Ethics on-the-run

Midwives are involved in a very dynamic profession. As they face their everyday tasks they encounter many different situations and a variety of people which results in a vast number of interactions. This narrative research project sought to identify some of the ‘ordinary’ encounters and interactions that midwives working in a hospital environment experience in their daily work and explore them from an ethical perspective. It found that many ethical decisions have to be made ‘on-the-run’, with no time to contemplate or decide what the best course of action might be. As ethics is embedded within every encounter a midwife has, it is essential that all midwives have an awareness and understanding of their own value systems, professional ethical codes and ethical principles that can act as guides when they have to make choices in these situations, which are frequently challenging.

Ethics, Law and Health Care : a Guide for Nurses and Midwives

Understanding ethics and law in health care is an essential part of nurses’ and midwives’ professional standards. Ethics, Law and Health Care focuses on teaching applied ethics and law in a manner that illustrates the real world applications of these core components of the nursing and midwifery curriculum and practice. It equips readers with the ability to recognise and address legal and ethical issues that will arise in their professional practice. The book uses the four principles of biomedical ethics (autonomy, non-maleficence, beneficence and justice) together with the use of both the Nursing and Midwifery Codes of Ethics and Codes of Professional Conduct, issued by the Nursing and Midwifery Board of Australia, as a central means through which to analyse and approach ethical and legal issues. Ethics, Law and Health Care is scaffolded to assist readers in understanding legal and ethical principles, to integrate them in the context of a particular issue within professional practice, and provide them with a decision-making framework to take action in a professional context by utilising the Codes as well as state and federal law. Aided by pedagogical features such as case studies, review questions, further reading and a glossary of common terms, this book is an essential resource for students, academics and practitioners.

Pregnant Adolescents in Vietnam : Social context and health care needs

Background: The number of childbearing adolescents in Vietnam is relatively low but they are more prone to experience adverse outcome than adult women. Reports of increasing rates of abortion and prevalence of STIs including HIV among youth indicate a need to improve services and counselling for these groups. Midwives are key persons in the promotion of young people’s sexual and reproductive health in Vietnam. Aim: The overall aim of this thesis is to describe the prevalence and outcome of adolescent pregnancies in Vietnam (I), to explore the social context and health care seeking behavior of pregnant adolescents (II), as well as to explore the perspectives of health care providers and midwifery students regarding adolescent sexuality and reproductive health service needs (III, IV). Methods: The studies were conducted from 2002 to 2005, combining qualitative and quantitative research methods. A population based prospective survey was used to estimate rates and outcomes of adolescent pregnancies (I). Pregnant and newly delivered adolescents’ experiences of childbearing and their encounters with health care providers were studied using qualitative interviews (II). Health care providers’ perspective on adolescent sexual and reproductive health (ASRH) and views on how to improve the quality of abortion care was explored in focus group discussions (FGD). The values and attitudes of midwifery students about ASRH were investigated using questionnaires and interviews (IV). Descriptive statistics was used to analyse quantitative data (I, IV) and content analysis were applied for qualitative data (II, III, and IV). Findings: Adolescent birth rate was similar to previously reported in Vietnam but lower when compared to other Asian countries. The incidence of stillborn among adolescents was higher than for women in higher reproductive ages. The proportion of preterm deliveries was 20 % of all births, higher than previous findings from Vietnam. About 2 % of the deliveries were home deliveries, more common among women with low education, belonging to ethnic minority and/or living in mountainous areas (I). Ambivalence facing motherhood, pride and happiness but also worries and lack of self-confidence emerged as themes from the interviews; and experience of ‘being in the hands of others’ in a positive, caring sense but also in a sense of subordination in relation to husband, family and health care providers (II). Health care providers at abortion clinics and midwifery students generally disapproved of pre-marital sex, but had a pragmatic view on the need for contraceptive services and counselling to reduce the burden of unwanted pregnancies and abortions for young women. Providers and midwifery students expressed a need for training on ASRH issues (III, IV). Conclusion: Cultural norms and gender inequity make pregnant adolescent women in Vietnam vulnerable to sexual and reproductive health risks. Health care providers experience ethical dilemmas while counselling unmarried adolescents who come for abortion and this has a negative impact on the quality of care. Integrated ASRH in education and training programmes for health care providers, including midwives, as well as continued in-service training on these issues are suggested to improve reproductive health care services in Vietnam.

Diffusing research into routine midwifery practice

This research applied Greenhalgh et al's (2005) organisational change theoretical framework and a case study method approach to explore the process of implementing a smoking cessation intervention for pregnant women. The study was carried out according to the principles laid down in the National statement on ethical conduct in human research, produced by the National Health and Medical Research Council, Australia. Ethical approval for the research was sought and received from Queensland University of Technology human research ethics committee, prior to the start of the study. The sample constituted four participants who had been involved in the process of disseminating a training programme for midwives to implement a smoking cessation intervention. Eight semi-structured interviews were undertaken with these participants and the interviews and background programme data were subjected to theoretical analysis. The data were analysed through the lens of the Greenhalgh et al (2005) framework. The result was a disaggregation and (re)aggregation of data in the formation of an analytical outcome (Charmaz, 2006).

IT professionals' experience of ethics and its implications for IT education

This study investigates variation in IT professionals' experience of ethics with a view to enhancing their formation and support. This is explored through an examination of the experience of IT, IT professional ethics and IT professional ethics education. The study's principal contribution is the empirical study and description of IT professionals' experience of ethics. The empirical phase is preceded by a review of conceptions of IT and followed by an application of the findings to IT education. The study's empirical findings are based on 30 semi-structured interviews with IT professionals who represent a wide demographic, experience and IT sub-discipline range. Their experience of ethics is depicted as five citizenships: Citizenship of my world, Citizenship of the corporate world, Citizenship of a shared world, Citizenship of the client's world and Citizenship of the wider world. These signify an expanding awareness, which progressively accords rights to others and defines responsibility in terms of others. The empirical findings inform a Model of Ethical IT. This maps an IT professional space increasingly oriented towards others. Such a model provides a conceptual tool, available to prompt discussion and reflection, and which may be employed in pursuing formation aimed at experiential change. Its usefulness for the education of IT professionals with respect to ethics is explored. The research approach employed in this study is phenomenography. This method seeks to elicit and represent variation of experience. It understands experience as a relationship between a subject (IT professionals) and an object (ethics), and describes this relationship in terms of its foci and boundaries. The study's findings culminate in three observations, that change is indicated in the formation and support of IT professionals in: 1. IT professionals' experience of their discipline, moving towards a focus on information users; 2. IT professionals' experience of professional ethics, moving towards the adoption of other-centred attitudes; and 3. IT professionals' experience of professional development, moving towards an emphasis on a change in lived experience. Based on these results, employers, educators and professional bodies may want to evaluate how they approach professional formation and support, if they aim to promote a comprehensive awareness of ethics in IT professionals.

Being ethical : how process drama assists pre-service drama teachers to reflect on professional ethics

This research thesis focuses on the experiences of pre-service drama teachers and considers how process drama may assist them to reflect on key aspects of professional ethics such as mandatory codes or standards, principled moral reasoning, moral character, moral agency, and moral literacy. Research from higher education provides evidence that current pedagogical approaches used to prepare pre –professionals for practice in medicine, engineering, accountancy, business, psychology, counselling, nursing and education, rarely address the more holistic or affective dimensions of professional ethics such as moral character. Process drama, a form of educational drama, is a complex improvisational group experience that invites participants to create and assume roles, and select and manage symbols in order to create a fictional world exploring human experience. Many practitioners claim that process drama offers an aesthetic space to develop a deeper understanding of self and situations, expanding the participant’s consciousness and ways of knowing. However, little research has been conducted into the potential efficacy of process drama in professional ethics education for pre-professionals. This study utilizes practitioner research and case study to explore how process drama may contribute to the development of professional ethics education and pedagogy.

Encouraging ethics and challenging corruption : reforming governance in public institutions

Encouraging Ethics and Preventing Corruption brings theory and practice together in addressing the question: How are we to be ethical in public life and through public institutions? It is a major contribution to public sector ethics within Australia and internationally because it provides an exhaustive analysis of reform across a decade in one jurisdiction, Queensland, and then proceeds to itemise a best practice integrity system or ethics regime. Drawing on the extensive research of two of Australia's leading practical ethicists, this text is essential reading for all students and practitioners of applied and professional ethics in the public sphere. Part A of the text provides a preferred theoretical and conceptual framework which both justifies and guides the development of a public sector ethics regime. Part B examines the place of the individual within a world of institutional ethics. Part C outlines the Queensland governance reforms introduced since 1989 following the Fitzgerald Inquiry which exposed corruption in the police and ministry. The final chapter, the 'Epilogue', gathers the insights of earlier chapters and suggests a more explicitly ethics-centred approach to governance reform that may take us 'beyond best practice'. Clearly, while it is the Australian context we have in mind, we are confident that this is a text which addresses the quest for integrity and ethics in government wherever society is committed to social and liberal democratic ideals.