Problems Of Ethics

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Read about the latest changes. A framework to help resolve ethical problems starting with identifying the problems and parties involved to implementing the course of action and monitoring its progress. The ethics advisory team has also developed a Resolving ethical issues flowchart to help members resolve ethical issues as they arise. When faced with an ethical issue, it may be in your best interests to document your thought processes, discussions and the decisions taken. Written records will be useful if you need to justify your course of action.

In addition to ICAEW's framework for revolving ethical problems, there are a number of other frameworks for resolving such problems which you may find helpful. Skip to content. Home Resources Ethics Framework for resolving ethical problems. Framework for resolving ethical problems A framework to help resolve ethical problems starting with identifying the problems and parties involved to implementing the course of action and monitoring its progress.

View the flowchart ICAEW framework - how to resolve ethical problems 1 Gather the relevant facts and identify the problems Do I have all the facts relevant to the situation? Am I making assumptions? If so, could facts be identified to replace these assumptions? Is it really your problem? Can anybody else help?

In what way are they affected? Are there conflicts between different stakeholders? Informed consent is the major ethical issue in conducting research. According to Armiger: "it means that a person knowingly, voluntarily and intelligently, and in a clear and manifest way, gives his consent". Informed consent is one of the means by which a patient's right to autonomy is protected.

Frank Jackson

Beauchamp and Childress define autonomy as the ability for self determination in action according to a personal plan. It also seeks to prevent assaults on the integrity of the patient and protect personal liberty and veracity. In this study, rural black men were chosen as subjects in a study of syphilis.

Although a cure for syphilis was found after the start of the study, it was decided not to treat them and they had not been told that penicillin was effective to their disease.

He must also provide a "Noncoersive Disclaimer" which states that participation is voluntary and no penalties are involved in refusal to participate. The researcher must also take into account that persons with physical, cultural and emotional barriers may require a very simple language in order to understand him. The Declaration of Helsinki provide some help as it declares that the interest of the subject must always prevail over the interests of society and science.

Another major ethical issue is obtaining an informed consent from groups with diminished autonomy which will be further discussed later. From what has been discussed, it becomes clear that disclosure, comprehension, competency and voluntariness are the four essential parts of a consent. The ethical principle of beneficence refers to the Hippocratic "be of benefit, do not harm".

Beauchamp and Childress, suggest that. Beneficence is sometimes difficult to predict when creating a hypothesis especially in qualitative research. Carr says that if the research findings prove that it was not beneficial as it s expected, this can raise immense ethical considerations especially for nurses. According to Burns and Grove "discomfort and harm can be physiological, emotional, social and economic in nature".

When a researcher tries to learn intimate details of the participants lives he has to deal with opening old wounds. A researcher must consider all possible consequences of the research and balance the risks with proportionate benefit. The type, degree, and number of potential risks must be assessed as well as the patients value system which ranks various harms. If the risks outweigh the benefits, the study should be revised. Last, debriefing at the end of a study, should be mentioned.

Treece and Treece say that debriefing refers to explaining the exact aim of the study and why the disclosure was not full. The issue of confidentiality and anonymity is closely connected with the rights of beneficence, respect for the dignity and fidelity. If the researcher is not able to promise anonymity he has to address confidentiality, which is the management of private information by the researcher in order to protect the subject's identity.

Clarke addresses the ethical dilemma of the researcher when confidentiality must be broken because of the moral duty to protect society. According to the utilitarian theory, which focuses on the best interest of all involved, the happiness of society is of greater importance. On the other hand, the deontological theory which ignores the result implies that the moral duty is what really matters. If a researcher, though, acts deontologically he may feel that he has not protected society.

Another issue is that the researcher may have to report confidential information to courts which can also cause. In that cases it can be argued that the moral duty and personal ethos can be stronger than legal requirements.

What are the most important moral problems of our time? - Will MacAskill

Ford and Reutter suggest using pseudonyms and distorting identifying details of interviews when transcribing the tapes used. In situations that are particularly complex, sensitive, and in which the participants are extremely vulnerable, a Certificate of Confidentiality issued by the U. Department of Health and Human Services DHHS may be useful to help ensure the privacy of research participants especially in studies in which participants and researchers may be exposed to compelled legal disclosure of research data.

The researchers must always bear in mind all psychological and social implications that a breach of confidentiality may have on subjects. In order to protect participants, they have to inform them on their rights, and use all possible coding systems that they regard appropriate in each case. The fifth principle of the entitled "A Patient's Bill of rights" document published in by the American Hospital Association AHA , affirm the patient's right of privacy. Kelman believes that an invasion of privacy happens when private information such as beliefs, attitudes, opinions and records, is shared with others, without the patients knowledge or consent.

A researcher cannot decide on behalf of other persons on those delicate issues. All aims, instruments and methodology must be discussed with the prospective subject and the research workers prior to the investigation. Treece and Treece suggest that whenever subjects refuse to report personal information as they regard it an invasion of privacy, the researcher ought to respect their views.

They also imply that privacy can be invaded when researchers study certain groups without their knowledge and without identifying themselves. An example of such a study that the researcher hid his identity, was Humphrie's study "Impersonal Sex in public places" in which, he observed homosexuals during sexual activities in public men's rooms.

Nowadays, there is an increased concern about vulnerable groups and whether it is ethical or not for them to be used as research subjects. The different opinions about their participation in research can be attributed to their inability to give an informed consent and also to their need for further protection and sensitivity from the researcher as they are in a greater risk of being deceived, threatened or forced to participate.

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Location Problem for Ethics: Moral Properties and Moral Content - Oxford Scholarship

Many are in favour of the use of such subjects in research whilst others would argue strongly against it. Most condition their responses according to the seriousness of the research, the level of potential risk and the availability of alternatives. Persons with diminished autonomy are also more vulnerable to invasion of privacy, since their right to privacy is limited in contrast to other's right to know.

In the case of mentally ill, family as well as employers and colleagues have the right to know while patients may not be able to see the testimony of others in their own record. In the case of mentally ill patients, it is important to measure comprehension and develop valid tools for it, before obtaining informed consent to participate in a research study.

Ethics: a general introduction

In a descriptive study of Beebe and Smith the Evaluation to Sign Consent ESC form was used in order to document comprehension in 29 schizophrenia outpatients. Participants prescribed two antipsychotic medications were significantly more likely to require a prompt than those prescribed only one antipsychotic. According to Lasagna there are strong feelings among professionals who disagree with experimentation on vulnerable groups.


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Jameton declares that in research the three more important elements are the competency of the researcher, the careful design, and worthwhile expected outcomes. Any lack of knowledge in the area under research must be clearly stated. Inexperienced researchers should work under qualified supervision which has to be reviewed by an ethics committee. What is more, careful choice of method for data collection, to ensure validity and reliability, are two main requirements that must be met in all kinds of research. The choice depends on the object of the study.

When human beings are involved, all the ethical issues, discussed above, must be taken into account. The nature and essence of nursing reflects on human beings and their relationship with health. Raya focuses on the unique element of caring in nursing while Swanson views Nursing in the same scope as "informed caring for the wellbeing of others".

Swanson suggests that nursing has to do with "science, concern for humanity and caring. What exactly does it mean to care?


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  7. Mayeroff describes caring as an interaction which offers space for personal growth for both the carer and the cared. As McNeil et al say, "care is the basis and precondition of all cure".

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    Doing for, means predicting individual needs, encouraging, performing tasks with adequate skills and competence, protecting the patient from harm and preserving the dignity. On the other hand, enabling, means enhancing self-care by training, informing and explaining to the patient as well as assisting with finding alternatives. However, caring is not unique in nursing. Other professions can also claim that caring is an important part of their practice.

    The Location Problem for Ethics: Moral Properties and Moral Content

    It can not be stated either that all nursing procedures include caring. The vulnerability of the sick and the lack of patient participation in health care, creates a danger of patient exploitation by nurses. The rapid change and development of nursing emerged the need for a code of professional conduct to guide nurses in their practice. Advocacy primarily used in legal contexts, refers to the protection of human rights of people who cannot defend them for themselves.

    They also aim to protect and enhance personal autonomy. They should also support the patients' confidence in their own decisions and prevent limitations of their freedom.