Medical travel and the sale of human biological materials: suggestions for ethical policy development

The international medical travel industry includes patients seeking to access human biological materials (HBM) including gametes, organs and stem cells. Of the various niche markets, ‘transplant tourism’ has earned global condemnation and efforts to eradicate cross-border trade in organs, while other markets continue to expand. This article reviews the ethical issues raised by medical travel for HBM, in particular those concerning trade in HBM. It argues that a more consistent approach to the regulation of cross-border trade is imperative to ensure that the perils of ‘transplant tourism’ are not replicated in other markets. In addition, it discusses the role of the self-sufficiency model in assisting the development of ethical and practical policies regarding the procurement and use of human biological materials at a national level, thereby minimizing demand for medical travel.

É mais fácil condenar quem já cumpre pena de vida: um estudo sobre a prática profissional do assistente social no Sistema Penitenciário do Estado do Rio de Janeiro

Este trabalho tem como objetivo analisar a prática do assistente social no Sistema Penitenciário do Estado do Rio de Janeiro, a partir dos pressupostos estabelecidos pelo Projeto Ético Político da Profissão. A relevância deste estudo consiste em colocar no centro do debate o desafio que representa para a categoria, com um direcionamento profissional ético e político comprometido com os interesses da classe trabalhadora e com a efetivação dos direitos da mesma, efetivar estes pressupostos num campo de atuação marcado pelo controle e repressão dos indivíduos pertencentes a esta classe. A prisão é uma instituição total, punitiva, vingativa, onde observamos a face mais dura do Estado, onde, muitas vezes, o assistente social se vê sozinho na defesa e efetivação dos direitos do preso. Constitui-se como objetivo central deste estudo analisar se dentro desta instituição, o assistente social consegue efetivar os valores defendidos e consagrados pelo projeto profissional. Para realização do estudo nos debruçamos sobre a produção teórica e a história do sistema penitenciário; sobre a legislação específica da área (Lei de Execução Penal e Regulamento Penitenciário do Estado do Rio de Janeiro) e sobre documentos, relatórios, manuais, etc., elaborados pela Coordenação de Serviço Social da Secretaria de Estado de Administração Penitenciária (SEAP). Devido às limitações impostas pela instituição, os sujeitos de nosso estudo foram os gestores e ex-gestores que aturam na Coordenação de Serviço Social e na antiga Divisão de Serviço Social da SEAP. Procuramos resgatar a trajetória histórica do Serviço Social dentro do Sistema Prisional fluminense, destacando as batalhas e conquistas alcançadas pela categoria, ao longo dos quase sessenta anos de inserção nas unidades prisionais do Rio de Janeiro. Observamos ao longo do estudo que a inserção do assistente social no Sistema Penitenciário encontra-se devidamente institucionalizada, regulamentada e organizada, o que demonstra a relevância do trabalho deste profissional, que muitas vezes ainda é visto como benfeitor do preso. Hoje, a execução penal pode ser considerada uma área consolidada para a atuação profissional dos assistentes sociais, embora apresente uma série de inconsistências e discrepâncias, tais como péssimas condições de trabalho, violação de direitos, entre outras. Procuramos mostrar neste estudo como o profissional de Serviço Social enfrenta essa realidade e contribui para a sua transformação, a partir dos ideais defendidos pelo Projeto Ético Político da profissão.

Home is Where the Human is?:Ethics, Intervention and Hospitality in Kosovo

The human is frequently made central to the way international ethics is thought and practiced. Yet, frequently, the human can be used to close down ethical options rather than open them up. This article examines the case of British foreign policy in Kosovo. It argues that the human in this context was placed at the centre of ethical action, but was discursively constructed as a silent, biopolitial mass which could only be saved close to its territorially qualified home. It could not be protected by being brought to the UK. To remain human, the subject of ethical concern, the Kosovan refugee, had to remain near Kosovo. This construction of the human-home relationship meant that military humanitarian intervention became the only ethical policy available; hospitality, a welcoming of the Kosovan refugee into the British home, was ruled out. This article questions such a construction of the human, listening to the voices of Kosovan refugees to open up the relationship between the human and its home. The complexity that results shows that a more nuanced view of the human would not allow itself to be co-opted so easily to a simplistic logic of intervention. Rather, it could enable the possibility of hospitality as another way of practicing international ethics.

The power of Australian small accounting firms’ unethical exposure

Purpose– The purpose of this paper is to investigate small business owner/manager’s exposure to unethical behavior, and to examine the influence of unethical exposure on organizational intention to implement ethical policies and practices.

Design/methodology/approach– Using a sample of 209 Australian small accounting firms with a path analysis, this paper adopts a modified ethical decision-making model to test the relationship between exposure and personal attitudes toward unethical behavior, and the relationship between exposure and intentions to implement ethical policies and practices at firm level.

Findings– The results show that increased exposure to unethical behavior triggered stronger personal attitudes with small accounting firm owners/managers tending toward accepting unethical behavior. In contrast, at the firm level, more exposure to unethical behavior creates cautious overtones and motivates owners/managers to take action and implement more ethical policies, with the underlying aim of addressing serious ethical issues.

Research limitations/implications– The study tests the ethical decision-making model but focuses only on three constructs (i.e. exposure, attitude and response). The aim is to examine whether extensive exposure to unethical behavior would change personal attitudes toward accepting such behavior, and whether unethical exposure would trigger firm owner/managers to take action and address the ethical dilemma by establishing some ethical guidelines. Other important variables (such as subjective norm, personal locus of control) embedded in the ethical decision-making model should be included in future research.

Practical implications– The study draws attention to ethical dilemmas encountered by many small accounting professionals and their organizations. It addresses the importance of upholding the ethical standard and avoiding the extensive exposure to unethical behavior. It also emphasizes the needs for small businesses to establish some ethical policies and practices.

Originality/value– The paper is purposely set out to reduce the gap in studying how small accounting firms make decisions in implementing their ethical policies and practices to address the rampant ethical dilemma faced by their employees as a result of many corporate scandals and financial crises of the past decade. The results are particularly valuable for small accounting firm owners/managers. The findings also have educational and policy implications.

A new national women's health policy : legal, ethical and policy initiatives to support women's health

In 1989 the first National Women's Health Policy was launched in Australia. Now, 20 years later, the Federal Government has announced plans for the development of a new National Women's Health Policy to address the health needs of Australian women. The Policy will be based on five principles: gender equity; health equity between women; a focus on prevention; an evidence base for interventions; and a life course approach. This editorial examines the role for law in the development of a new National Women's Health Policy. It considers the relevance of regulatory frameworks for health research in supporting an evidence base for health interventions and analyses the requirement in the National Health and Medical Research Council's National Statement on Ethical Conduct in Human Research for "fair inclusion" of research participants. The editorial argues for a holistic approach to women's health that includes regulatory frameworks for research, identification of funding priorities for research, and the need for a dedicated government department or agency to promote women's health.

‘Complementary & alternative medicine’ (CAM): ethical and policy issues

Editorial for Bioethics 2016. 30:(2)

The politics of ethical foreign policy::A responsibility to protect whom?

Ethical foreign policy persists as a problem of international relations, especially regarding humanitarian intervention. However, despite apparent international upheavals, the debate about the ethics of humanitarian intervention has remained fundamentally unchanged. To escape the limits of this debate, this article deconstructs British claims to ethical foreign policy since 1997, reading these claims against themselves and against contemporary humanitarian intervention literature. It finds that Britain’s ethical framework, the ‘doctrine of international community’, which justifies interventions in Kosovo, Sierra Leone and Afghanistan, is undone by the anomalous, yet exemplary, invasion of Iraq. This demonstrates the politics of ethical foreign policy: first, that any intervention, no matter how ‘ethical’ or ‘right’, produces suffering and death; and, second, that we cannot know for sure whether we are doing the right thing by intervening. Embracing, rather than effacing, the political nature of ethical foreign policy opens up a more intellectually honest and positive potential future for relating to the foreign in a responsible manner.

Fear and loathing in public policy : ethical issues in laws for sex offenders

Laws intended to increase protection from sex offenders are often prompted by sensational crimes that provoke public outrage. As public policy, questions have been raised about the legality and effectiveness of these legislative initiatives as enacted in North America, Australasia and the UK since the early 1990s. Mental health professionals involved in the implementation of these laws are faced with ethical concerns that distinguish this area of forensic practice from other clinical roles. This article presents a brief description of the impetus for specific laws allowing for involuntary civil commitment, extended supervision and community notification of sex offenders in different jurisdictions. A model of human rights is then used to consider the ways in which these laws threaten the rights of offenders, and provides a framework for identifying ethical concerns inherent in professional practice in this area.

The ethical and policy implications of profiling 'vulnerable' customers

In the shadow of the global financial crisis, the issue of the marketing of credit has become an increasing concern in the past 12 months. Outstanding personal debt in the UK currently stands at £1479 billion and is rising by £1 million every 10.6 min. In Australia, there is currently $44.6 billion worth of outstanding credit card debt, and in the US, $2596 billion was owed on credit cards in 2008. At present, the banking sector utilizes sophisticated research methods to profile consumers, including those who might be considered financially vulnerable. However, the policy frameworks in most industrialized countries do not account for this form of target marketing when considering how to protect vulnerable groups. This paper is an initial attempt to examine the different methods by which profiling is conducted and the policy implications of this sophisticated form of segmentation and targeting. We argue that current consumer policies are inadequate in protecting vulnerable consumers from these marketing techniques, and recent recommendations from the Federal Reserve Bank of the United States, and the Australian Law Reform Commission to allow banks and lenders to ‘pre-screen’ potential customers will exacerbate personal debt levels, rather than reducing them.

Ethical issues for internet use policy : balancing employer and employee perspectives

An organisational internet use policy (IUP) is a recognised deterrent to manage insider internet misuse. However, IUPs have proven ineffective against this threat, perhaps because of their neglect of the ethical issues involved. An important part of setting an IUP involves the resolution of key ethical dilemmas when employer and employee perspectives conflict. This paper explores the ethical issues that must be addressed when developing an organisational IUP. It draws on a conceptual analysis and an interpretive study of five medium-size and large organisations in Australia and North America. The paper provides a set of key ethical issues for an IUP and compares and contrasts the employer and employee perspectives. It highlights the need to balance the employer and employee perspectives when setting an IUP. Other implications for theory and practice are discussed.

The policy and ethical implications of genetic research on attention deficit hyperactivity disorder

Objective: To review the policy and ethical implications of recent research on the molecular genetics of attention deficit hyperactivity disorder (ADHD). Method: MEDLINE and psycINFO database searches were used to identify studies on the genetics of ADHD. The implications of replicated candidate genes are discussed. Results: The findings for most genes have been inconsistent but several studies have implicated the genes in the dopaminergic pathway in the aetiology of ADHD. Conclusions: The current evidence on the genetics of ADHD is insufficient to justify genetic screening tests but it will provide important clues as to the aetiology of ADHD. Genetic information on susceptibility to ADHD has the potential to be abused and to stigmatize individuals. Researchers and clinicians need to be mindful of these issues in interpreting and disseminating the results of genetic studies of ADHD.

E-Government, targeting and data profiling: Policy and ethical issues of differential treatment

Networked information and communication technologies are rapidly advancing the capacities of governments to target and separately manage specific sub-populations, groups and individuals. Targeting uses data profiling to calculate the differential probabilities of outcomes associated with various personal characteristics. This knowledge is used to classify and sort people for differentiated levels of treatment. Targeting is often used to efficiently and effectively target government resources to the most disadvantaged. Although having many benefits, targeting raises several policy and ethical issues. This paper discusses these issues and the policy responses governments may take to maximise the benefits of targeting while ameliorating the negative aspects.

What does the community think about lifespan extension technologies? The need for an empirical base for ethical and policy debates

Objectives: This paper examines public understandings of possibilities for increasing life expectancy, interest in taking up lifespan-extending interventions, and motivations influencing these intentions. Methods: Structured interviews were conducted with 31 adults, aged 50 and over. Results: Participants believed that technological advances would increase life expectancy but questioned the value of quantity over quality of life. Life in itself was not considered valuable without the ability to put it to good use. Participants would not use technologies to extend their own lifespan unless the result would also enhance their health. Conclusions: These findings may not be generalisable to the general public but they provide the first empirical evidence on the plausibility of common assumptions about public interest in 'anti-ageing' interventions. Surveys of the views of representative samples of the population are needed to inform the development of a research agenda on the ethical, legal and social implications of lifespan extension.