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1.
Rev Med Chil ; 149(3): 458-463, 2021 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-34479325

RESUMO

BACKGROUND: The recognition of ethical problems in medical practice and the potential harmful effects that they may have on patients, underscores the importance of the ethical training of professionals as well as the development of Ethics Committees in Healthcare institutions. However, there is a paucity of national studies about the type of problems faced by professionals and the role of Ethics Committees in hospitals. AIM: To explore the perception about ethical problems in clinical practice of Chilean physicians of different specialties of two public teaching hospitals. MATERIAL AND METHODS: Physicians of both sexes and different specialties working in two teaching hospitals of Metropolitan Santiago, were invited to participate in focus groups of seven to eight participants. They discussed the ethical problems faced during their clinical practice. A content analysis based on the Grounded Theory was performed with the obtained information. RESULTS: Different types of ethical problems could be distinguished according to their content and the actors involved. The data obtained shows that the ethical dimension is present in the daily work of physicians. The evolution of the narrative throughout the interviews corroborated the importance of installing ethical issues and culture in the working routine of health care professionals. CONCLUSIONS: Human resources and an adequate institutional environment are required to promote the discussion about ethical issues such as the relationship between physicians and patient, the role of teaching in health care and institutional decisions.


Assuntos
Médicos , Atenção à Saúde , Feminino , Pessoal de Saúde , Hospitais Públicos , Humanos , Masculino , Princípios Morais
2.
BMC Public Health ; 21(1): 1567, 2021 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-34407781

RESUMO

BACKGROUND: Public health (PH) practitioners have a strong moral commitment to health equity and social justice. However, PH values often do not align with health systems values, making it challenging for PH practitioners to promote health equity. In spite of a growing range of PH ethics frameworks and theories, little is known about ethical concerns related to promotion of health equity in PH practice. The purpose of this paper is to examine the ethical concerns of PH practitioners in promoting health equity in the context of mental health promotion and prevention of harms of substance use. METHODS: As part of a broader program of public health systems and services research, we interviewed 32 PH practitioners. RESULTS: Using constant comparative analysis, we identified four systemic ethical tensions: [1] biomedical versus social determinants of health agenda; [2] systems driven agendas versus situational care; [3] stigma and discrimination versus respect for persons; and [4] trust and autonomy versus surveillance and social control. CONCLUSIONS: Naming these tensions provides insights into the daily ethical challenges of PH practitioners and an opportunity to reflect on the relevance of PH frameworks. These findings highlight the value of relational ethics as a promising approach for developing ethical frameworks for PH practice.


Assuntos
Equidade em Saúde , Promoção da Saúde , Humanos , Princípios Morais , Saúde Pública , Justiça Social
3.
J Int Bioethique Ethique Sci ; Vol. 32(1): 61-74, 2021 May 24.
Artigo em Espanhol | MEDLINE | ID: mdl-34378885

RESUMO

The Artavia Murillo v. Costa Rica judgement wants to make the Convention say the opposite of what it clearly states: that one is a person from the moment of conception. Contrary to what the Inter-American Court maintains, conduct cannot be ethical if it is not based on criteria of justice, and the concept of justice is based on reality.In order to know how to treat something, it is first necessary to know what the thing – in reality – is. Then it is necessary to treat it as it is in reality: to treat each thing as it should be treated, according to its being.Human life cannot be treated like animal or vegetable life. Human life is superior. The capacity to will and to understand give it an exclusive nobility characterized by freedom. It must therefore be treated in accordance with its dignity.For treatment to be dignified, it must first prevent the destruction of its object (abortion). The principle of preservation applies. Once its reality, its being, has been preserved, its integrity must be respected. The violation of integrity is the removal of part of the being. Then we must respect its nature, which presupposes the idea of an end according to the operations that are proper to it. If we maintain that human life is an end in itself, it cannot be instrumentalized. This rule is universally accepted in the Western world from the ethical point of view, and it is the application of the golden rule of Kantian ethics: “treat the human being as an end in itself”; “treat others as I would like to be treated myself”.The concept of personhood is not fundamental to assigning special dignity to human life. It is its consequence. Personhood is an essential attribute of human life. It is the attribute that best corresponds to it. However, recent legal systems have not granted personal status to unborn life because they are old norms. They come from times when science was not able to prove its existence. Their evolution is hindered by scientific hesitations created by the dispute between different criteria. But this discussion does not make sense, it should not exist. If there is any doubt, whatever it may be, one must pronounce oneself in favour of life. This must be an essential principle of today’s bioethics – derived from the primum non nocere – and therefore, of the law based on it, and in particular that provided for in the Inter-American Convention.


Assuntos
Bioética , Pessoalidade , Costa Rica , Feminino , Humanos , Princípios Morais , Gravidez , Estados Unidos
4.
Artigo em Inglês | MEDLINE | ID: mdl-34444260

RESUMO

Some organisations, and some individual humans, violate moral and ethical rules, whether or not they are written down in laws or codes of conduct. Corporate transgressions, as this behaviour is called, occur because of the actions of those in charge, usually bright and dedicated people. Immoral and unethical conduct can adversely affect the safety of workers, the general public and the environment. A scoping review method for a literature search is used to explore morality and ethics in relation to health and safety management. Our findings show that controlling the risks associated with misconduct and corporate transgression is not usually seen as a responsibility allocated to safety systems but is left to general management and corporate governance. The moral and ethical principles, however, can be applied in safety management systems to prevent misconduct and transgression-related safety risks. Our results show that ethical leadership, ethical behaviour, sustaining an ethical climate and implementation of an ethical decision-making process emerge as key preventive measures. The discussion presents a proposed way to include these measures in safety management systems. Conclusion and recommendations underline that unwanted behaviour and transgression risks can be brought under control, starting from a set of best practices. Not only the managers themselves but also board members, independent external supervisors and government regulators need to embrace these practices.


Assuntos
Obrigações Morais , Princípios Morais , Humanos , Liderança , Gestão da Segurança
5.
Artigo em Inglês | MEDLINE | ID: mdl-34444344

RESUMO

This study aims to review and quantify the value of several well-established positive leadership styles for employee work engagement in organizations. We perform both a quantitative and qualitative review (k = 86). Our (moderated) meta-analysis indicates that transformational, authentic, empowering, ethical, and servant leadership all share overlap in confidence and credibility intervals, and they may result in the same effect on work engagement (general r = 0.47). Additional theoretical analysis indicated a common ground within these positive leadership styles, i.e., having a moral perspective as a leader, role-modelling behaviour, follower self-determination, and positive social exchanges with employees. Based on the studies in the sample, we also build an integrative research model with several categories of mediators and moderators that have a well-established impact on work engagement. The moderator categories were follower characteristics and team- and organizational-level moderators. The mediator categories were psychological needs, trust, resources, and organizational-level variables. The combination of a meta-analysis with systematic review and research model can facilitate future research and supports practitioners to improve leadership.


Assuntos
Liderança , Engajamento no Trabalho , Princípios Morais , Autonomia Pessoal , Confiança
6.
Rev Infirm ; 70(273): 46-47, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34446238

RESUMO

Clinical ethics can be conceived as thought marked by uncertainty and on uncertainty. Its difficulties must be highlighted and discussed, in order to help guide the actions of caregivers, both on a scientific and human level, for the benefit of the patient. As an intellectual and moral virtue, humility is likely to favour a high standard of reflection and action.


Assuntos
Ética Clínica , Princípios Morais , Cuidadores , Humanos , Incerteza
7.
Comput Biol Med ; 135: 104660, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34346319

RESUMO

The growth of artificial intelligence in promoting healthcare is rapidly progressing. Notwithstanding its promising nature, however, AI in healthcare embodies certain ethical challenges as well. This research aims to delineate the most influential elements of scientific research on AI ethics in healthcare by conducting bibliometric, social network analysis, and cluster-based content analysis of scientific articles. Not only did the bibliometric analysis identify the most influential authors, countries, institutions, sources, and documents, but it also recognized four ethical concerns associated with 12 medical issues. These ethical categories are composed of normative, meta-ethics, epistemological and medical practice. The content analysis complemented this list of ethical categories and distinguished seven more ethical categories: ethics of relationships, medico-legal concerns, ethics of robots, ethics of ambient intelligence, patients' rights, physicians' rights, and ethics of predictive analytics. This analysis likewise identified 40 general research gaps in the literature and plausible future research strands. This analysis furthers conversations on the ethics of AI and associated emerging technologies such as nanotech and biotech in healthcare, hence, advances convergence research on the ethics of AI in healthcare. Practically, this research will provide a map for policymakers and AI engineers and scientists on what dimensions of AI-based medical interventions require stricter policies and guidelines and robust ethical design and development.


Assuntos
Inteligência Artificial , Atenção à Saúde , Bibliometria , Instalações de Saúde , Humanos , Princípios Morais
8.
New Bioeth ; 27(3): 266-284, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34355660

RESUMO

Babylon 5, like other great sci-fi franchises, touched on important ethical questions. Two ethical conundrums relating to the series' main characters included providing life-saving treatment to a child against their parents' wishes and potential involvement with a highly beneficial but morally dubious medication. I use these cases to discuss some aspects of the COVID-19 vaccines' development and roll-out, demonstrating that people (be it patients or clinicians) might object to some vaccines due to reasonable ethics and safety-based concerns rather than due to an anti-vaxxer mind-set. I highlight that it would be disingenuous to lump these two groups of objections together for not all objections to specific vaccines are objections to vaccination in general. Rather, governments and pharmaceutical companies should seriously engage with the concerns of reasonable objectors to provide citizens with the appropriate products and ensure large vaccination uptake - in the case of COVID-19 this should include giving patients the choice of the product they will be inoculated with.


Assuntos
COVID-19/prevenção & controle , Consciência , Recusa do Médico a Tratar/ética , Vacinas contra COVID-19/administração & dosagem , Criança , Drama , Humanos , Princípios Morais , Segurança do Paciente
9.
Acta Psychol (Amst) ; 219: 103392, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34399140

RESUMO

The present preregistered study investigated the relationship between personality traits and third-party moral judgment, with specific predictions about honesty-humility, emotionality, and conscientiousness. Participants (N = 405) completed the HEXACO personality questionnaire and read short narratives describing the interaction between an agent and a victim. We manipulated the intent of the agent (harmful or neutral) and the outcome for the victim (harmful or neutral) and participants judged the agent's behavior. While higher honesty-humility was associated with harsher judgment overall, higher emotionality was associated with harsher judgment of a malevolent agent, and higher conscientiousness was associated with harsher judgment of an agent who harmed intentionally. The results thus suggest that third-party moral judgment is selectively related to personality traits depending on the agent's intention.


Assuntos
Julgamento , Princípios Morais , Humanos , Intenção , Narração , Personalidade
10.
Artigo em Inglês | MEDLINE | ID: mdl-34444023

RESUMO

The purpose of this research is to empirically examine relationships between a multi-dimensional set of corporate social responsibility (CSR) initiatives, numerous dimensions of customer trust, and corporate image in an emerging economy. It also analyzes the mediating effect of customer trust on the relationship between CSR and corporate image. This study focuses on two of the most well-known hotel chains situated in Pakistan. Close-ended, self-administered questionnaires were circulated amongst a total of 300 hotel customers. The research data was analyzed using a partial least square-structural equation modeling (PLS-SEM) model. The results revealed that economic, legal, and ethical CSR significantly impacted corporate image, while philanthropic CSR did not affect the corporate image. However, economic, legal, and philanthropic CSRs were found to be in a significant relationship with customer trust, while ethical CSR was not in a significant relationship with customer trust. Finally, customer trust fully mediated the relationship between economic and legal CSR with corporate image, whereas it partially mediated the relationship between ethical and philanthropic CSR. This study is unique from earlier CSR research based on an assessment of the connection between CSR dimensions and corporate image to examine customers' trust in an emerging economy, especially in times of crisis.


Assuntos
Responsabilidade Social , Confiança , Princípios Morais , Organizações , Inquéritos e Questionários
11.
Artigo em Inglês | MEDLINE | ID: mdl-34444104

RESUMO

During the COVID-19 pandemic, the market environment for the information technology (IT) industry changed dramatically, presenting companies with numerous obstacles in day-to-day management activities and changing business needs. Previous studies found that job insecurity due to COVID-19 significantly impacted millennials. Our research explored the effect of job insecurity on counterproductive work behavior among millennial employees during the COVID-19 period, using moral disengagement as a mediating variable, and psychological capital and negative emotions as moderating variables. In this study, 298 employees working in Chinese IT companies completed the questionnaire survey. We collected data from employees over three different time intervals (baseline, three weeks later, and six weeks later) to mitigate the issues of common method bias and single-source data. We analyzed the collected data using SPSS25.0 and Amos24.0 for structural modeling. Our research results indicate that job insecurity is positively associated with counterproductive work behavior, and moral disengagement plays a mediating role. In addition, psychological capital moderates the relationship between job insecurity, moral disengagement, and counterproductive work behavior. Negative emotions also moderate the mediating effect of moral disengagement between job insecurity and CWB.


Assuntos
COVID-19 , Pandemias , Emprego , Humanos , Satisfação no Emprego , Princípios Morais , SARS-CoV-2
12.
Artigo em Inglês | MEDLINE | ID: mdl-34444469

RESUMO

BACKGROUND: Sudden changes in clinical practice and the altered ability to care for patients due to the COVID-19 pandemic have been associated with moral distress and mental health concerns in healthcare workers internationally. This study aimed to investigate the severity, prevalence, and predictors of moral distress experienced by Australian healthcare workers during the COVID-19 pandemic. METHODS: A nationwide, voluntary, anonymous, single time-point, online survey of self-identified frontline healthcare workers was conducted between 27th August and 23rd October 2020. Participants were recruited through health organisations, professional associations, or colleges, universities, government contacts, and national media. RESULTS: 7846 complete responses were received from nurses (39.4%), doctors (31.1%), allied health staff (16.7%), or other roles (6.7%). Many participants reported moral distress related to resource scarcity (58.3%), wearing PPE (31.7%) limiting their ability to care for patients, exclusion of family going against their values (60.2%), and fear of letting co-workers down if they were infected (55.0%). Many personal and workplace predictors of moral distress were identified, with those working in certain frontline areas, metropolitan locations, and with prior mental health diagnoses at particular risk of distress. Moral distress was associated with increased risk of anxiety, depression, post-traumatic stress disorder, and burnout. Conversely, feeling appreciated by the community protected against these risks in healthcare workers. CONCLUSIONS: Safeguarding healthcare workforces during crises is important for both patient safety and workforce longevity. Targeted interventions are required to prevent or minimise moral distress and associated mental health concerns in healthcare workers during COVID-19 and other crises.


Assuntos
COVID-19 , Pandemias , Austrália/epidemiologia , Estudos Transversais , Pessoal de Saúde , Humanos , Saúde Mental , Princípios Morais , SARS-CoV-2
13.
Artigo em Inglês | MEDLINE | ID: mdl-34360328

RESUMO

Research on morality has focused on differences in moral judgment and action. In this study, we investigated self-reported moral reasoning after a hypothetical moral dilemma was presented on paper, and moral reasoning after that very same dilemma was experienced in immersive virtual reality (IVR). We asked open-ended questions and used content analysis to determine moral reasoning in a sample of 107 participants. We found that participants referred significantly more often to abstract principles and consequences for themselves (i.e., it is against the law) after the paper-based moral dilemma compared to the IVR dilemma. In IVR participants significantly more often referred to the consequences for the people involved in the dilemma (i.e., not wanting to hurt that particular person). This supports the separate process theory, suggesting that decision and action might be different moral concepts with different foci regarding moral reasoning. Using simulated moral scenarios thus seems essential as it illustrates possible mechanisms of empathy and altruism being more relevant for moral actions especially given the physical presence of virtual humans in IVR.


Assuntos
Realidade Virtual , Empatia , Humanos , Julgamento , Princípios Morais , Resolução de Problemas
14.
Artigo em Inglês | MEDLINE | ID: mdl-34360430

RESUMO

In the field of organizational behavior, the influence of leadership in organizations and the organizational citizenship behavior (OCB) of employees have always been two hot topics studied by scholars. However, previous studies have mainly examined the OCB of baby boomers and Generation Xers. With millennials now entering the workforce, they will highly likely not take the initiative to engage in OCB due to their different values. Scholars have found that millennials respond well to ethical leadership. Although this statement has a theoretical basis, empirical research regarding this topic is still insufficient. Thus, this study explores whether ethical leadership can effectively promote millennials' OCB. Moreover, the mediating effect of group-level ethical climate and individual-level affective well-being, and the moderating effect of individual-level moral identity, were examined. The study hypotheses were verified based on 384 valid questionnaires collected from 61 teams using Mplus 8.3. The results showed that (1) ethical leadership was a positive predictor of millennials' OCB; (2) ethical climate and affective well-being partially mediated the relationship between ethical leadership and OCB; and (3) moral identity moderated the relationship between ethical leadership and affective well-being and the indirect impact of ethical leadership on OCB. These findings provide empirical support for applying social learning theory, social information processing theory, and conservation of resources (COR)theory. This research also provides several managerial implications through which managers can more effectively improve the OCB of millennial employees.


Assuntos
Liderança , Comportamento Social , Humanos , Princípios Morais , Organizações , Inquéritos e Questionários
15.
AMA J Ethics ; 23(7): E580-581, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34351270

RESUMO

This acrylic painting considers intimacy and its ethical demands during our personal and professional encounters with one another, drawing on Pablo Picasso's 1907 Head of the Medical Student.


Assuntos
Pinturas , Estudantes de Medicina , Ética Médica , Humanos , Princípios Morais , Comportamento Sexual , Parceiros Sexuais
16.
Dimens Crit Care Nurs ; 40(5): 301-307, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34398568

RESUMO

BACKGROUND: Moral distress (MD) has been linked to health care professional burnout, intent to leave, and decreased quality of care. OBJECTIVES: The aim of this study was to describe the perceptions of MD among critical care interdisciplinary team members and assess the association of MD with team member characteristics. METHODS: A descriptive cross-sectional design was used with interdisciplinary team members in an intensive care unit setting at an NCI-designated Comprehensive Cancer Center in the southeastern United States. The Measure of Moral Distress for Healthcare Professionals was provided to registered nurses, oncology technicians, providers, respiratory therapists, and ancillary team members (social workers, pharmacists, dietitians). RESULTS: A total of 67 team members completed the survey. Mean responses for 3 items were higher than 8 (halfway point of scale): "Follow family's insistence to continue aggressive treatment even though I believe it is not in the best interest of patient" (mean [SD], 11.4 [4.8]); "Continue to provide aggressive treatment for a patient most likely to die regardless of this treatment when no one will make a decision to withdraw it" (mean [SD], 10.5 [5.3]); and "Witness providers giving 'false hope' to patient/family" (mean [SD], 9.0 [5.3]). Higher responses on the "Continuing to provide aggressive treatment" item was associated with having "considered leaving due to MD" (P = .027) and "considering leaving now due to MD" (P = .016). Higher total scores were related to having left or considered leaving a job (P = .04). When examining education level, registered nurses with a master's degree (n = 5) exhibited the most MD (P = .04). CONCLUSION: This study suggests that the Measure of Moral Distress for Healthcare Professionals is useful in identifying areas for focused efforts at reducing MD for interdisciplinary teams.


Assuntos
Esgotamento Profissional , Neoplasias , Atitude do Pessoal de Saúde , Cuidados Críticos , Estudos Transversais , Humanos , Princípios Morais
17.
Span J Psychol ; 24: e42, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34384509

RESUMO

Analyze whether the content of three moral messages (deontological, ethical utilitarianism, ethical virtue) and a control message differentially affect the probability of engaging in four behaviors: Washing their hands, participating in public gatherings, staying at home/avoiding social contact, and forwarding the message to inform more people. In our study, the sender of the message is a university professor. These variables are measured in terms of their behavioral intentions and others' behavioral intentions (beliefs about others' behavior). Randomized Controlled Trial. Our study includes the analysis of the possible moderating effect of the country of residence (Spain n = 1,122, Chile n = 1,107, and Colombia n = 1,433). The message with content referring to ethical virtue and staying at home obtains statistically significant lower scores on the probability of carrying out public health behaviors and sharing the message received. Regarding beliefs about the behavior of others, the message of ethical virtue has the same negative effect, but only on the likelihood of other people washing their hands, staying at home, and sharing the public health message. Institutional messages aimed at promoting public health behaviors are necessary in a pandemic situation. Our recommendation is to use deontological and utilitarian, or non-moral, content.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Desinfecção das Mãos , Promoção da Saúde , Princípios Morais , Comunicação Persuasiva , Saúde Pública , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Chile , Colômbia , Teoria Ética , Ética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distanciamento Físico , Política Pública , SARS-CoV-2 , Espanha , Virtudes , Adulto Jovem
18.
J Contin Educ Nurs ; 52(9): 429-437, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34432577

RESUMO

BACKGROUND: Moral and professional values vary among cultures. The purpose of this study was to explore the moral and professional values of registered nurses at a university medical center in a Middle Eastern country and determine the relationship among formal ethics education, background variables (age, gender, nursing degree, regular daily prayer), and nurses' professional and moral values. METHOD: A cross-sectional survey method with 123 nurses was used. Data on background variables, moral and professional values, and confidence in ethical decision-making were assessed. RESULTS: Professional values were significantly higher among older nurses and nurses with master's degrees compared with younger nurses and nurses with bachelor's degrees. Daily prayer was related to higher mean scores for moral values. Nurses were confident in their ethical decision-making; however, formal education in ethics did not influence professional or moral values. CONCLUSION: Although formal education in ethics did not influence the professional or moral values of nurses in Lebanon, this finding does not negate the need for future studies to investigate the content and duration of ethics education that is likely to affect professional or moral values. [J Contin Educ Nurs. 2021;52(9):429-437.].


Assuntos
Ética em Enfermagem , Enfermeiras e Enfermeiros , Estudos Transversais , Humanos , Líbano , Princípios Morais
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