even hamper such awareness. However, such an appreciation of the risk is facilitated through CR’s environmental and stakeholder management ethos. The study contributes further by separating risk into distinct relational and performance components. The results of a firm-level survey confirm the mediation effect, highlighting the value to supply chain strategy and design of investing in EEB on three fronts: building internal awareness, monitoring and sharing best practice.

A TRAINING COURSE ON BIOETHICS FOR FAMILY HEALTH STRATEGY PROFESSIONALS IN SANTO ANDRE, SP

This case report presents the experience of a training course on bioethics for nurses and physicians of the Family Health Strategy in Santo Andre, SP. This study is based on problem-based learning and deliberative bioethics, and aimed at presenting the deliberation procedure as a means of handling ethical issues. Contents were addressed in a cross-section manner through five sequential activity sessions at two different moments of concentration with one dispersion interval. In the first moment of concentration, key concepts and deliberative bioethics contents were developed. The second involved deliberation sessions on moral conflicts, which were selected and prepared during the dispersion interval. Participants evaluated the deliberation as an appropriate instrument to deal with the ethical issues they are faced with. Problem-based learning was an effective educational strategy for continuing education in deliberative bioethics.

Toward an inclusive and a little bit ethical world trading system : listening to the voices of the people in LDCs

Many specialists in international trade have started saying that the era of a mega FTA is approaching. If the three poles of the global economy, namely East Asia, EU and the United States, form mega FTAs, most of the volume of global trade will be covered. That may be fine, but there will be many countries left out of the mega FTA, most of which will be the least developed countries (LDCs). Since the inception of the Doha Development Agenda (DDA) negotiations in 2001, the WTO and its member countries have tried to include LDCs in the world trading system through various means, including DFQF and AfT. Although these means have some positive impact on the economic development of LDCs, most of the LDCs will never feel comfortable with the current world trading system. To overcome the stalemate in the DDA and to create an inclusive world trading system, we need more commitment from both LDCs and non-LDCs. To surmount the prolonged stalemate in the DDA, we should understand how ordinary people in LDCs feel and think about the current world trading system. Those voices have seldom been listened to, even by the decision makers of their own countries. So as to understand the situation of the people in LDCs, IDE-JETRO carried out several research projects using macro, meso and micro approaches. For the micro level, we collected and analyzed statements from ordinary people concerning their opinions about the world trading system. The interviewees are ordinary people such as street vendors, farmers and factory workers. We asked about where they buy and sell daily necessities, their perception of imported goods, export promotion and free trade at large, etc. These ‘voices of the people’ surveys were conducted in Madagascar and Cambodia during 2013. Based on this research, and especially the findings from the ‘voices of the people’ surveys, we propose a ‘DDA-MDGs hybrid’ strategy to conclude DDA negotiations and develop a more inclusive and a little bit more ethical world trading system. Our proposal may be summarized in the following three points. (1) Aid for Trade (AfT) ver. 2 Currently AfT is mainly focused on coordinating several aid projects related to LDCs’ capacity building. However, this is inadequate; for the proposed ‘DDA-MDGs hybrid’, a super AfT is needed. The WTO, other development agencies and LDC governments will not only coordinate but also plan together aid projects for trade capacity building. AfT ver. 2 includes infrastructure projects either gran aid, ODA loans and private investment. This is in accordance with the post-MDGs argument which emphasizes the role of the private sector. (2) Ethical Attitude Reciprocity is a principle of multilateral agreement, and it has been a core promise since GATT. However, for designing an inclusive system, special and differential treatment (S&D) is still needed for disadvantaged members. To compromise full reciprocity and less than full reciprocity, an ethical attitude on the part of every member is needed in which every member refrains from insisting on the full rights and demands of its own country. As used herein, the term ‘ethical’ implies more consideration for LDCs, and it is almost identical to S&D but with a more positive attitude from developed countries (super S&D). (3) Collect Voices of the People In order to grasp the real situation of the people, the voices of the people on free trade will continue to be collected in other LDCs, and the findings and leanings will be fed back to the WTO negotiation space.

Első- és másodfajú etikai kudarcok (Type I and type II ethical errors)

A cikkben a szerző a piac és a kormányzat kudarcaiból kiindulva azonosítja a közjó elérését célzó harmadik rendszer, az etikai felelősség kudarcait. Statisztikai analógiát használva elsőfajú kudarcként azonosítja, mikor az etikát nem veszik figyelembe, pedig szükség van rá. Ugyanakkor másodfajú kudarcként kezeli az etika profitnövelést célzó használatát, mely megtéveszti az érintetteteket, így még szélesebb utat enged az opportunista üzleti tevékenységnek. Meglátása szerint a három rendszer egymást nemcsak kiegészíti, de kölcsönösen korrigálja is. Ez az elsőfajú kudarc esetében általánosabb, a másodfajú kudarc megoldásához azonban a gazdasági élet alapvetéseinek átfogalmazására, az önérdek és az egydimenziós teljesítményértékelés helyett egy új, holisztikusabb szemléletű közgazdaságra van szükség. _______ In the article the author identifies the errors of ethical responsibility. That is the third system to attain common good, but have similar failures like the other two: the hands of the market and the government. Using statistical analogy the author identifies Type I error when ethics are not considered but it should be (null hypothesis is rejected however it’s true). She treats the usage of ethics to extend profit as Type II error. This misleads the stakeholders and makes room for opportunistic behaviour in business (null hypothesis is accepted in turn it’s false). In her opinion the three systems: the hand of the market, the government and the ethical management not only amend but interdependently correct each other. In the case of Type I error it is more general. Nevertheless to solve the Type II error we have to redefine the core principles of business. We need a more holistic approach in economics instead of self-interest and one-dimensional interpretation of value.

An Ethical and Legal Framework for Physicians as Surrogate Decision-Makers for Their Patients.

In Western industrialized countries, it is well established that legally competent individuals may choose a surrogate healthcare decision-maker to represent their interests should they lose the capacity to do so themselves. There are few limitations on who they may select to fulfill this function. However, many jurisdictions place restrictions on or prohibit the patient's attending physician or other provider involved with an individual's care to serve in this role. Several authors have previously suggested that respect for the autonomy of patients requires that there be few (if any) constraints on whomever they may appoint as a proxy. In this essay we revisit this topic by first providing a survey of current state laws governing this activity. We then analyze the clinical and ethical circumstances in which potential difficulties could arise. We take a more nuanced and circumspect view of prior suggestions that patients should have virtually unfettered liberty to choose their healthcare proxies. We suggest a strategy to balance the freedom of patients' right to choose their surrogates with fiduciary duty of the state as regulator of medical practice. We identify six domains of possible concern with such relationships and suggest straightforward methods of mitigating their potential negative effects that could be plausibly be incorporated into physician practice.