Policy relevance and the ethical conduct of science.

Scientific enquiry and the communication of science are essential to achieving development goals. The demand for evidence-based policy poses a challenge to maintaining the ethical conduct of science. The modern scientist faces intense competition in light of the changing nature of collaborative efforts, the quickening pace and increasing complexity of research endeavours and a growing emphasis on commercialisation of research results. Academic performance criteria continually change, becoming more demanding and increasing complex to measure. The integrity of the scientific community is challenged by cases of falsification, fabrication and plagiarism. The mass production of science outputs, evidenced by the incredible rise of predatory journals, poses risks for the veracity of science. Yet, scientists are not the only ones driven by performance targets. Under the constant scrutiny of governing boards, research and development funders-both public and private-are increasingly pressed to demonstrate outputs, outcomes and impact. There is an urgent need for independent research but also a need for consensus with regard to policy guidance. Consensus studies expect scientists to make sense of the available science and find a way of presenting the controversies, contradictions and convergence of evidence to guide policy decisions. Policy consensus dialogues can valorise science guidance. These practices adopt multidisciplinary approaches, bringing top-rated scientists from a variety of disciplines around the table to contribute best practice examples, share experiences and lessons learnt against the background of solid critique of existing research.

"You took an Oath!": Engaging Medical Students About the Importance of Oaths and Codes Through Film and Television.

In this paper, we will consider the role of oaths and codes of ethics in undergraduate medical education. Studies of ethics syllabi suggest that ethics educators typically use well-known bioethics texts such as Beauchamp and Childress (Principles of biomedical ethics, 8th ed. Oxford University Press, Oxford, 2019). Yet, many issues that medical students will face (as students and as physicians) are addressed by codes of ethics and oaths. We will first provide a historical survey of oaths and codes and then address how these sources of ethical guidance can be effectively used in ethics education of medical students. Oaths and codes can be engagingly taught using a range of techniques including visual narrative. Excerpts from television and film can be used to highlight challenging ethical dilemmas in a variety of settings, taking the learning from the theoretical to the more applied while offering context.

Human rights and nursing codes of ethics in Canada 1953-2017.

Human rights are foundational to the health and well-being of all individuals and have remained a central tenet of nursing's ethical framework throughout history. The purpose of this study is to explore continuity and changes to human rights in nursing codes of ethics in the Canadian context. This study examines nursing codes of ethics between the years 1953 and 2017, which spans the very first code in Canada to the most recently adopted. The historical method is used to compare and contrast human rights language, positioning and descriptions between different code editions. The findings suggest there has been very little change in how human rights have been included within the Canadian nursing codes of ethics. Furthermore, we consider how changes within the nursing profession have influenced the authority of codes of ethics and their ability to support nurses in carrying out ethical obligations specific to human rights. Finally, the impacts and implications of these changes are discussed concerning the protection of human rights in today's healthcare landscape in Canada.

Información clínica, consentimiento informado y deontología médica. Una relación reciente / Clinical information, informed consent and medical deontology. A recent relationship

El derecho a la información clínica y el consentimiento informado como expresión práctica del principio de autonomía, son conquistas legales en España de finales del siglo XX que se han trasladado a la normativa deontológica médica. Se estudia el ritmo de ese traslado. Revisión histórica de los diferentes códigos de deontología médica desde la Guerra Civil, buscando la presencia de estas ideas en ella. Hasta el código de 1979 la idea de información clínica no aparece en la normativa deontológica vigente y el consentimiento lo hace en casos muy restringidos. A partir de esa fecha su aparición es progresiva en los sucesivos códigos. Actualmente ambas ideas están completamente desarrolladas en la normativa deontológica española. La Deontología médica ha asumido como suyas las ideas de información al paciente y consentimiento in-formado. Este ha sido un proceso largo en el tiempo que ha cambiado en buena medida la orientación deontológica para las relaciones médico-enfermo. En estos aspectos, la Deontología médica pasa, de hacer hincapié en la prudencia del médico, a subrayar el deber de informar y de dar amplio espacio a las decisiones del paciente, al que reconoce como un agente moral autónomo y reflexivo, capaz de tomar sus propias decisiones sobre su salud

In Spain, the right to clinical information and informed consent as a practical expression of the principle of autonomy, are legal conquests achieved in the late twentieth century. From the law they have been transferred to the codes of medical deontology. The aim of this work is to study the pace of this transfer. Historical review of the different codes of medical deontology in Spain since the Civil War, see-king the presence of these ideas in them. Until code of medical deontology of 1979, the idea of clinical information did not appear in the contemporary deontological norm, and the rules on consent did so in very restricted cases. As of that date, their appearance is progressive in the successive codes. Currently, both concepts are fully developed in Spanish deontological regulations. Medical Deontology has take on the ideas of patient information and informed consent. This has been a long process which have brought considerable changes the deontological orientations of the traditional form of doctor-patient relationship. In these aspects, medical deontology has drifted, from emphasizing the prudence of the doctor, to emphasize the duty to inform and give ample space to the patient’s decisions, which he recognizes as an autonomous and reflective moral agent, capable of taking his own decisions about your health

The Ethical Perils of Personal, Communal Relations: A Language Perspective.

Most companies use codes of conduct, ethics training, and regular communication to ensure that employees know about rules to follow to avoid misconduct. In the present research, we focused on the type of language used in codes of conduct and showed that impersonal language (e.g., "employees" or "members") and personal, communal language (e.g., "we") lead to different behaviors because they change how people perceive the group or organization of which they are a part. Using multiple methods, including lab- and field-based experiments (total N = 1,443), and a large data set of S&P 500 firms (i.e., publicly traded, large U.S. companies that are part of the S&P 500 stock market index), we robustly demonstrated that personal, communal language (compared with impersonal language) influences perceptions of a group's warmth, which, in turn, increases levels of dishonesty among its members.

Guidance for Ethical Leadership in Nursing Codes of Ethics: An Integrative Review.

There has been limited attention to ethical leadership for formal nurse leaders around the world. Assuming that codes of ethics provide meaningful standards of what is expected of health professionals, what specific guidance for ethical leadership is available to formal nurse leaders in national nursing codes of ethics? We conducted an integrative review of national nursing codes of ethics for 131 member countries of the International Council of Nurses (ICN). In the ICN Code, nurse managers/leaders are highlighted for their role in ethical practice. With the exception of the US, no other country code focuses as much attention on formal nurse leaders. While all country codes (except the United States) implicitly group nurses, practitioners and managers together, most codes do not provide meaningful guidance for formal nurse leaders. The level of ethical guidance provided to formal nurse leaders in national nursing codes of ethics is lacking. However, creating a separate code of ethics for formal nurse leaders is not the answer. Rather, including specific guidance in nursing codes of ethics not only informs nurses about what they can expect of nurse leaders but also allows formal nurse leaders to use the code with their own senior leaders, conveying what their professional body expects of them.

Are country level prevalences of rule violations associated with knowledge overclaiming among students?

Cultural norms of behaviour influence desirable and problematic behaviours of individuals. In particular, cultural norms should influence individuals' dishonesty. In a recent Nature study, prevalence of rule violations was introduced as a new country-level measure of behavioural norms. However, information on individuals' actual honesty was not available due to characteristics of the experimental design. Overcoming this limitation, we show that country-level behavioural norms are related to individual-level knowledge overclaiming behaviour (i.e., claiming to know concepts that do not exist, a measure of individuals' actual behavioural dishonesty) among 290,954 students from 57 countries (from the 2012 PISA study). Our study represents a crucial test of the argument that cultural norms influence individual's behaviour and of the validity of the measurement of countries' prevalences of rule violations. These results imply that shaping the behaviour of today's students may result in new behavioural norms that emphasise honesty and rule adherence more strongly.

How American Nurses Association Code of Ethics informs genetic/genomic nursing.

Members of the Ethics and Public Policy Committee of the International Society of Nurses in Genetics prepared this article to assist nurses in interpreting the American Nurses Association (2015) Code of Ethics for Nurses with Interpretive Statements (Code) within the context of genetics/genomics. The Code explicates the nursing profession's norms and responsibilities in managing ethical issues. The nearly ubiquitous application of genetic/genomic technologies in healthcare poses unique ethical challenges for nursing. Therefore, authors conducted literature searches that drew from various professional resources to elucidate implications of the code in genetic/genomic nursing practice, education, research, and public policy. We contend that the revised Code coupled with the application of genomic technologies to healthcare creates moral obligations for nurses to continually refresh their knowledge and capacities to translate genetic/genomic research into evidence-based practice, assure the ethical conduct of scientific inquiry, and continually develop or revise national/international guidelines that protect the rights of individuals and populations within the context of genetics/genomics. Thus, nurses have an ethical responsibility to remain knowledgeable about advances in genetics/genomics and incorporate emergent evidence into their work.

Thomas Percival. Discussing the foundation of Medical Ethics.

BACKGROUND AND AIM OF THE WORK: In 1803, the English physician Thomas Percival published Medical Ethics, a work destined to become a milestone in the development of modern codes of medical ethics, starting from the first edition of the American Medical Association's ethical code. Notwithstanding the undeniable influence that this book has exerted upon the codification of the principles of medical ethics, researchers and experts foster different and opposing points of views on its real nature. They question whether Medical Ethics truly belongs to the literary genre of codes of medical ethics or, better yet, to that of medical etiquettes. METHODS: This debate is crucial in the field both of medical history and of medical ethics, with regard not only to Percival's work, but also to the ethical value of the current codes of medical ethics and deontology. RESULTS: The lack of a rigorous philosophical-moral analysis of the current medical codification is reflected in its mere loyalty to the legal regulation, in substantial continuity with the past. However, the constant challenges proposed by the biomedical development, require the need to rethink the traditional conceptual tools of the current codes of medical ethics, with the purpose to achieve new schemes and innovative solutions. CONCLUSIONS: On this perspective, when the codes of medical ethics are worked out by physicians, they could be considered as wrongly titled medical etiquettes. This consideration could regard current codes of medical ethics, that remain faithful to tradition and that would more probably be codes of medical etiquette with a wrong title.

Deontological aspects of the nursing profession: understanding the code of ethics / Vivencia deontológica de la enfermería: develando el código de ética profesional / Vivência deontológica da enfermagem: desvelando o código de ética profissional

ABSTRACT Objective: to investigate nursing professionals' understanding concerning the Code of Ethics; to assess the relevance of the Code of Ethics of the nursing profession and its use in practice; to identify how problem-solving is performed when facing ethical dilemmas in professional practice. Method: exploratory descriptive study, conducted with 34 (thirty-four) nursing professionals from a teaching hospital in João Pessoa, PB - Brazil. Results: four thematic categories emerged: conception of professional ethics in nursing practice; interpretations of ethics in the practice of care; use of the Code of Ethics in the professional practice; strategies for solving ethical issues in the professional practice. Final considerations: some of the nursing professionals comprehend the meaning coherently; others have a limited comprehension, based on jargon. Therefore, a deeper understanding of the text contained in this code is necessary so that it can be applied into practice, aiming to provide a quality care that is, above all, ethical and legal.

RESUMEN Objetivo: Comprobar el entendimiento de los profesionales de enfermería acerca del Código de Ética; averiguar la relevancia del Código de Ética de los profesionales de enfermería y su utilización en la práctica; identificar la mecánica de resolución de los dilemas éticos en la práctica profesional. Método: estudio exploratorio, descriptivo, involucrando 34 (treinta y cuatro) profesionales de enfermería de un hospital universitario en João Pessoa, Paraíba. Resultados: han surgido cuatro categorías temáticas: concepción del saber ético profesional en el ejercicio de la enfermería; inferencias éticas del profesional en la práctica asistencial; utilización del Código de Ética en el ejercicio profesional; estrategias resolutivas de los embrollos (imbroglios) éticos en el ejercicio profesional. Consideraciones finales: parte de los profesionales de enfermería aprehende, de forma coherente, su significado; otros presentan una comprensión fragilizada y permeada de jergas. Por esta razón, es imprescindible que haya una mejor comprensión de las directivas contenidas en este código, para poder aplicarlo en la práctica asistencial con el intuito de ofrecer cuidados de calidad con respaldo ético y legal.

RESUMO Objetivo: verificar o entendimento de profissionais de enfermagem acerca do Código de Ética; averiguar a relevância do Código de Ética para os profissionais de enfermagem e sua utilização na prática; identificar como se dá a resolutividade diante de dilemas éticos na prática profissional. Método: estudo exploratório, descritivo, envolvendo 34 (trinta e quatro) profissionais de enfermagem de um hospital universitário em João Pessoa-PB. Resultados: emergiram quatro categorias temáticas: concepção do saber ético profissional no exercício da enfermagem; inferências éticas do profissional na prática assistencial; utilização do Código de Ética no exercício profissional; estratégias resolutivas dos imbróglios éticos no exercício profissional. Considerações finais: parte dos profissionais de enfermagem apreende, de forma coerente, seu significado; outros, apresentam compreensão fragilizada e permeada de jargões. Nesse sentido, é imprescindível haver maior compreensão das diretrizes contidas nesse código, para que ele seja aplicado na prática assistencial com o intuito de ofertar cuidados de qualidade e, sobretudo, com respaldo ético e legal.

Deontological aspects of the nursing profession: understanding the code of ethics.

OBJECTIVE: to investigate nursing professionals' understanding concerning the Code of Ethics; to assess the relevance of the Code of Ethics of the nursing profession and its use in practice; to identify how problem-solving is performed when facing ethical dilemmas in professional practice. METHOD: exploratory descriptive study, conducted with 34 (thirty-four) nursing professionals from a teaching hospital in João Pessoa, PB - Brazil. RESULTS: four thematic categories emerged: conception of professional ethics in nursing practice; interpretations of ethics in the practice of care; use of the Code of Ethics in the professional practice; strategies for solving ethical issues in the professional practice. FINAL CONSIDERATIONS: some of the nursing professionals comprehend the meaning coherently; others have a limited comprehension, based on jargon. Therefore, a deeper understanding of the text contained in this code is necessary so that it can be applied into practice, aiming to provide a quality care that is, above all, ethical and legal.

The reason for having a code of pharmaceutical ethics: Spanish Pharmacists Code of Ethics / El porqué de un código de ética farmacéutica: Código Español de Ética Farmacéutica

The pharmacist profession needs its own code of conduct set out in writing to serve as a stimulus to pharmacists in their day-to-day work in the different areas of pharmacy, in conjunction always with each individual pharmacist´s personal commitment to their patients, to other healthcare professionals and to society. An overview is provided of the different codes of ethics for pharmacists on the national and international scale, the most up-to-date code for 2015 being presented as a set of principles which must guide a pharmacutical conduct from the standpoint of deliberative judgment. The difference between codes of ethics and codes of practice is discussed. In the era of massive-scale collaboration, this code is a project holding bright prospects for the future. Each individual pharmacutical attitude in practicing their profession must be identified with the pursuit of excellence in their own personal practice for the purpose of achieving the ethical and professional values above and beyond complying with regulations and code of practice (AU)

Se necesita un código de conducta propio y escrito, que dinamice la realidad de la profesión farmacéutica en el trabajo cotidiano en sus distintas áreas, siempre como un compromiso individual del farmacéutico con el paciente, con otros profesionales sanitarios y con la sociedad. Se hace una panorámica de los diversos códigos de ética farmacéutica a nivel nacional e internacional, presentando el más actualizado, de 2015, como un conjunto de principios que debe guiar el comportamiento del farmacéutico desde la prudencia deliberativa. Se plantea la diferencia ante los códigos de ética y deontología. En la era de la colaboración masiva, el código es un proyecto de futuro de oportunidades. La actitud del farmacéutico en su ejercicio profesional deberá identificarse con la búsqueda de la excelencia en la práctica individual, que tiene como objetivo alcanzar los valores éticos y profesionales que van más allá del cumplimiento de la normativa legal y los códigos deontológicos (AU)

An Analysis of the Changes in Communication Techniques in the Italian Codes of Medical Deontology.

BACKGROUND AND AIM OF THE WORK: The code of deontology of the Italian National Federation of the Colleges of Physicians, Surgeons and Dentists (FNOMCeO) contains the principles and rules to which the professional medical practitioner must adhere. This work identifies and analyzes the medical-linguistic choices and the expressive techniques present in the different editions of the code, and evaluates their purpose and function, focusing on the first appearance and the subsequent frequency of key terms. METHODS: Various aspects of the formal and expressive revisions of the eight editions of the Codes of Medical Deontology published after the Second World War (from 1947/48 to 2014) are here presented, starting from a brief comparison with the first edition of 1903. Formal characteristics, choices of medical terminology and the introduction of new concepts and communicative attitudes are here identified and evaluated. RESULTS: This paper, in presenting a quantitative and epistemological analysis of variations, modifications and confirmations in the different editions of the Italian code of medical deontology over the last century, enucleates and demonstrates the dynamic paradigm of changing attitudes in the medical profession. CONCLUSIONS: This analysis shows the evolution in medical-scientific communication as embodied in the Italian code of medical deontology. This code, in its adoption, changes and adaptations, as evidenced in its successive editions, bears witness to the expressions and attitudes pertinent to and characteristic of the deontological stance of the medical profession during the twentieth century.

Demographic factors associated with moral sensitivity among nursing students.

BACKGROUND: Today's healthcare environment is often characterized by an ethically demanding work situation, and nursing students need to prepare to meet ethical challenges in their future role. Moral sensitivity is an important aspect of the ethical decision-making process, but little is known regarding nursing students' moral sensitivity and its possible development during nursing education. OBJECTIVES: The aims of this study were to investigate moral sensitivity among nursing students, differences in moral sensitivity according to sample sub-group, and the relation between demographic characteristics of nursing students and moral sensitivity. RESEARCH DESIGN: A convenience sample of 299 nursing students from one university completed a questionnaire comprising questions about demographic information and the revised Moral Sensitivity Questionnaire. With the use of SPSS, non-parametric statistics, including logistic regression models, were used to investigate the relationship between demographic characteristics and moral sensitivity. Ethical considerations: The study followed the regulations according to the Swedish Ethical Review Act and was reviewed by the Ethics Committee of South-East Sweden. FINDINGS: The findings showed that mean scores of nursing students' moral sensitivity were found in the middle to upper segment of the rating scale. Multivariate analysis showed that gender (odds ratio = 3.32), age (odds ratio = 2.09; 1.73), and parental status (odds ratio = 0.31) were of relevance to nursing students' moral sensitivity. Academic year was found to be unrelated to moral sensitivity. DISCUSSION AND CONCLUSION: These demographic aspects should be considered when designing ethics education for nursing students. Future studies should continue to investigate moral sensitivity in nursing students, such as if and how various pedagogical strategies in ethics may contribute to moral sensitivity in nursing students.

ICOH International Code of Ethics for Occupational Health Professionals: Historical fortune and future perspectives in Italy. / I1 Codice Internazionale di Etica ICOH per gli operatori di Medicina del Lvoro: fortuna storica e prospettive future in Italia.

The Working Group responsible for the Italian translation of the third edition of the International Code of Ethics, appointed by the President of the International Commission on Occupational Health (ICOH), Dr. Jukka Takala, completed last April the revision work. The final text, already available on the ICOH website, has been printed and distributed by the Italian National Institute for Insurance against Accidents at Work (INAIL) at the 79th National Congress of the Italian Society of Occupational Medicine and Industrial Hygiene (SIMLII), in Rome. The curators of this third Italian edition have accomplished the delicate task of adaptation in Italian, taking into account the specificities of the practice of medicine in the Italian work environment. It involves many professionals with diverse roles and responsibilities in the public and private sectors for safety, hygiene, health and environment in relation to work. More than twenty years after the first Italian edition, we trace the evolution of the ICOH International Code of Ethics, in order to focus its birth, national and international distribution, and continuous improvement as well as its ability to direct the stakeholders towards a participatory prevention model, in a legislative framework that has seen over the past two decades a radical change in the Italian world of work.

Las responsabilidades éticas / Ethical responsibilities

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The state of ethical-legal oaths in UK medical practice today: Is it time to look at standardising?

The taking of an ethical-legal oath is a "rite of passage" for many medical practitioners. A 1997 paper noted that half of medical schools in the UK administer an oath. I performed a survey of UK medical schools to see whether these are still used today. An electronic survey was sent to 31 UK medical schools, asking them whether the Hippocratic Oath (in any version) was taken by their medical students; non-respondents were followed up by telephone. Information was obtained from 21 UK medical schools, giving a response rate of 68% (21/31). A total of 18 (86%) institutions use an oath. Ethical-legal oaths are therefore taken in the vast majority of UK medical schools today. However, a great variety are used, and there are advantages in standardisation. My recommendation is that the Standard Medical Oath of the UK (SMOUK) is adopted by all medical schools, and that this is also taken regularly by doctors as part of revalidation.

Estudio descriptivo de la actividad de las Comisiones de Deontología Provinciales hoy en España / Descriptive study of the activities performed by the provincial medical deontology commissions

Objetivo: Describir las características de los expedientes que dirimen las comisiones de deontología de los colegios de médicos provinciales (CdDP). Material y método: Estudio descriptivo, retrospectivo de la tipología de las reclamaciones llegadas a las CdDP entre 01-06-2013 y 31-05-2014. Selección de los colegios mediante muestreo aleatorio estratificado simple. Se recogieron variables relacionadas con el origen de la queja, capítulo del Código de Deontología (CD) afectado, plazos de resolución, dictamen y otras. Análisis descriptivo de las variables, expresando con medianas las cuantitativas con sus correspondientes rangos intercuartílicos (IQR, p25-p75) y con frecuencias absolutas y relativas las cualitativas. Análisis bivariante, mediante las pruebas de Kruskal-Wallis y test de Ji-Cuadrado. Resultados: Participaron 10 colegios (47.625 colegiados; 20,2% de todos los de España) que comunicaron 120 reclamaciones. Incidencia global: 2,5 reclamaciones ‰ colegiados/año. Principalmente denuncian los pacientes (96 casos, 80%), siendo medicina de familia la especialidad más afectada (19,2% de las reclamaciones), la calidad de la atención médica es el capítulo del CD más afectado (60% de las reclamaciones). El plazo de resolución global fue de 111,5 días (55-187). La CdDP dictaminó falta deontológica en 17 casos (14,2%), 10 de ellos en ejercicio privado. 8 (6,7%) estaban pendientes de resolución con fecha 01-03-2015. 8 casos (6,7%) acabaron en expediente disciplinario por la Junta Directiva, uno en amonestación verbal y otro estaba pendiente de resolución. Conclusiones: La incidencia de quejas deontológicas es baja, igual que la proporción de faltas. Existen demasiadas discrepancias entre los dictámenes de las CdDM y las Juntas Directivas colegiales

Aim: to describe the expedient’s features those settle the medical ethics commissions of the provincial colleges (PMEC). Material and methodology: descriptive study, retrospective from the typology of the received claims to the PMEC between 01-06-2013 and 31-05-2014. The colleges were selected by simple stratified random sample. Variables related with the origin of the claim, chapter of the Medical Ethics Code affected, resolution timescales, judgement and others; were gathered. Descriptive analysis of the variables, expressing with medians the quantitative variables and their corresponding interquartile ranges; and with absolute and relative frequencies the qualitative ones. A bivariate analysis, through Kruskal-Wallis and Chisquare tests. Results: 10 provincial colleges participated (47.652 members, 20.2% from the Spanish total) that communicated 120 claims. Overall impact: 2.5 claims %0 members/year. The denouncers are mainly patients (80%). The family medicine is the most affected specialty (19.2% of the claims), the quality of the medical attention the most affected chapter of the CD (60% of the claims). The global resolution timescale was 115.5 days (55-187). The PMEC judged ethical failure in 17 cases (14.2), 10 of them within the private sector. 8 (6.7%) were pending on the date 01-03-2015. 8 cases (6.7%) ended in disciplinary file by the management board, one in verbal amonestation and one was pendent of resolution. Conclusions: the incidence of the medical ethics claims is low, as well as the proportion of disciplinary files. Too many discrepancies exist between the judgements of the PMEC and the college’s management boards