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1.
PLoS One ; 15(8): e0238141, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32866171

RESUMO

Academic dishonesty is a common problem at universities around the world, leading to undesirable consequences for both students and the education system. To effectively address this problem, it is necessary to identify specific predispositions that promote cheating. In Polish undergraduate students (N = 390), we examined the role of psychopathy, achievement goals, and self-efficacy as predictors of academic dishonesty. We found that the disinhibition aspect of psychopathy and mastery-goal orientation predicted the frequency of students' academic dishonesty and mastery-goal orientation mediated the relationship between the disinhibition and meanness aspects of psychopathy and dishonesty. Furthermore, general self-efficacy moderated the indirect effect of disinhibition on academic dishonesty through mastery-goal orientation. The practical implications of the study include the identification of risk factors and potential mechanisms leading to students' dishonest behavior that can be used to plan personalized interventions to prevent or deal with academic dishonesty.


Assuntos
Motivação/fisiologia , Má Conduta Profissional/psicologia , Má Conduta Profissional/estatística & dados numéricos , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Universidades/estatística & dados numéricos , Adulto , Transtorno da Personalidade Antissocial/psicologia , Decepção , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação/ética , Polônia , Má Conduta Profissional/ética , Autoeficácia , Inquéritos e Questionários , Universidades/ética , Adulto Jovem
5.
PLoS One ; 15(5): e0230961, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32374737

RESUMO

Is it appropriate for scientists to engage in political advocacy? Some political critics of scientists argue that scientists have become partisan political actors with self-serving financial agendas. However, most scientists strongly reject this view. While social scientists have explored the effects of science politicization on public trust in science, little empirical work directly examines the drivers of scientists' interest in and willingness to engage in political advocacy. Using a natural experiment involving the U.S. National Science Foundation Graduate Research Fellowship (NSF-GRF), we causally estimate for the first time whether scientists who have received federal science funding are more likely to engage in both science-related and non-science-related political behaviors. Comparing otherwise similar individuals who received or did not receive NSF support, we find that scientists' preferences for political advocacy are not shaped by receiving government benefits. Government funding did not impact scientists' support of the 2017 March for Science nor did it shape the likelihood that scientists donated to either Republican or Democratic political groups. Our results offer empirical evidence that scientists' political behaviors are not motivated by self-serving financial agendas. They also highlight the limited capacity of even generous government support programs to increase civic participation by their beneficiaries.


Assuntos
Comportamento/ética , Financiamento Governamental , Pessoal de Laboratório/ética , Política , Política Ambiental/economia , Política Ambiental/legislação & jurisprudência , Financiamento Governamental/ética , Financiamento Governamental/normas , Programas Governamentais/economia , Programas Governamentais/ética , Programas Governamentais/normas , Política de Saúde/economia , Política de Saúde/legislação & jurisprudência , Humanos , Pessoal de Laboratório/economia , Pessoal de Laboratório/psicologia , Má Conduta Profissional/ética , Política Pública , Setor Público/ética , Publicações/economia , Publicações/ética , Publicações/legislação & jurisprudência , Publicações/normas , Ciência/economia , Ciência/ética , Confiança , Estados Unidos
8.
Ann Thorac Surg ; 109(2): 317-324, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31479640

RESUMO

BACKGROUND: The literature on unprofessional behavior is reviewed. It is well accepted that unprofessional behavior, including a lack of civility and respect, can have a negative impact on patient safety and quality of care. METHODS: We used a focused review in the context of 20 years of experience of assessing, treating, and remediating unprofessional behavior. The review highlights that unprofessional behavior can stem from a variety of sources, including health, psychological/psychiatric issues, social functioning or support, or a combination of these. The review covers the challenges in the work environment and the relationship between outcome, as experienced by the physician, and the likelihood the physician will repeat or modify his or her behavior. RESULTS: Based on the evidence provided in the review and our clinical and research experience, we offer a new framework for the assessment, treatment, and remediation of physicians with professionalism transgressions: the Environmentally Valid Learning Approach. The approach is related to and expands on Miller's Pyramid by adding bio-psycho-social functioning and professional identity to the Pyramid. It emphasizes the dynamic and environmental characteristics of professional identity. CONCLUSIONS: Effective intervention is possible. Consideration of contributory factors, addressing/treating those factors, teaching/remediating skill deficiencies, and determining elements that need to be in place to foster implementation and maintenance of the developing skills are necessary components for successful resolution. The behavior is fully remediated when a self-sustaining alternative to the unprofessional behavior is established and the desired behavior becomes a permanent part of the physician's behavioral repertoire.


Assuntos
Avaliação de Resultados em Cuidados de Saúde , Má Conduta Profissional/ética , Profissionalismo/ética , Cirurgiões/psicologia , Atitude do Pessoal de Saúde , Compreensão , Feminino , Humanos , Relações Interprofissionais , Masculino , Determinação de Necessidades de Cuidados de Saúde , Estados Unidos
10.
Tunis Med ; 97(3): 397-406, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31729714

RESUMO

INTRODUCTION: Corruption in the health care system is a universal phenomenon, putting at risk the health of populations. The purpose of this work was to synthesize the international literature on corruption in the health sector. METHODS: This is a systematic review of literature dealing with articles on health corruption practices, published between July 2008 and June 2018, via two search engines: PubMed and Google Scholar. The extracted data were narratively summarized in three major areas: defining the concept of corruption in health, its typology / manifestations and anti-corruption interventions. RESULTS: A total of 23 articles were selected for final analysis. The articles that defined health corruption shared two key aspects: "abuse of power" and "benefit". The main types of corruption were "abuse of therapeutic indication", followed by "bribes" and "falsification". The anti-corruption interventions were synthesized into seven types: creation of an independent multi-interventional agency, support for scientific research, law enforcement, awareness raising, detection, reporting and institutional commitment. CONCLUSION: Based on the use of power, corruption in health is a complex phenomenon whose struggle requires a specific and contextualized strategy integrating information, detection and punishment.


Assuntos
Assistência à Saúde/ética , Ética Médica , Fraude/estatística & dados numéricos , Acesso aos Serviços de Saúde/ética , Padrões de Prática Médica , Má Conduta Profissional , Acesso à Informação/ética , África do Norte/epidemiologia , Decepção , Assistência à Saúde/economia , Assistência à Saúde/organização & administração , Assistência à Saúde/normas , Fraude/ética , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/normas , Mau Uso de Serviços de Saúde/estatística & dados numéricos , Humanos , Relações Médico-Paciente/ética , Padrões de Prática Médica/ética , Padrões de Prática Médica/estatística & dados numéricos , Má Conduta Profissional/ética , Má Conduta Profissional/estatística & dados numéricos , Charlatanismo/ética , Charlatanismo/estatística & dados numéricos
12.
BMC Pregnancy Childbirth ; 19(1): 231, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277609

RESUMO

BACKGROUND: While there has been a trend for greater number of women to deliver at health facilities across Tanzania, mothers and their family members continue to face mistreatment with respectful maternity care during childbirth being violated. The objective of this study was to describe the experience of mothers and fathers in relation to (mis) treatment during childbirth in Tanzania. METHODS: Using a qualitative descriptive design, 12 semi-structured interviews and four focus group discussions were held with mothers and fathers who were attending a postnatal clinic in the Lake Zone region of Tanzania. Mothers' age ranged from 20 to 45 years whereas fathers' age ranged from 25 to 60 years. Data were analyzed using a priori coding based on Bohren's et al. typology of the mistreatment of women during childbirth. RESULTS: Mothers reported facing mistreatment and disrespectful maternity care through verbal abuse (harsh or rude language and judgmental or accusatory comments), failure to meet professional standards of care (refused pain relief, unconsented surgical operations, neglect, abandonment or long delays, and skilled attendant absent at time of delivery), poor rapport between women and providers (poor communication, lack of supportive care, denied husbands presence at birth, denied mobility, denied safe traditional practices, no respect for their preferred birth positions), and health system conditions and constraints (poor physical condition of facilities, supply constraints, bribery and extortion, unclear fee structures). Despite some poor care, some mothers also reported positive birthing experiences and respectful maternity care by having a skilled attendant assistance at delivery, having good communication from nurses, receiving supportive care from nurses and privacy during delivery. CONCLUSION: Despite the increasing number of deliveries occurring in the hospital, there continue to be challenges in providing respectful maternity care. Humanizing birth care in Tanzania continues to have a long way to go, however, there is evidence that changes are occurring as mothers notice and report positive changes in delivery care practices.


Assuntos
Serviços de Saúde Materna , Parto/psicologia , Direitos do Paciente , Satisfação do Paciente , Má Conduta Profissional , Relações Profissional-Paciente , Adulto , Atitude do Pessoal de Saúde , Pai/psicologia , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Serviços de Saúde Materna/ética , Serviços de Saúde Materna/normas , Pessoa de Meia-Idade , Mães/psicologia , Direitos do Paciente/ética , Direitos do Paciente/normas , Gravidez , Má Conduta Profissional/ética , Relações Profissional-Paciente/ética , Pesquisa Qualitativa , Tanzânia
13.
BMC Med Educ ; 19(1): 218, 2019 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-31215454

RESUMO

BACKGROUND: Ethical behavior and professionalism is an ideal characteristic required of medical students and included as 'must achieve' and critical aspect of medical students' curriculum. This study proposes to determine the perceived unethical and unprofessional behavior among medical students in a private medical university from year 1 to year 5 of the medical curriculum. METHODS: A cross-sectional study was conducted among year 1 to year 5 medical students in a private medical university. A self-administered questionnaire was used with the 3 major domains of professionalism and ethics i.e. discipline plagiarism and cheating. RESULTS: A total of 464 respondents responded to the survey and they included medical students from year 1 and year 2 (pre-clinical) and years 3-5 (clinical years). Majority of the students, 275 (59.2%) answered that they had not seen any form of unethical behavior among other students. The females seem to have a larger number 172(63%) among the same gender compared to the males. Majority 352 (75%) of them had not heard of the 'Code of Professional Conduct by the Malaysian Medical Council'. About fifty three (53.1%) of the students answered that the training was sufficient. CONCLUSIONS: This study showed that the perception of unethical behavior was 58.8% in the 1st year (pre-clinical) and it increased to 65.2% in the 5th year (clinical). The 3 main discipline issues were students do not show interest in class (mean 2.9/4), they are rude to other students (mean 2.8/4) and talking during class (mean 2.6/4). Despite the existence of unethical behavior among the students majority of them (71.7%) claimed that they had adequate training in ethics and professionalism. It is proposed that not only the teaching of ethics and professionalism be reviewed but an assessment strategy be introduced to strengthen the importance of professionalism and ethics.


Assuntos
Educação de Graduação em Medicina/ética , Má Conduta Profissional/ética , Profissionalismo/ética , Estudantes de Medicina/psicologia , Universidades , Estudos Transversais , Feminino , Humanos , Malásia , Masculino , Princípios Morais , Plágio , Competência Profissional , Má Conduta Profissional/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Adulto Jovem
14.
R I Med J (2013) ; 102(2): 36-38, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30823699

RESUMO

Boundary violations are serious occurrences that result in a breach of the physician-patient relationship. Boundary violations are regulated by the Rhode Island Board of Medical Licensure and Discipline (Board). A review of all disciplinary actions from 2012 through 2018 involving physicians found boundary violations relating to sexual misconduct the most common boundary violations. All disciplinary actions that pertained to boundary violations were isolated, and trends regarding gender, medical specialty, and outcome of action were assessed. Sexual boundary violations (n=15) represented 94% of all boundary violations during this time period. Psychiatrists (31.3%), internists (25%) and family medicine physicians (18.8%) were the most common specialties of those who had boundary issues. Loss of license occurred for all physicians who had sexual intercourse with a patient. Reinstatement of license was possible for some physicians after a comprehensive forensic psychiatry evaluation. Physicians are reminded of the ethical obligations we have to our patients and the profession and to maintain a professional relationship with their patients at all times. This type of professional misconduct is preventable and avoids injury to patients and to the medical profession. [Full article available at http://rimed.org/rimedicaljournal-2019-03.asp].


Assuntos
Relações Médico-Paciente/ética , Médicos/estatística & dados numéricos , Má Conduta Profissional/ética , Má Conduta Profissional/estatística & dados numéricos , Atitude do Pessoal de Saúde , Feminino , Humanos , Masculino , Qualidade da Assistência à Saúde , Rhode Island
15.
Am J Bioeth ; 19(1): 16-34, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30676904

RESUMO

Serious ethical violations in medicine, such as sexual abuse, criminal prescribing of opioids, and unnecessary surgeries, directly harm patients and undermine trust in the profession of medicine. We review the literature on violations in medicine and present an analysis of 280 cases. Nearly all cases involved repeated instances (97%) of intentional wrongdoing (99%), by males (95%) in nonacademic medical settings (95%), with oversight problems (89%) and a selfish motive such as financial gain or sex (90%). More than half of cases involved a wrongdoer with a suspected personality disorder or substance use disorder (51%). Despite clear patterns, no factors provide readily observable red flags, making prevention difficult. Early identification and intervention in cases requires significant policy shifts that prioritize the safety of patients over physician interests in privacy, fair processes, and proportionate disciplinary actions. We explore a series of 10 questions regarding policy, oversight, discipline, and education options. Satisfactory answers to these questions will require input from diverse stakeholders to help society negotiate effective and ethically balanced solutions.


Assuntos
Análise Ética , Ética Médica , Prescrição Inadequada/estatística & dados numéricos , Licenciamento em Medicina/legislação & jurisprudência , Imperícia/estatística & dados numéricos , Médicos/legislação & jurisprudência , Má Conduta Profissional/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Disciplina no Trabalho , Humanos , Prescrição Inadequada/ética , Prescrição Inadequada/legislação & jurisprudência , Licenciamento em Medicina/ética , Licenciamento em Medicina/estatística & dados numéricos , Imperícia/legislação & jurisprudência , Médicos/ética , Má Conduta Profissional/ética , Má Conduta Profissional/legislação & jurisprudência , Delitos Sexuais/ética , Delitos Sexuais/legislação & jurisprudência , Estados Unidos
16.
J Zhejiang Univ Sci B ; 20(1): 32-38, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30614228

RESUMO

The rapid developments of science and technology in China over recent decades, particularly in biomedical research, have brought forward serious challenges regarding ethical governance. Recently, Jian-kui HE, a Chinese scientist, claimed to have "created" the first gene-edited babies, designed to be naturally immune to the human immunodeficiency virus (HIV). The news immediately triggered widespread criticism, denouncement, and debate over the scientific and ethical legitimacy of HE's genetic experiments. China's guidelines and regulations have banned germline genome editing on human embryos for clinical use because of scientific and ethical concerns, in accordance with the international consensus. HE's human experimentation has not only violated these Chinese regulations, but also breached other ethical and regulatory norms. These include questionable scientific value, unreasonable risk-benefit ratio, illegitimate ethics review, invalid informed consent, and regulatory misconduct. This series of ethical failings of HE and his team reveal the institutional failure of the current ethics governance system which largely depends on scientist's self-regulation. The incident highlights the need for urgent improvement of ethics governance at all levels, the enforcement of technical and ethical guidelines, and the establishment of laws relating to such bioethical issues.


Assuntos
Edição de Genes/ética , Sistemas CRISPR-Cas , China , Termos de Consentimento/ética , Ética Médica , Feminino , Edição de Genes/legislação & jurisprudência , Técnicas de Inativação de Genes/ética , Infecções por HIV/genética , Infecções por HIV/imunologia , Infecções por HIV/prevenção & controle , Experimentação Humana/ética , Experimentação Humana/legislação & jurisprudência , Humanos , Recém-Nascido , Gravidez , Má Conduta Profissional/ética , Receptores CCR5/deficiência , Receptores CCR5/genética
18.
Monash Bioeth Rev ; 36(1-4): 23-35, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30593648

RESUMO

The ethical issues associated with germline gene modification and embryo research are some of the most contentious in current international science policy debates. In this paper, we argue that new genetic techniques, such as CRISPR, demonstrate that there is an urgent need for China to develop its own regulatory and ethical framework governing new developments in genetic and embryo research. While China has in place a regulatory framework, it needs to be strengthened to include better compliance oversight and explicit criteria for how different types of research should be reviewed by regulatory authorities. We also document a variety of opinions about the new technologies among the public, scholars, and policy makers. China needs to develop its own regulations in coordination with other countries; but it is unlikely that an international consensus will be achieved in this area, given the existing differences in regulations between countries. We should aim at harmonization, not necessarily complete consensus, and the perspective from China is vital when international norms are developed and harmonized. Chinese policy makers and researchers need to be aware of the international discussions, at the same time as the international community is aware of, and accommodates, Chinese positions on important policy options.


Assuntos
Edição de Genes/ética , Experimentação Humana/ética , Técnicas de Reprodução Assistida/ética , Genética Médica/ética , Humanos , Má Conduta Profissional/ética
19.
Fertil Steril ; 110(6): 1012-1016, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30396537

RESUMO

Professionals who discover misconduct or other undisclosed information that would be material to the participation of another party (such as a donor, gestational carrier, intended parent, or lawyer) in an assisted reproductive technology arrangement should encourage disclosure to that party. In some instances, it is ethically permissible for the physician either to disclose material information to the affected party or to decline to provide care. In all cases involving the legal status or rights of the parties, referral to legal professionals is advised. This document replaces the document of the same name, last published in 2014 (Fertil Steril 2014;101:38-42).


Assuntos
Comissão de Ética/ética , Má Conduta Profissional/ética , Técnicas de Reprodução Assistida/ética , Consentimento do Representante Legal/ética , Doação Dirigida de Tecido/ética , Doação Dirigida de Tecido/legislação & jurisprudência , Comissão de Ética/legislação & jurisprudência , Feminino , Humanos , Masculino , Papel do Médico , Má Conduta Profissional/legislação & jurisprudência , Técnicas de Reprodução Assistida/legislação & jurisprudência , Mães Substitutas/legislação & jurisprudência , Consentimento do Representante Legal/legislação & jurisprudência
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