Abuse of social care clients committed by nurses and other social service employees-Analysis of employees' reports.

AIM: The aim of the study was to describe the alleged abuse of social care clients committed by nurses and other social services employees and actions as well as sanctions that followed the alleged abuse. DESIGN: A retrospective study using a descriptive qualitative analysis. METHODS: The data comprised mandatory reports made by social service employees under the Social Welfare Act. This study focused on the reported abuses of clients (n = 75) by social services employees from 11 October 2016 to 31 December 2020 in Finland. The data were analysed using inductive content analysis and quantification. RESULTS: The majority of the reports were submitted practical nurses and other nursing personnel and by registered nurses. The severity of the abuse was most often mild or moderate. The most common abusers were nurses. The types of alleged abuse committed by professionals were as follows: (1) neglect of care, (2) physical violence/strong-arm treatments, (3) neglect of hygiene, (4) inappropriate or threatening behaviour and (5) sexual abuse. The actions and sanctions that followed the alleged abuse were: (1) discussing the situation together, requesting an explanation, initiating hearing or defining developmental measures, (2) initiating disciplinary actions and providing verbal or written warnings, (3) dismissing or terminating the employee and (4) initiating a police investigation. CONCLUSION: Nurses are an important group working in social services and might also be involved in cases of abuse. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: It is important that risks, wrongdoings and abuses are reported. Transparent reporting indicates strong professional ethics. IMPACT: Knowledge about abuse in social services from the viewpoint of nursing is important for ensuring the quality and safety of services. REPORTING METHOD: The Standards for Reporting Qualitative Research guideline was followed. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Reasoning for whistleblowing in health care.

BACKGROUND: Whistleblowing is recognised as part of solving wrongdoing. It requires individual reasoning as it is a potentially complicated process with a risk of possible negative consequences for oneself. Knowledge on how individuals reason for whistleblowing in healthcare context is lacking. AIM: This study aimed to create a theoretical construct to describe individual reasoning for whistleblowing. METHODS: The methodology was grounded theory, with 244 nurses as informants. The data consisted of nurses' written narratives in response to a wrongdoing situation presented in a video vignette. To ensure the heterogeneity of the population and variation in nurses' professional expertise, experiences and geographical locations in health care to capture the multidimensionality of the responses, nurses were invited to participate, and data were collected electronically from the membership register of the Finnish Nurses' Association on a national level. Constant comparison was used to analyse the open data. RESULTS: The core category of the theoretical construct, 'The formation of morally courageous intervening', was discovered, reflecting individual's values and beliefs. It forms mentally as an integration of cognition and emotion for recognising one's own strengths and limits to act to do the right thing despite the risk of negative consequences for oneself. The core category consists of three dimensions of reasoning: (1) Reasoning Actors, (2) Reasoning Justifications and (3) Reasoning Activities, their categories and three patterns of reasoning connecting the dimensions and their categories with each other: (I) Individual Reasoning, (II) Collaborative Reasoning and (III) Collective Reasoning. DISCUSSION AND CONCLUSION: The theoretical construct indicate that reasoning is a multidimensional phenomenon. In future, a theoretical construct could be further developed. In health care, managers could use the theoretical construct to support employees in their whistleblowing.

Addressing Clinical Misconduct: Resigning and Whistleblowing in Clinical Ethics Consultation.

Clinical ethics consultants occasionally encounter unethical and/or unprofessional behavior as part of their normal job functions. In this article, we explore whether resigning (i.e., threatening resignation or resigning) and whistleblowing are acceptable methods ethics consultants can use to address these situations. Per our analysis, whether one considers ethics consultants private or public employees, loyal to their employer or to patients, families, and the public, resigning and whistleblowing are all acceptable, if not obligatory, actions of ethics consultants in certain circumstances. In this article, we analyze salient characteristics of ethics consultation as a profession as they pertain to resignation and whistleblowing in the context of ethics consultation. We also present tentative criteria for when ethics consultants are justified, if not obligated, to resign or blow the whistle.

Understanding the role of wrongdoing in technological disasters: Utilizing ecofeminist philosophy to examine commemoration.

Stemming from human accident, error, or neglect, technological disasters, such as chemical spills, toxic waste contamination, nuclear radiation, transportation accidents, and factory explosions, are products of the modern industrial complex. Toxic contamination of the land can permanently displace people from their homes and erase places from the landscape. Commemoration provides an opportunity to remember the past and celebrate culturally significant place attachments while contributing to the recovery process by aiding in community healing after devastating events. We focus on two key components regarding commemoration after technological disaster, namely the acknowledgement of wrongdoing and the celebration of a resilient population and landscape. We argue that a combination of ecofeminist philosophy and environmental justice frameworks allows for a better understanding of the cycle of disaster and mitigation as it pertains to targeted groups, and that commemorative acts and artifacts following human-made disasters often fail to successfully reform this cycle. Moreover, the combination of ecofeminist philosophy and environmental justice allows us to examine the complex relationship between responsibility and targeted groups through disaster commemoration, which serves as an important way to communicate wrongdoing to both the local and greater population. Through engagement with ecofeminist philosophy and environmental justice frameworks, we explicate how commemoration after technological disaster can disrupt or reinforce systematic inequalities.

Wrongdoing and whistleblowing in health care.

AIM(S): To describe healthcare professionals' experiences of observed wrongdoing and potential whistleblowing acts regarding it. The main goal is to strengthen the whistleblowing process described based on the existing literature and to make it more visible for future research. DESIGN: A descriptive cross-sectional survey. METHODS: Data were collected between 26 June 2015-17 July 2015 from the Finnish trade union's membership register, electronically using one open question. A total of 226 healthcare professionals participated providing written narratives, which were analysed using inductive content analysis. FINDINGS: The whistleblowing process in health care was strengthened, identifying the content of observed wrongdoings and whistleblowing acts regarding them. Three themes were identified: wrongdoing related to patients, healthcare professionals, and healthcare managers. Whistleblowing acts were performed internally, externally, or left undone. Three main paths: internal, external, and no whistleblowing, between an observation of wrongdoing and whistleblowing act were identified. CONCLUSION: The whistleblowing process should be further developed and ethically effective programmes and interventions should be developed for increasing whistleblowing and preventing wrongdoing in health care.

Sexual Violation of Patients by Physicians: A Mixed-Methods, Exploratory Analysis of 101 Cases.

A mixed-method, exploratory design was used to examine 101 cases of sexual violations in medicine. The study involved content analysis of cases to characterize the physicians, patient-victims, the practice setting, kinds of sexual violations, and consequences to the perpetrator. In each case, a criminal law framework was used to examine how motives, means, and opportunity combined to generate sexual misconduct. Finally, cross-case analysis was performed to identify clusters of causal factors that explain specific kinds of sexual misconduct. Most cases involved a combination of five factors: male physicians (100%), older than the age of 39 (92%), who were not board certified (70%), practicing in nonacademic settings (94%) where they always examined patients alone (85%). Only three factors (suspected antisocial personality, physician board certification, and vulnerable patients) differed significantly across the different kinds of sexual abuse: personality disorders were suspected most frequently in cases of rape, physicians were more frequently board certified in cases of consensual sex with patients, and patients were more commonly vulnerable in cases of child molestation. Drawing on study findings and past research, we offer a series of recommendations to medical schools, medical boards, chaperones, patients, and the national practitioners database.

Whistle-blowing process in healthcare: From suspicion to action.

BACKGROUND:: Whistle-blowing is an ethical activity that tries to end wrongdoing. Wrongdoing in healthcare varies from inappropriate behaviour to illegal action. Whistle-blowing can have negative consequences for the whistle-blower, often in the form of bullying or retribution. Despite the wrongdoing and negative tone of whistle-blowing, there is limited literature exploring them in healthcare. OBJECTIVE:: The aim was to describe possible wrongdoing in Finnish healthcare and to examine whistle-blowing processes described on the basis of the existing literature in healthcare as perceived by healthcare professionals. RESEARCH DESIGN:: The study was a cross-sectional descriptive survey. The data were collected using the electronic questionnaire Whistle-blowing in Health Care and analysed statistically. PARTICIPANTS AND RESEARCH CONTEXT:: A total of 397 Finnish healthcare professionals participated, 278 of whom had either suspected or observed wrongdoing in healthcare, which established the data for this article. ETHICAL CONSIDERATIONS:: Ethical approval was obtained from the Ethics Committee of the University (20/2015). Permission to conduct the study was received according to the organisation's policies. FINDINGS:: Wrongdoing occurs in healthcare, as 96% of the participants had suspected and 94% had observed wrongdoing. Regarding the frequency, wrongdoing was suspected (57%) and observed (52%) more than once a month. Organisation-related wrongdoing was the most common type of wrongdoing (suspected 70%, observed 66%). In total, two whistle-blowing processes were confirmed in healthcare: (1) from suspicion to consequences occurred to 27%, and (2) from observation to consequences occurred to 37% of the participants. DISCUSSION AND CONCLUSION:: Wrongdoing occurs in healthcare quite frequently. Whistle-blowing processes were described based on the existing literature, but two separate processes were confirmed by the empirical data. More research is needed on wrongdoing and whistle-blowing on it in healthcare.

Conscientious Objection, Complicity in Wrongdoing, and a Not-So-Moderate Approach.

This article analyzes the problem of complicity in wrongdoing in the case of healthcare practitioners (and in particular Roman Catholic ones) who refuse to perform abortions, but who are nonetheless required to facilitate abortions by informing their patients about this option and by referring them to a willing colleague. Although this solution is widely supported in the literature and is also widely represented in much legislation, the argument here is that it fails to both (1) safeguard the well-being of the patients, and (2) protect the moral integrity of healthcare practitioners. Finally, the article proposes a new solution to this problem that is based on a desirable ratio of conscientious objectors to non-conscientious objectors in a hospital or in a given geographic area.

Do organizational and political-legal arrangements explain financial wrongdoing?

The 2008 financial crisis was a systemic problem with deep-rooted structural causes that created opportunities to engage in financial malfeasance, a form of corporate wrongdoing. However, few quantitative studies exist on the effects of organizational and political-legal arrangements on financial malfeasance. In this paper, we examine the effects of organizational and political-legal arrangements that emerged in the 1990s in the FIRE sector (i.e., financial, insurance, and real estate) on financial malfeasance. Our historical contextualization demonstrates how changes in the political-legal arrangements facilitate the emergence of new corporate structures and opportunities for financial malfeasance. Our longitudinal quantitative analysis demonstrates that US FIRE sector corporations with a more complex organizational structure, larger size, lower dividend payment, and higher executive compensation are more prone to commit financial malfeasance.

The puzzle of wrongless injustice: Reflections on Kürthy and Sousa.

The Database of Exemplars (DOE) account of moral cognition emerged in part to explain how wrongless harms could arise (Royzman & Borislow, 2022; henceforth, RB) in spite of being denied by most traditional models (Schein & Gray, 2018; Turiel, 1983; Shweder, 1997; Haidt, 2012). Herein, we defend this account against a set of results that have been claimed to disprove it (Kurthy & Sousa, this issue; henceforth, KS). We argue that DOE is in line with all the findings KS perceive as uniquely supportive of their own account (appraising an act as unjust engenders a judgment of wrong) while RB's findings (Royzman & Borislow, 2022, Studies 2 and 3) do challenge KS under varied conceptions of what it would take for an agent to be or appear unjust in his or her treatment of others, affirming that wrongless injustice is an empirical fact that one must strive to explain and that DOE helps us explain.

The deflationary model of harm and moral wrongdoing: A rejoinder to Royzman & Borislow.

With a series of studies, Royzman and Borislow (2022) purport to show that extant models about the conditions under which harmful actions are deemed morally wrong do not have explanatory power-for any proposed condition, various harmful actions meet the condition but are not deemed immoral. And they reach the following conclusion: judgments of moral wrongdoing in the context of harmful actions (or judgments of moral wrongdoing more generally) are not reducible to an explanatory template. However, they did not address the main claim of the deflationary model of harm and moral wrongdoing, which is that intuitions of injustice connect harmful actions to judgments of moral wrongdoing (Sousa & Piazza, 2014). Our first study adjusts Royzman and Borislow' design to include a measure of perceived injustice, while our second elaborates their design to manipulate perceived injustice. The results undermine their conclusion and support the deflationary model, which we further refine here in light of the results of Royzman and Borislow's studies and ours.

Harming by Deceit: Epistemic Malevolence and Organizational Wrongdoing.

Research on organizational epistemic vice alleges that some organizations are epistemically malevolent, i.e. they habitually harm others by deceiving them. Yet, there is a lack of empirical research on epistemic malevolence. We connect the discussion of epistemic malevolence to the empirical literature on organizational deception. The existing empirical literature does not pay sufficient attention to the impact of an organization's ability to control compromising information on its deception strategy. We address this gap by studying eighty high-penalty corporate misconduct cases between 2000 and 2020 in the United States. We find that organizations use two different strategies to deceive: Organizations 'sow doubt' when they contest information about them or their impacts that others have access to. By contrast, organizations 'exploit trust' when they deceive others by obfuscating, concealing, or falsifying information that they themselves control. While previous research has focused on cases of 'sowing doubt', we find that organizations 'exploit trust' in the majority of cases that we studied. This has important policy implications because the strategy of 'exploiting trust' calls for a different response from regulators and organizations than the strategy of 'sowing doubt'.

What Can State Medical Boards Do to Effectively Address Serious Ethical Violations?

State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team's larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious wrongdoing by physicians.

What Makes You a Whistleblower? A Multi-Country Field Study on the Determinants of the Intention to Report Wrongdoing.

Whistleblowers have significantly shaped the state of contemporary society; in this context, this research sheds light on a persistently neglected research area: what are the key determinants of whistleblowing within government agencies? Taking a unique methodological approach, we combine evidence from two pieces of fieldwork, conducted using both primary and secondary data from the US and Indonesia. In Study 1, we use a large-scale survey conducted by the US Merit Systems Protection Board (MSPB). Additional tests are conducted in Study 1, making comparisons between those who have and those who do not have whistleblowing experience. In Study 2, we replicate the survey conducted by the MSPB, using empirical data collected in Indonesia. We find a mixture of corroboration of previous results and unexpected findings between the two samples (US and Indonesia). The most relevant result is that perceived organizational protection has a significant positive effect on whistleblowing intention in the US sample, but a similar result was not found in the Indonesian sample. We argue that this difference is potentially due to the weakness of whistleblowing protection in Indonesia, which opens avenues for further understanding the role of societal cultures in protecting whistleblowers around the globe. Supplementary Information: The online version contains supplementary material available at 10.1007/s10551-022-05089-y.

Winter's Topography, Law, and the Colonial Legal Imaginary in British Columbia.

This article examines how images of nature, weather, and topography disclose a politics of recognition (who is visible/invisible) invested in a burgeoning criminal justice milieu, where punishment of wrongdoing became increasingly racialized in British Columbia during the early confederation period of Canada's history. Drawing from archived court documents and colonial writing, it examines dominant environmental metaphors and tropes that structured this politics of recognition within the colonial legal imaginary. I argue that images and understandings of topography, nature, weather, and seasons shaped the background enactment of law in early Canadian lawmaking practices. By examining these natural tropes, this article seeks to understand the contours of a contextually specific colonial legal imaginary as a vital component for entry into the criminal justice system. This colonial legal imaginary predisposes certain groups, and particularly Indigenous peoples, as subject to the constraining power of law, thereby fueling the growth of crime control industries over the last 150 years.

How Victims of Strangulation Survived: Enhancing the Admissibility of Victim Statements to the Police When Survivors are Reluctant to Cooperate.

Holding perpetrators accountable for family violence is challenged when survivors are reluctant to testify. In light of recent Supreme Court precedents limiting the admissibility of statements to law enforcement in victimless prosecutions, the current study examined 130 cases of nonfatal strangulation (NFS) to determine whether case characteristics and themes across survivors' on-scene statements can help prosecutors combat common legal defenses raised when victims are unavailable for trial. The history of prior violence and how only 6% of perpetrators stopped strangling victims on their own suggests that NFS complaints should be investigated as an attempted homicide until evidence suggests otherwise.

Throwing off the dark legacy when going down: Experience of status loss undermines reparation intentions prompted by narratives of the ingroup's past wrongdoings.

Two experiments tested whether group members' reparation intentions towards victims of the ingroup's past wrongdoings depend on their experience of relative status change. We manipulated born-free White South Africans' experience of accessibility of memories of past ingroup wrongdoings and their current experiences of status loss. For participants believing in the ingroup's responsibility for past wrongdoing towards Black South Africans during Apartheid, status-loss experiences reduced reparation intentions prompted by the experience of memorizing examples of such wrongdoing as easy (Experiment 1, N = 193), and the ease to remember wrongdoing examples increased reparation intentions only if participants were reminded of status stability, but not if they were reminded of status loss (Experiment, N = 126). We conclude that the implications of narratives referring to past ingroup wrongdoings are contingent upon their relational function in ongoing social change processes.

Social perception in moral judgments of interpersonal transgressions.

Moral judgments about interpersonal transgressions are shaped by attributions about the actor's mental state (intent), responsibility, and harmful consequences. Curiously, most research has investigated these judgments from a third-party perspective, often overlooking perceptions of the individuals directly involved in the transgression. We address this by reviewing research on how victims and transgressors involved in interpersonal transgressions form judgments about the transgressor's intent, responsibility, and how much harm was caused, and the ways in which victims' and transgressors' judgments diverge from one another. Our review indicates that both cognitive biases and motivation-based differences give rise to asymmetries. We argue that future research could investigate not only social perceptions but also meta-perceptions and that a better understanding of the content and causes of divergent interpersonal perceptions in this domain will lead to a more complete understanding of how to resolve conflicts.

The German Organ Transplant Scandal - Unwritten rules of organizational wrongdoings.

Using data from organ transplant medicine in Germany, we propose a method for understanding the content of unwritten rules supportive of violations of written rules in light of the "German Organ Transplant Scandal". Grounded in the sociology of organizational crime, we reconstruct the cultural repertoires of medical professionals working with organ allocation when confronted with the applicable guidelines using collective mindset analysis. Four dimensions of cognitive and normative rules of interpretation were identified and discussed as a an occupational-professional form of deviance. Apart from not relying on data from the alleged perpetrators and still gazing at the latent structures of meaning behind misconduct, our approach offers a more general methodological framework for empirical studies of the unwritten rules at work in an organizational field where wrongdoing has been reported.

Examining Whistleblowing Intention: The Influence of Rationalization on Wrongdoing and Threat of Retaliation.

Whistleblowers who expose wrongdoing often face several concerns, pressures, and threats of retaliation before reaching a final decision. Specifically, this study examines the effects of perceived seriousness of wrongdoing (PSW) and perceived threat of retaliation (PTR), as well as the impact of rationalization (RNL), comparing perceived seriousness of wrongdoing, perceived threat of retaliation and whistleblowing intention. Furthermore, this study aims to determine the mediating effect of anticipated regret (AR) on the relationship between perceived seriousness of wrongdoing and whistleblowing intention. We validated our model by analyzing data gathered across three stages from employees in the telecom sector in Pakistan. The key findings of our research may be summarized as follows: (i) individuals' willingness to 'blow the whistle' increases as a result of perceived seriousness of wrongdoing; (ii) whistleblowers are more likely to opt to remain silent if they anticipate a greater threat of retaliation, and (iii) our study establishes a positive connection between perceived seriousness of wrongdoing and whistleblowing intention, indicating that perceived seriousness of wrongdoing enhances people's willingness to blow the whistle, and whistleblowers are more likely to choose to emerge if the behaviour is more serious in nature; (iv) the data we have uncovered indicates a moderating role of rationalization in regulating the connections between perceived seriousness of wrongdoing, perceived threat of retaliation, and whistleblowing intention; and (v) the findings demonstrate that anticipated regret mediates the connection between perceived seriousness of wrongdoing and the intention to report wrongdoing. Additionally, the results are discussed in terms of their significance for corporate ethics researchers and managers, as well as for end-users who are interested in whistleblowing.