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Bremer, Anders, María Jiménez Herrera, Christer Axelsson, Dolors Burjalés Martí, Lars Sandman, and Gian Luca Casali. "Ethical values in emergency medical services." Nursing Ethics 22, no. 8 (October 28, 2014): 928–42. http://dx.doi.org/10.1177/0969733014551597.
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Background: Ambulance professionals often address conflicts between ethical values. As individuals’ values represent basic convictions of what is right or good and motivate behaviour, research is needed to understand their value profiles. Objectives: To translate and adapt the Managerial Values Profile to Spanish and Swedish, and measure the presence of utilitarianism, moral rights and/or social justice in ambulance professionals’ value profiles in Spain and Sweden. Methods: The instrument was translated and culturally adapted. A content validity index was calculated. Pilot tests were carried out with 46 participants. Ethical considerations: This study conforms to the ethical principles for research involving human subjects and adheres to national laws and regulations concerning informed consent and confidentiality. Findings: Spanish professionals favoured justice and Swedish professionals’ rights in their ambulance organizations. Both countries favoured utilitarianism least. Gender differences across countries showed that males favoured rights. Spanish female professionals favoured justice most strongly of all. Discussion: Swedes favour rights while Spaniards favour justice. Both contexts scored low on utilitarianism focusing on total population effect, preferring the opposite, individualized approach of the rights and justice perspectives. Organizational investment in a utilitarian perspective might jeopardize ambulance professionals’ moral right to make individual assessments based on the needs of the patient at hand. Utilitarianism and a caring ethos appear as stark opposites. However, a caring ethos in its turn might well involve unreasonable demands on the individual carer’s professional role. Since both the justice and rights perspectives portrayed in the survey mainly concern relationship to the organization and peers within the organization, this relationship might at worst be given priority over the equal treatment and moral rights of the patient. Conclusion: A balanced view on ethical perspectives is needed to make professionals observant and ready to act optimally – especially if these perspectives are used in patient care. Research is needed to clarify how justice and rights are prioritized by ambulance services and whether or not these organization-related values are also implemented in patient care.
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Ohnishi, Kayoko, Teresa E. Stone, Takashi Yoshiike, and Kazuyo Kitaoka. "The role of online ethics consultation on mental health." Nursing Ethics 27, no. 5 (April 23, 2020): 1261–69. http://dx.doi.org/10.1177/0969733020906596.
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Background Nurses experience moral distress when they cannot do what they believe is right or when they must do what they believe is wrong. Given the limited mechanisms for managing ethical issues for nurses in Japan, an Online Ethics Consultation on mental health (OEC) was established open to anyone seeking anonymous consultation on mental health practice. Research objective To report the establishment of the Online Ethics Consultation and describe and evaluate its effectiveness. Ethical considerations The research was conducted in accordance with the Declaration of Helsinki. Research design This evaluation describes the outcomes of 5 years of operation of the Online Ethics Consultation on mental health in Japan Participants The Online Ethics Consultation received 12 emails requesting consultation. Consultees included mental health nurses, psychiatrists, and service users. Findings The most common questions directed to the service were about seclusion and physical restraint. Response time from receipt of email to sending a reply was between 1 and 14 days. Despite the disappointing number of consultations, feedback has been positive. Discussion The Online Ethics Consultation was established to assist morally sensitive nurses in resolving their ethical problems through provision of unbiased and encouraging advice. Mental health care in Japan has been less than ideal: long-term social hospitalization, seclusion, and restraint are common practices that often lead to moral distress in nurses and the questions received reflected this. The head of the Online Ethics Consultation sent a supportive, facilitative response summarizing the opinions of several consultants. Conclusion This study provides key information for the establishment of an online ethics resource the adoption of which has the potential to improve the experience of nurses, allied health and clients of mental health services. This paper has implications for services concerned with improving patient care, managing nurses’ moral distress, building ethics into decision-making.
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Storaker, Anne, Dagfinn Nåden, and Berit Sæteren. "From painful busyness to emotional immunization: Nurses’ experiences of ethical challenges." Nursing Ethics 24, no. 5 (January 24, 2016): 556–68. http://dx.doi.org/10.1177/0969733015620938.
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Background: The professional values presented in ethical guidelines of the Norwegian Nurses Organisation and International Council of Nurses describe nurses’ professional ethics and the obligations that pertain to good nursing practice. The foundation of all nursing shall be respect for life and the inherent dignity of the individual. Research proposes that nurses lack insight in ethical competence and that ethical issues are rarely discussed on the wards. Furthermore, research has for some time confirmed that nurses experience moral distress in their daily work and that this has become a major problem for the nursing profession. Objectives: The purpose of this article is to obtain a deeper understanding of the ethical challenges that nurses face in daily practice. The chosen research questions are “What ethical challenges do nurses experience in their daily practice?” Research design: We conducted a qualitative interview study using a hermeneutical approach to analyzing data describing nurses’ experiences. Ethical considerations: The Norwegian Social Science Data services approved the study. Furthermore, the head of the hospital gave permission to conduct the investigation. The requirement of anonymity and proper data storage in accordance with the World Medical Association Declaration of Helsinki was met. Method and results: The context for the study comprised three different clinical wards at a university hospital in Norway. Nine qualified nurses were interviewed. The results were obtained through a systematic development beginning with the discovery of busyness as a painful phenomenon that can lead to conflicts in terms of ethical values. Furthermore, the consequences compromising professional principles in nursing care emerged and ended in moral blindness and emotional immunization of the healthcare providers. Emotional immunization occurred as a new dimension involving moral blindness and immunity in relation to being emotionally touched.
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�nyshko, Oksana. "LEGAL, SOCIAL AND HISTORICAL ASPECTS OF LEGALIZATION OF SEXUAL SERVICES." Social Legal Studios 10, no. 4 (December 25, 2020): 101–8. http://dx.doi.org/10.32518/2617-4162-2020-4-101-108.
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The main legal ways to the socio-political regulation of sexual services (prostitution) in different countries are considered. The main problems facing the society of each state in the field of regulation of prostitutes activity, their so-called �curatores� and clients. The participation of the state in identifying and solving the problems of the sex industry are defined. It is determined that an important role in the legalization of prostitution is played not only by the legal but also by the moral and ethical aspects, which have a lot of limits in every society. Four models of prostitution regulation that exist in different countries of the world are analyzed. It is substantiated that not every model in itself is effective and is optimal for implementation. It depends of the legal system, level of consolidation of society and position of the government on this issue. Criminal liability for pimping, which exists in Ukraine, is only a small positive step in the fight against illegal profits related to the exploitation (voluntary or forced) of another person's body. The negative point in this area is the lack of social, medical and legal protection of prostitutes, as their clients are also at risk. So, the legalization on of the sexual services is necessary for our state, but it must be preceded by a series of successive authority�s steps: public dialogue on different public platforms, changes in legislation and government administrative decisions.
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Jansen, Trine-Lise, Marit Helene Hem, Lars Johan Dambolt, and Ingrid Hanssen. "Moral distress in acute psychiatric nursing: Multifaceted dilemmas and demands." Nursing Ethics 27, no. 5 (October 20, 2019): 1315–26. http://dx.doi.org/10.1177/0969733019877526.
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Background In this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored. Research design A qualitative design with 16 individual in-depth interviews was chosen. Braun and Clarke’s six analytic phases were used. Ethical considerations Approval was obtained from the Norwegian Social Science Data Services. Participation was confidential and voluntary. Findings Based on findings, a somewhat wider definition of moral distress is introduced where nurses experiencing being morally constrained, facing moral dilemmas or moral doubt are included. Coercive administration of medicines, coercion that might be avoided and resistance to the use of coercion are all morally stressful situations. Insufficient resources, mentally poorer patients and quicker discharges lead to superficial treatment. Few staff on evening shifts/weekends make nurses worry when follow-up of the most ill patients, often suicidal, in need of seclusion or with heightened risk of violence, must be done by untrained personnel. Provision of good care when exposed to violence is morally challenging. Feelings of inadequacy, being squeezed between ideals and clinical reality, and failing the patients create moral distress. Moral distress causes bad conscience and feelings of guilt, frustration, anger, sadness, inadequacy, mental tiredness, emotional numbness and being fragmented. Others feel emotionally ‘flat’, cold and empty, and develop high blood pressure and problems sleeping. Even so, some nurses find that moral stress hones their ethical awareness. Conclusion Moral distress in acute psychiatric care may be caused by multiple reasons and cause a variety of reactions. Multifaceted ethical dilemmas, incompatible demands and proximity to patients’ suffering make nurses exposed to moral distress. Moral distress may lead to reduced quality care, which again may lead to bad conscience and cause moral distress. It is particularly problematic if moral distress results in nurses distancing and disconnecting themselves from the patients and their inner selves.
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McClimans, Leah, Geah Pressgrove, and Emmaling Campbell. "Objectives and outcomes of clinical ethics services: a Delphi study." Journal of Medical Ethics 45, no. 12 (September 4, 2019): 761–69. http://dx.doi.org/10.1136/medethics-2018-105203.
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ObjectivesTo explore the objectives and outcomes most appropriate for evaluating clinical ethics support services (CESs) in the USA.MethodsA three-round e-Delphi was sent to two professional medical ethics listservs (Medical College of Wisconsin-Bioethics and American Society for Bioethics and Humanities) as well as 19 individual experts. The survey originally contained 15 objectives and 9 outcomes. In round 1, participants were asked to validate the content of these lists. In round 2, we had 17 objectives and 10 outcomes, and participants were asked to rank them for appropriateness in a top 10 list of objectives and a top 5 list of outcomes.ResultsParticipants came to a high(at least 70%) level of agreement on seven objectives: mediate, educate, develop policy, improve the moral quality of a decision or action, counsel, create a moral space and manage moral distress. Participants came to a moderate (at least 51%) level of agreement on three objectives: empower, awareness of ethics and preventative ethics. Participants also came to a moderate (at least 51%) level of agreement on five outcomes: ethical justification, transformation of institution, improvement of quality of life, principled consensus and satisfaction with the expertise of a CES.ConclusionThis e-Delphi identified 10 objectives and 5 outcomes that are a good starting point for developing outcome measures to evaluate CESs in the USA, while reminding us of the diversity of perspectives still evident in the field.
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Hunter, Kiri, and Catherine Cook. "Indigenous nurses’ practice realities of cultural safety and socioethical nursing." Nursing Ethics 27, no. 6 (July 28, 2020): 1472–83. http://dx.doi.org/10.1177/0969733020940376.
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Background: Persistent healthcare emphasis on universal moral philosophy has not advantaged indigenous and marginalised groups. Centralising cultural components of care is vital to provide ethical healthcare services to indigenous people and cultural minorities internationally. Woods’ theoretical explication of how nurses can integrate cultural safety into a socioethical approach signposts ethical practice that reflects culturally congruent relational care and systemic critique. Aim: To demonstrate the empirical utility of Woods’ ethical elements of cultural safety within a socioethical model, through analysis of indigenous nurses’ practice realities in Aotearoa New Zealand. Research design: The study used a qualitative indigenous narrative inquiry. Participants and research context: Participants were recruited nationally. Twelve Māori registered nurses and nurse practitioners were interviewed. All participants provided direct care in either primary or secondary health services. Ethical considerations: Research approval was gained from the Human Ethics Committee of the lead author’s tertiary institution. Participation was voluntary, and written informed consent was obtained. Findings: Analysis highlighted the following: (1) cultural needs, which for Māori were integral to care, were easily subsumed by clinical care being prioritised; (2) ethical care by non-indigenous nurses requires critical reflection about broader equity issues that impact Māori disengagement from healthcare; (3) retention of indigenous nurses was seen as essential because their advocacy and the cultural ‘fit’ for Māori contributed to positive healthcare outcomes; and (4) committed leadership ensured culturally safe care was not eroded through workplace efficiencies. Discussion: The data provide rich representation of Woods’ model. The data indicate that nurses must engage reflexively with a relational ethic of care and social justice dimensions in order to deliver culturally safe care. Conclusion: Woods’ model provides a critical lens for nurses to examine their relational practice and systemic factors that enhance or detract from culturally safe care when caring for members of any indigenous group.
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Crigger, Nancy, Maria Fox, Tarris Rosell, and Wilaiporn Rojjanasrirat. "Moving It Along: A study of healthcare professionals’ experience with ethics consultations." Nursing Ethics 24, no. 3 (September 3, 2015): 279–91. http://dx.doi.org/10.1177/0969733015597571.
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Background: Ethics consultation is the traditional way of resolving challenging ethical questions raised about patient care in the United States. Little research has been published on the resolution process used during ethics consultations and on how this experience affects healthcare professionals who participate in them. Objectives: The purpose of this qualitative research was to uncover the basic process that occurs in consultation services through study of the perceptions of healthcare professionals. Design and Method: The researchers in this study used a constructivist grounded theory approach that represents how one group of professionals experienced ethics consultations in their hospital in the United States. Results: The results were sufficient to develop an initial theory that has been named after the core concept: Moving It Along. Three process stages emerged from data interpretation: moral questioning, seeing the big picture, and coming together. It is hoped that this initial work stimulates additional research in describing and understanding the complex social process that occurs for healthcare professionals as they address the difficult moral issues that arise in clinical practice.
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Söderhamn, Ulrika, Helga Tofte Kjøstvedt, and Åshild Slettebø. "Evaluation of ethical reflections in community healthcare." Nursing Ethics 22, no. 2 (April 8, 2014): 194–204. http://dx.doi.org/10.1177/0969733014524762.
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Background: Ethical reflections over care practices are important. In order to be able to perform such reflections, healthcare professionals must learn to think critically about their care practice. Aim: The aim of this study was to evaluate whether an introduction to and practice in ethical reflections in community healthcare have consequences for the healthcare personnel’s practice. Research design: A mixed-methods design was adopted with five focus group interviews and an electronic questionnaire based on results from the interviews. Participants and research context: A total of 29 community healthcare personnel with experience in ethical reflections participated in the interviews. The electronic questionnaire was sent via email to 2382 employees in community healthcare services in 13 municipalities in southern part of Norway. Ethical considerations: The study was guided by the intentions of the Declaration of Helsinki and ethical standard principles and approved by the Norwegian Social Science Data Services. Results: An introduction to and practice in performing ethical reflections brought about an ethical awareness with understanding and respect for both colleagues and patients. The leader had a key role. Lack of time was a hindrance for ethical reflections. Three factors could predict meaningful ethical reflections: higher age of personnel, higher percentage of employment and longer experience with ethical reflections. Discussion: According to other studies, ethical reflections may enhance moral development of colleagues and their actions as advocates for the patients. A deepened ethical awareness, professional competency and sufficient time resources will guarantee proper caregiving. Conclusion: A supportive environment that prioritizes participation in reflection meetings is decisive. To practice ethical reflections will provide better care for patients. A challenge for the community healthcare system is to offer adequate positions that provide the personnel an opportunity to be involved as caregivers and to participate in ethical reflections.
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Ramvi, Ellen, and Venke Irene Ueland. "Between the patient and the next of kin in end-of-life care: A critical study based on feminist theory." Nursing Ethics 26, no. 1 (January 24, 2017): 201–11. http://dx.doi.org/10.1177/0969733016688939.
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Background: For the experience of end-of-life care to be ‘good’ many ethical challenges in various relationships have to be resolved. In this article, we focus on challenges in the nurse–next of kin relationship. Little is known about difficulties in this relationship, when the next of kin are seen as separate from the patient. Research problem: From the perspective of nurses: What are the ethical challenges in relation to next of kin in end-of-life care? Research design: A critical qualitative approach was used, based on four focus group interviews. Participants: A total of 22 registered nurses enrolled on an Oncology nursing specialisation programme with experience from end-of-life care from various practice areas participated. Ethical considerations: The study was approved by the Norwegian Social Science Data Service, Bergen, Norway, project number 41109, and signed informed consent obtained from the participants before the focus groups began. Findings and discussion: Two descriptive themes emerged from the inductive analysis: ‘A feeling of mistrust, control and rejection’ and ‘Being between hope and denial of next of kin and the desire of the patient to die when the time is up’. Deductive reinterpretation of data (in the light of moral distress from a Feminist ethics perspective) has made visible the constraints that certain relations with next of kin in end-of-life care lay upon the nurses’ moral identity, the relationship and their responsibility. We discuss how these constraints have political and societal dimensions, as well as personal and relational ones. Conclusion: There is complex moral distress related to the nurse–next of kin relationship which calls for ethical reflections regarding these relationships within end-of-life care.
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Fowler, Marsha D. "Why the history of nursing ethics matters." Nursing Ethics 24, no. 3 (May 2017): 292–304. http://dx.doi.org/10.1177/0969733016684581.
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Modern American nursing has an extensive ethical heritage literature that extends from the 1870s to 1965 when the American Nurses Association issued a policy paper that called for moving nursing education out of hospital diploma programs and into colleges and universities. One consequence of this move was the dispersion of nursing libraries and the loss of nursing ethics textbooks, as they were largely not brought over into the college libraries. In addition to approximately 100 nursing ethics textbooks, the nursing ethics heritage literature also includes hundreds of journal articles that are often made less accessible in modern databases that concentrate on the past 20 or 30 years. A second consequence of nursing’s movement into colleges and universities is that ethics was no longer taught by nursing faculty, but becomes separated and placed as a discrete ethics (later bioethics) course in departments of philosophy or theology. These courses were medically identified and rarely incorporated authentic nursing content. This shift in nursing education occurs contemporaneously with the rise of the field of bioethics. Bioethics is rapidly embraced by nursing, and as it develops within nursing, it fails to incorporate the rich ethical heritage, history, and literature of nursing prior to the development of the field of bioethics. This creates a radical disjunction in nursing’s ethics; a failure to more adequately explore the moral identity of nursing; the development of an ethics with a lack of fit with nursing’s ethical history, literature, and theory; a neglect of nursing’s ideal of service; a diminution of the scope and richness of nursing ethics as social ethics; and a loss of nursing ethical heritage of social justice activism and education. We must reclaim nursing’s rich and capacious ethics heritage literature; the history of nursing ethics matters profoundly.
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Truman, Carole. "Ethics and the Ruling Relations of Research Production." Sociological Research Online 8, no. 1 (February 2003): 70–80. http://dx.doi.org/10.5153/sro.773.
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The role of research ethics committees has expanded across the UK and North America and the process of ethical review has become re-institutionalised under proposals for research governance proposed by government. Ethics committees have gained a powerful role as gatekeepers within the research process. Underpinning the re-constitution of ethical guidelines and research governance, are a range of measures which protect institutional interests, without necessarily providing an effective means to address the moral obligations and responsibilities of researchers in relation to the production of social research. Discussion of research ethics from the standpoint of research participants who in this paper, are service users within health and social care, provides a useful dimension to current debate. In this paper I draw upon experiences of gaining ethical approval for a research study which focused on user participation within a community mental health service. I discuss the strategies used to gain ethical approval and the ‘formal concerns’ raised by the ethics committee. I then describe and discuss ethical issues which emerged from a participants’ perspective during the actual research as it was carried out. These experiences are analysed using aspects of institutional ethnography which provides a framework to explore how the experiences of research participants are mediated by texts which govern the processes of research production. The paper highlights incongruities between the formal ethical regulation of research, and the experiences of research participants in relation to ethical concerns within a research process.
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Colaco, Keith A., Alanna Courtright, Sandra Andreychuk, Andrea Frolic, Ji Cheng, and April Jacqueline Kam. "Ethics consultation in paediatric and adult emergency departments: an assessment of clinical, ethical, learning and resource needs." Journal of Medical Ethics 44, no. 1 (July 27, 2017): 13–20. http://dx.doi.org/10.1136/medethics-2016-103531.
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ObjectiveWe sought to understand ethics and education needs of emergency nurses and physicians in paediatric and adult emergency departments (EDs) in order to build ethics capacity and provide a foundation for the development of an ethics education programme.MethodsThis was a prospective cross-sectional survey of all staff nurses and physicians in three tertiary care EDs. The survey tool, called Clinical Ethics Needs Assessment Survey, was pilot tested on a similar target audience for question content and clarity.ResultsOf the 123 participants surveyed, 72% and 84% of nurses and physicians fully/somewhat agreed with an overall positive ethical climate, respectively. 69% of participants reported encountering daily or weekly ethical challenges. Participants expressed the greatest need for additional support to address moral distress (16%), conflict management with patients or families (16%) and resource issues (15%). Of the 23 reported occurrences of moral distress, 61% were associated with paediatric mental health cases. When asked how the ethics consultation service could be used in the ED, providing education to teams (42%) was the most desired method.ConclusionsNurses report a greater need for ethics education and resources compared with their physician colleagues. Ethical challenges in paediatric EDs are more prevalent than adult EDs and nurses voice specific moral distress that are different than adult EDs. These results highlight the need for a suitable educational strategy, which can be developed in collaboration with the leadership of each ED and team of hospital ethicists.
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Macleod, Jack, Sermed Mezher, and Ragheb Hasan. "Surgery during COVID-19 crisis conditions: can we protect our ethical integrity against the odds?" Journal of Medical Ethics 46, no. 8 (June 12, 2020): 505–7. http://dx.doi.org/10.1136/medethics-2020-106446.
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COVID-19 is reducing the ability to perform surgical procedures worldwide, giving rise to a multitude of ethical, practical and medical dilemmas. Adapting to crisis conditions requires a rethink of traditional best practices in surgical management, delving into an area of unknown risk profiles. Key challenging areas include cancelling elective operations, modifying procedures to adapt local services and updating the consenting process. We aim to provide an ethical rationale to support change in practice and guide future decision-making. Using the four principles approach as a structure, Medline was searched for existing ethical frameworks aimed at resolving conflicting moral duties. Where insufficient data were available, best guidance was sought from educational institutions: National Health Service England and The Royal College of Surgeons. Multiple papers presenting high-quality, reasoned, ethical theory and practice guidance were collected. Using this as a basis to assess current practice, multiple requirements were generated to ensure preservation of ethical integrity when making management decisions. Careful consideration of ethical principles must guide production of local guidance ensuring consistent patient selection thus preserving equality as well as quality of clinical services. A critical issue is balancing the benefit of surgery against the unknown risk of developing COVID-19 and its associated complications. As such, the need for surgery must be sufficiently pressing to proceed with conventional or non-conventional operative management; otherwise, delaying intervention is justified. For delayed operations, it is our duty to quantify the long-term impact on patients’ outcome within the constraints of pandemic management and its long-term outlook.
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Alderson, Priscilla. "Prenatal Screening, Ethics and Down’s Syndrome: a literature review." Nursing Ethics 8, no. 4 (July 2001): 360–74. http://dx.doi.org/10.1177/096973300100800408.
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This article reviews the literature on prenatal screening for Down’s syndrome. To be evidence based, medicine and nursing have to take account of research evidence and also of how this evidence is processed through the influence of prevailing social and moral attitudes. This review of the extensive literature examines how appropriate widely-held understandings of Down’s syndrome are, and asks whether or not practitioners and prospective parents have access to the full range of moral arguments and social evidence on the matter. Highly valued ideals of justice, personal autonomy, parental choice, women’s control over their reproduction and of avoiding harm can all tend towards negative rather than neutral approaches to Down’s syndrome. This article considers how ethics and prenatal screening policies and practice that take greater account of social evidence of disability could use moral arguments that inform rather than determine the choices of people who use prenatal services.
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Kristoffersen, Margareth, and Febe Friberg. "The nursing discipline and self-realization." Nursing Ethics 22, no. 6 (August 20, 2014): 723–33. http://dx.doi.org/10.1177/0969733014543967.
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Background: It is obvious from literature within the nursing discipline that nursing is related to moral or moral–philosophical related ideas which are other-oriented. The socio-cultural process of change in modern society implies that more self-oriented ideas have been found to be significant. Aim: The overall aim of this article is to highlight self-oriented moral or moral–philosophical related ideas as an important part of the nursing discipline. This is achieved by (a) exploring self-realization as a significant self-oriented moral or moral–philosophical related idea based on a philosophical anthropological perspective, (b) demonstrating how moral or moral–philosophical related ideas are expressed by nurses, (c) discussing the relevance of self-realization for the nursing discipline, and (d) pointing out possible consequences for the future development of the discipline of nursing. Research design: This theoretical study draws empirical examples from interviews. Participants and research context: Data consisted of interviews with 13 nurses with varying work experience within the primary and secondary somatic and psychiatric health service, from inside as well as outside institutions. Ethical considerations: The empirical study was approved by the Norwegian Social Science Data Services. Information was given and consent was obtained from the study participants. Findings: Findings are presented in two themes: (a) other-oriented ideas and (b) self-oriented ideas. More concretely, the findings show that nurses hope to make life as good as possible for the patient and they have a wish to improve themselves as human beings, to become better persons. Discussion: The relevance of self-realization for the nursing discipline is discussed along two lines, first, by connecting nurses’ self-understanding to a horizon of identity and second, by considering what self-realization could offer. Conclusion: It is of ultimate concern for the nursing discipline to highlight self-realization connected to the positive view of freedom understood as an exercise-concept. Further identifying and articulating the contribution of self-realization to nurses and nursing practice is of particular importance.
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McCarthy, Joan, Katherine O’Donnell, Louise Campbell, and Dolores Dooley. "Ethical arguments for access to abortion services in the Republic of Ireland: recent developments in the public discourse." Journal of Medical Ethics 44, no. 8 (May 18, 2018): 513–17. http://dx.doi.org/10.1136/medethics-2017-104728.
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The Republic of Ireland has some of the most restrictive abortion legislation in the world which grants to the ‘unborn’ an equal right to life to that of the pregnant woman. This article outlines recent developments in the public discourse on abortion in Ireland and explains the particular cultural and religious context that informs the ethical case for access to abortion services. Our perspective rests on respect for two very familiar moral principles – autonomy and justice – which are at the centre of social and democratic societies around the world. This article explains the context for the deployment of these concepts in order to support the claim that the current legislation and its operationalisation in clinical practice poses serious risks to the health, lives and well-being of pregnant women, tramples on their autonomy rights and requires of them a self-sacrifice that is unreasonable and unjust.
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Stephens, Darryl W. "Bearing Witness as Social Action: Religious Ethics and Trauma-Informed Response." Trauma Care 1, no. 1 (June 18, 2021): 49–63. http://dx.doi.org/10.3390/traumacare1010005.
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Written from a standpoint of religious ethics, this article interprets the work of trauma response and recovery in transcendent and moral terms not always apparent to the practitioner or institution. This article provides a broad understanding of spirituality, transcendence, and faith as these concepts relate to Judith Herman’s stages of trauma healing and the characteristics of trauma-informed response articulated by the Substance Abuse and Mental Health Services Administration. These features are then mapped onto specific modes of transcendence and moral themes identifiable in a wide range of religious traditions. The connective framework for this mapping is provided by utilizing the concept “bearing witness,” as synthesized from a wide range of disciplinary perspectives, to describe the work of trauma-informed response. This article concludes by recognizing bearing witness as a form of social action, a moral response with implied if not explicit religious dimensions and spiritual implications, for which an understanding of religious ethics is a helpful ally. Thus, this article concludes that religious ethics can be a valuable resource and partner in addressing the personal, systemic, and political aspects of trauma response and recovery, enabling attention to spiritual well-being of both the trauma survivor and the one responding to the survivor.
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Pilgrim, David, and Anne Rogers. "Mass Childhood Immunization: Some Ethical Doubts for Primary Health Care Workers." Nursing Ethics 2, no. 1 (March 1995): 63–70. http://dx.doi.org/10.1177/096973309500200108.
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The mass childhood immunization programme has traditionally been viewed as a safe and effective preventative measure by health promoters, primary health care professionals and governments. This consensus has meant that immunization has rarely been viewed as ethically problematic. A number of recent changes in the context of the delivery of health care, particularly the emphasis on consumerism and the effect of the marketization of services, makes timely an examination of ethical, social and political issues. This article examines four main grounds for problematizing the mass childhood immunization programme. These are: clinical research evidence about the safety and efficacy of vaccines; the masking of wider social and political determinants of ill health; the contradictory strictures about collective and individual rights in relation to immunization; and the uniqueness of childhood immunization as a physical intrusion into a healthy body. The implications of these ethical issues are discussed in relation to informed consent and the need for a 'greenfield' review that includes the views of dissenting parents, lawyers and moral philosophers, as well as health professionals. Les promoteurs de santé, les soignants et les gouvernements ont tous traditionellement vu le programme d'immunisation globale des enfants comme sain et efficace. Cela voulait dire que l'immunisation a rarement posé un problème éthique. Pourtant, actuellement des changements dans les contextes de la distribution des soins, le consumérisme et de l'effet de la commercialisation des services de santé, exigent une revue des problèmes éthiques, sociaux et politiques. Cet article discute quatre éléments problématiques du programme d'immunisation globale: les données des recherches médicales sur la sûreté et l'efficacité des vaccins; la dissimulation des déterminatifs sociaux et politiques des maladies; les critiques contradictoires des droits individuels et collectifs concernant l'immunisation; et le caractère unique de l'immunisation des enfants comme une intrusion physique dans un corps sain. Les effets de ces questions éthiques sont repris en rapport du consentement informé et de la nécessité d'une revue 'verte' qui comprend les vues des parents dissidents, des juristes, des philsophes et des membres des professions soignantes. Das Massenimpfungsprogramm von Kindern wurde allgemein von Gesundheits behörden, medizinischem Fachpersonal und Regierungen als sichere und wirksame Vorbeugungsmassnahme betrachtet. Diese Uebereinstimmung bedeutete, dass Imp fungen selten ein ethisches Problem darstellten. Eine Anzahl von Aenderungen im Gesundheitswesen - besonders im Hinblickin auf Konsum und Marktwirtschaft im Dienstleistungsbereich - berechtigen jedoch zu einer Untersuchung der ethischen, sozialen und politischen Fragen. Dieser Artikel untersucht vier Hauptgründe, die das Massenimpfungsprogramm für Kinder in Frage stellen: Forschungsergebnisse über die Sicherheit und Wirksamkeit der Impfstoffe; die Verschleierung von andern sozialen und politischen Krankheitsursachen; die widersprüchlichen Anordnungen über kollektive und individuelle Rechte mit Bezug auf die Impfungen; und die aussergewöhnliche Art der Impfung als physische Verletzung eines gesunden Körpers. Die Bedeutung dieser ethischen Fragen werden hier diskutiert im Zusammenhang mit der informierten Vereinstimmung und der Notwendigkeit eines 'grünen' Ueberblickes, der die Ansichten andersdenkender Eltern, Rechtsanwalte, Philosophen und Gesund heitsexperten einschliesst.
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Shahvisi, Arianne, and Fionnuala Finnerty. "Why it is unethical to charge migrant women for pregnancy care in the National Health Service." Journal of Medical Ethics 45, no. 8 (April 25, 2019): 489–96. http://dx.doi.org/10.1136/medethics-2018-105224.
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Pregnancy care is chargeable for migrants who do not have indefinite leave to remain in the UK. Women who are not ‘ordinarily resident’, including prospective asylum applicants, some refused asylum-seekers, unidentified victims of trafficking and undocumented people are required to pay substantial charges in order to access antenatal, intrapartum and postnatal services as well as abortion care within the National Health Service. In this paper, we consider the ethical issues generated by the exclusion of pregnancy care from the raft of services which are free to all. We argue that charging for pregnancy care amounts to sex discrimination, since without pregnancy care, sex may pose a barrier to good health. We also argue that charging for pregnancy care violates bodily autonomy, entrenches the sex asymmetry of sexual responsibility, centres the male body and produces health risks for women and neonates. We explore some of the ideological motivations for making maternity care chargeable, and suggest that its exclusion responds to xenophobic populism. We recommend that pregnancy care always be free regardless of citizenship or residence status, and briefly explore how these arguments bear on the broader moral case against chargeable healthcare for migrants.
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Witham, Gary, Gemma Yarwood, Sam Wright, and Sarah Galvani. "An ethical exploration of the narratives surrounding substance use and pain management at the end of life: a discussion paper." Nursing Ethics 27, no. 5 (September 16, 2019): 1344–54. http://dx.doi.org/10.1177/0969733019871685.
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This discussion article examines narrative positioning related to pain management for people who use substances at the end of life. We explore how dominant narrative genres associated with biomedicine, such as ‘restitution’ and narratives common within the context of drug services such as ‘recovery’ can hinder effective pain management within this population. We argue that these discourses can marginalise the ethical self-identity of patients who use substances at the end of life. It can also trouble health and social care professionals in supporting patients and generating counter-narratives that challenge those often associated with substance use. Stigma is a common experience for this population with stereotyping as ‘junkies’ and associated with criminality. They are positioned as drug-seeking, and this requires more surveillance at the end of life when opioid therapy is potentially more available and authorised. This can make it challenging to generate ‘companion’ stories that are positive and maintain moral adequacy. Dominant biomedical narrative genres often prevent the recognition of the fractured stories that people using substances can often present with. This can lead to narrative silencing and to the under treatment of pain. The person’s self-identity is invested in narratives of recovery, and opioid use symbolises their addicted past because for practitioners, this population is at clinical risk with the potential for drug seeking behaviours. Whilst not requiring formal ethical review this discussion paper was constructed in accordance with good scientific practice with the work of other researchers respected and cited appropriately.
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Cooke, Mary. "The Ethics of the Health Care Market." Nursing Ethics 3, no. 1 (March 1996): 3–7. http://dx.doi.org/10.1177/096973309600300102.
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The free market theory has as its basis the assumption of equity. This equity is ascribed to both purchasers and providers in a perfectly balanced system so that there are seen to be no 'winners' or 'losers' in the market-place. The health system that is developing in the UK is structured as a managed market, but agency relationships between GPs and health authorities buffer the costing process of goods and therefore may be described as distorting the price. This could also be distorting the ability of the users, who are the real purchasers, from exercising their economic freedom. They may also lose the autonomy to choose goods that suit their particular needs, and equally not to choose those services that they do not want or wish to pay for vicariously (i.e. that the common good is respected by both providers and purchasers). This assumes that users of the service know the level of choice that they have and that not only are providers protected at present by the practices of the purchasers but also entry into the market for new providers is severely curtailed. The exercise of true freedom of the market in economic terms is one of moral obliga tion to provide services that not only have a market value that is affordable and a require ment of the 'common good' but also are historically acceptable for social requirements (i.e. that the services are valued as fundamental tenets of the rights of individuals in soci ety). The expression of this need will therefore be utilitarian (i.e. the users of the services should benefit from them rather than the providers).
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Verweij, Marcel, and Koen Kramer. "Donor blood screening and moral responsibility: how safe should blood be?" Journal of Medical Ethics 44, no. 3 (February 11, 2016): 187–91. http://dx.doi.org/10.1136/medethics-2015-103338.
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Some screening tests for donor blood that are used by blood services to prevent transfusion-transmission of infectious diseases offer relatively few health benefits for the resources spent on them. Can good ethical arguments be provided for employing these tests nonetheless? This paper discusses—and ultimately rejects—three such arguments. According to the ‘rule of rescue’ argument, general standards for cost-effectiveness in healthcare may be ignored when rescuing identifiable individuals. The argument fails in this context, however, because we cannot identify beforehand who will benefit from additional blood screening tests. On the ‘imposed risk’ argument, general cost-effectiveness standards do not apply when healthcare interventions impose risks on patients. This argument ignores the fact that imposing risks on patients is inevitable in healthcare and that these risks can be countered only within reasonable limits. Finally, the ‘manufacturing standard’ argument premises that general cost-effectiveness standards do not apply to procedures preventing the contamination of manufactured medical products. We contend that while this argument seems reasonable insofar as commercially manufactured medical products are concerned, publicly funded blood screening tests should respect the standards for general healthcare. We conclude that these particular arguments are unpersuasive, and we offer directions to advance the debate.
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Nash, Woods, Sandra J. Mixer, Polly M. McArthur, and Annette Mendola. "The moral courage of nursing students who complete advance directives with homeless persons." Nursing Ethics 23, no. 7 (August 3, 2016): 743–53. http://dx.doi.org/10.1177/0969733015583926.
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Background: Homeless persons in the United States have disproportionately high rates of illness, injury, and mortality and tend to believe that the quality of their end-of-life care will be poor. No studies were found as to whether nurses or nursing students require moral courage to help homeless persons or members of any other demographic complete advance directives. Research hypothesis: We hypothesized that baccalaureate nursing students require moral courage to help homeless persons complete advance directives. Moral courage was defined as a trait of a person or an action that overcomes fears or other challenges to achieve something of great moral worth. Research design: The hypothesis was investigated through a qualitative descriptive study. Aside from the pre-selection of a single variable to study (i.e. moral courage), our investigation was a naturalistic inquiry with narrative hues insofar as it attended to specific words and phrases in the data that were associated with that variable. Participants and research context: A total of 15 baccalaureate nursing students at a public university in the United States responded to questionnaires that sought to elicit fears and other challenges that they both expected to experience and actually experienced while helping homeless persons complete advance directives at a local, non-profit service agency. Ethical considerations: The study was approved by the Internal Review Board of the authors’ university, and each participant signed an informed consent form, which stated that the study involved no reasonably foreseeable risks and that participation was voluntary. Findings: Before meeting with homeless persons, participants reported that they expected to experience two fears and a challenge: fear of behaving in ways that a homeless person would deem inappropriate, fear of discussing a homeless person’s dying and death, and the challenge of adequately conveying the advance directive’s meaning and accurately recording a homeless person’s end-of-life wishes. In contrast, after their meetings with homeless persons, relatively few participants reported having encountered those obstacles. So, while participants required moral courage to assist homeless persons with advance directives, they required greater moral courage as they anticipated their meetings than during those meetings. Discussion: Our study breaks new ground at the intersection of nursing, moral courage, and advance directives. It might also have important implications for how to improve the training that US nursing students receive before they provide this service. Conclusion: Our results cannot be generalized, but portions of our approach are likely to be transferable to similar social contexts. For example, because homeless persons are misunderstood and marginalized throughout the United States, our design for training nursing students to provide this service is also likely to be useful across the United States. Internationally, however, it is not yet known whether our participants’ fears and the challenge they faced are also experienced by those who assist homeless persons or members of other vulnerable populations in documenting healthcare wishes.
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Benitz, William E. "A Paradigm for Making Difficult Choices in the Intensive Care Nursery." Cambridge Quarterly of Healthcare Ethics 2, no. 3 (1993): 281–94. http://dx.doi.org/10.1017/s0963180100004291.
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In the 10 years since the birth of “Baby Doe,” the decisions confronted daily by neonatologists and parents of sick or premature infants have been the focus of a great deal of attention. Issues raised by these decisions have been vigorously debated and discussed in the popular media in political and governmental forums, and in the professional literatures of a variety of academic disciplines. These discourses have illuminated a number of moral and ethical principles that may govern these decisions and have contributed to the development of regulatory and procedural constraints upon this process, including requirements for establishment of infant care review committees at all hospitals that provide neonatal intensive care services. However, the philosophical concepts espoused by theoreticians, although often helpful as abstractions, are rarely invoked at the bedside as decisions are sought for individual patients. No clear consensus has emerged on how these ideas should be incorporated into clinical practice or on the role of mandated ethics committees or discretionary ethics consultants. Consequently, there are wide disparities in decision-making processes both within and among institutions. Failures of these systems to protect neonatal patients or their families remain distressingly common and have attracted considerable attention in the lay press. Although there can be no universal decision tree that can dictate the course of this complex process in all cases, a clearly articulated operative paradigm that defines essential features of an effective and equitable decision-making process is essential to identify the causes of failures and conflicts that arise when the process is dysfunctional and to prevent such problems by providing a framework for training practitioners to deal with these issues.
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Mooney-Doyle, Kim, Jessica Keim-Malpass, and Lisa C. Lindley. "The ethics of concurrent care for children: A social justice perspective." Nursing Ethics 26, no. 5 (April 15, 2018): 1518–27. http://dx.doi.org/10.1177/0969733018765308.
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Recent estimates indicate that over 40,000 children die annually in the United States and a majority have life-limiting conditions. Children at end of life require extensive healthcare resources, including multiple hospital readmissions and emergency room visits. Yet, many children still suffer from symptoms at end of life—including fatigue, pain, dyspnea, and anxiety—with less than 10% of these children utilizing hospice care services. A critical barrier to pediatric hospice use was the original federal regulations associated with the hospice care that required a diagnosis of 6 months to live and the discontinuation of all curative treatments. The Concurrent Care Provision of the United States’ Affordable Care Act eliminated the need to forgo curative therapies in order to enroll in hospice for children in Medicaid or Children’s Health Insurance Program. Concurrent care for children can help mitigate the tension families experience in choosing between essential forms of care, as well as contribute to improved end-of-life outcomes for the child and possibly bereavement outcomes for the family. Understanding concurrent care for children from a social justice perspective has important advocacy and research implications for hospice and palliative care clinicians providing care for children and their families. We apply Powers and Faden’s theory of social justice “as the moral foundation of public health and health policy” to the provision of concurrent care to children near end of life and families in the United States. The goals of applying this theory are to explore additional insights and perspectives into concurrent care policy may provide and to assess the usefulness of this theory when applied to end-of-life health policy. We argue that concurrent care policy is socially just since it has potential to promote well-being in vulnerable children and families and can limit the inequity children at end-of-life experience in access to high-quality hospice care.
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Emmerich, Nathan, and Christine Phillips. "Should professional interpreters be able to conscientiously object in healthcare settings?" Journal of Medical Ethics 46, no. 10 (December 3, 2019): 700–704. http://dx.doi.org/10.1136/medethics-2019-105767.
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In a globalised world, healthcare professionals will inevitably find themselves caring for patients whose first language differs from their own. Drawing on experiences in Australia, this paper examines a specific problem that can arise in medical consultations using professional interpreters: whether the moral objections of interpreters should be accommodated as conscientious objections if and when their services are required in contexts where healthcare professionals have such entitlements, most notably in relation to consultations concerning termination of pregnancy and voluntary assisted dying. We argue that existing statements of professional ethics suggest that interpreters should not be accorded such rights. The social organisation of healthcare and interpreting services in Australia may mean those who have serious objections to particular medical practices could provide their services in restricted healthcare contexts. Nevertheless, as a general rule, interpreters who have such objections should avoid working within healthcare.
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Watson, Samuel I., Mary Dixon-Woods, Celia A. Taylor, Emily B. Wroe, Elizabeth L. Dunbar, Peter J. Chilton, and Richard J. Lilford. "Revising ethical guidance for the evaluation of programmes and interventions not initiated by researchers." Journal of Medical Ethics 46, no. 1 (September 3, 2019): 26–30. http://dx.doi.org/10.1136/medethics-2018-105263.
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Public health and service delivery programmes, interventions and policies (collectively, ‘programmes’) are typically developed and implemented for the primary purpose of effecting change rather than generating knowledge. Nonetheless, evaluations of these programmes may produce valuable learning that helps determine effectiveness and costs as well as informing design and implementation of future programmes. Such studies might be termed ‘opportunistic evaluations’, since they are responsive to emergent opportunities rather than being studies of interventions that are initiated or designed by researchers. However, current ethical guidance and registration procedures make little allowance for scenarios where researchers have played no role in the development or implementation of a programme, but nevertheless plan to conduct a prospective evaluation. We explore the limitations of the guidance and procedures with respect to opportunistic evaluations, providing a number of examples. We propose that one key missing distinction in current guidance is moral responsibility: researchers can only be held accountable for those aspects of a study over which they have control. We argue that requiring researchers to justify an intervention, programme or policy that would occur regardless of their involvement prevents or hinders research in the public interest without providing any further protections to research participants. We recommend that trial consent and ethics procedures allow for a clear separation of responsibilities for the intervention and the evaluation.
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Bobrova, N. A., M. A. Vlasova, and V. G. Pozin. "CONFLICT OF INTERESTS IS THE BASIS OF CORRUPTION." Vektor nauki Tol’attinskogo gosudarstvennogo universiteta. Seria Uridicheskie nauki, no. 2 (2021): 5–13. http://dx.doi.org/10.18323/2220-7457-2021-2-5-13.
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Despite the permanent interest of scientists in the issue of corruption, the nature of its basics as an anti-social phenomenon remains understudied. As such principle, the paper considers the conflict of interests of participants in various public relations related to the exercise and abuse of power. The paper aims at showing the nature of the conflict of interests as the basis of such anti-social phenomenon as corruption, identifying subjective and objective causes of corruption. The authors analyze the gaps and weaknesses of current anti-corruption legislation and the practice of its application. The paper gives specific examples of a conflict of interests in various corruptogenic spheres and manifestations, for instance, in the sphere of economic entities’ participation in tenders announced by state and municipal authorities. The authors consider the legal and moral ways of preventing conflicts, the role of ethical norms in preventing conflicts, the legal framework of their prevention and resolution, the ratio of the conflict of interests and the employee’s qualification, the relationship between the material and personal interest, the activities of commissions for preventing a conflict of interests guaranteeing the role of written notification of a conflict of interests, special aspects of the notification procedure, and the consequences of non-compliance with the written notification. The study shows that a conflict of interests and corruption risks are eliminated both through legal means and moral ones, whereby the moral qualities of leaders and the requirements imposed on the heads of state and municipal authorities are of particular importance. Nepotism, increasingly prevalent in power and management structures (kinship and clientelism), is a common form of a conflict of interests, which undermines the moral foundations of public and municipal service.
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Läänemets, Urve, Katrin Kalamees-Ruubel, Kristi Kiilu, Kadi Kaja, and Anu Sepp. "VALUES CREATED BY MUSIC EDUCATION IN GENERAL COMPREHENSIVE SCHOOLS." SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference 2 (May 28, 2021): 318–29. http://dx.doi.org/10.17770/sie2021vol2.6297.
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This is the final part of research started in 2014 when development of the new National Curricula (NC) was initiated. The role of music education had to be mapped to prove its meaning as a traditional mandatory subject in the NC. According to the research program, different aspects, related to music education (content, integration of art subjects, informal and non-formal music activities, supportive learning environments, etc.), were analysed. The research of 2020 is summarising the values music education can provide for development of educated, responsible, ethical and creative people. The data collected from essays of school students and (future and in-service) music teachers (n=166), were analysed by qualitative methods. The values were classified by the following categories: social, cultural, cognitive, moral, aesthetic, personal. The research results can be used as arguments for developing music education syllabi in the NCs from kindergartens to gymnasia. The whole program of research is already being used for further development of music teacher education.
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Hofmann, B., and K. B. Lysdahl. "Moral principles and medical practice: the role of patient autonomy in the extensive use of radiological services." Journal of Medical Ethics 34, no. 6 (June 1, 2008): 446–49. http://dx.doi.org/10.1136/jme.2006.019307.
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TICHTCHENKO, PAVEL. "Changing Roles in Russian Healthcare." Cambridge Quarterly of Healthcare Ethics 12, no. 3 (July 2003): 265–67. http://dx.doi.org/10.1017/s0963180103123080.
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In the early 1990s, the primary problem in Russian bioethics was to gain the attention and recognition of the public and the medical establishment. Very few people were even familiar with the word “bioethics.” Within medical education, only a paternalistic and scholastic “medical deontology” was viewed as the professionally acceptable way to deal with the existing moral problems. The public was ignorant of the rights of patients and consumers of medical services. The usual way of resolving conflicts between patients and physicians was to complain to medical authorities. Very few cases of disputes were brought to the courts. Representatives of religious groups did not participate in discussions involving dilemmas generated by progress in biomedical technologies, and they did not seek to influence legislation in this area.
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Widiarti, Pratiwi Wahyu. "KONSEP DIRI (SELF CONCEPT) DAN KOMUNIKASI INTERPERSONAL DALAM PENDAMPINGAN PADA SISWA SMP SE KOTA YOGYAKARTA." INFORMASI 47, no. 1 (July 26, 2017): 135. http://dx.doi.org/10.21831/informasi.v47i1.15035.
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This study aims to determine, the self-concept of junior high school students in the city of Yogyakarta and description of the mentoring model for junior high school students in Yogyakarta city based on adolescent self concept. The research method used quantitative method, with descriptive statistical technique. The population of this research is all junior high school students in Yogyakarta city from 15 State Junior High School and 42 Private Junior High. The results is first, the self-concept of students is balanced between those who have low self-concept (222 people: 49.4%), with high self-concept (227 people: 50,6%). Second, from the self concept aspects, the results obtained, have: a) high self-concept/academic self as much as 262 students (58.4%); b) family self concept as high as 257 students (57.2%); c) high physical self-concept, ie 250 students (55.7%); d) low self-concept moral ethics there are 220 students (49%); e) low social self-concept there are 220 students (49%); f) Low self-concept personal there are 216 students (48.1%). Third, the low-tendentious concept of self is ethical-moral, social and personal, then approaches are used for the assistance: a) from the side of interpersonal communication: Self-fulfilling prophecy; opened self; self confidence; and selectivity; b) in terms of interaction style, by developing an enabling interaction style; c) in terms of guidance and counseling services by forming individual guidance and group guidance. Abstrak Penelitian ini bertujuan untuk mengetahui konsep diri remaja siswa SMP se kota Yogyakarta dan deskripsi model pendampingan bagi remaja siswa SMP se kota Yogyakarta berdasar konsep diri remaja. Melalui metode kuantitatif, dengan teknik statistik deskriptif. Populasi penelitian ini adalah seluruh siswa SMP se kota Yogyakarta dari 15 SMP Negeri dan 42 SMP Swasta. Hasil penelitian adalah, pertama, konsep diri siswa berimbang antara yang memiliki konsep diri yang rendah (222 orang: 49.4%), dengan yang memiliki konsep diri yang tinggi (yaitu 227 orang: 50.6%). Kedua, dari aspek-aspek konsep diri, diperoleh hasil, yang memiliki: a) konsep diri kerja/akademik yang tinggi sebanyak 262 siswa (58.4%); b) konsep diri keluarga yang tinggi sebanyak 257 siswa (57.2%); c) konsep diri fisik yang tinggi, yaitu 250 siswa (55.7%); d) konsep diri etik moral yang rendah ada 220 siswa (49%); e) konsep diri sosial yang rendah ada 220 siswa (49%); f) konsep diri personal yang rendah ada 216 siswa (48.1 persen). Ketiga, konsep diri yang cenderung rendah adalah konsep diri etik-moral, sosial dan personal, maka digunakan pendekatan bagi pendamping: a) dari sisi komunikasi interpersonal: Nubuat yang dipenuhi sendiri; membuka diri; percaya diri; dan selektivitas; b) dari sisi gaya interaksi, dengan mengembangkan gaya interaksi yang mendorong (enabling); c) dari sisi layanan bimbingan dan konseling dengan membentuk bimbingan kelompok dan bimbingan individual.
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Seriogin, S. M., O. S. Petrenko, and S. I. Sokolovskiy. "Psychological dependence of public servants as factor of corruption behavior." Public administration aspects 6, no. 11-12 (February 20, 2019): 102–10. http://dx.doi.org/10.15421/151879.
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The purpose of the article is to identify psychological aspects of preventing corruption in the professional activities of public servants by analyzing the main motives of systemic corruption behavior and socio-cultural aspects of their formation. It is revealed that research on the motives of corruption behavior is associated with several important factors: 1) the stereotypes of understanding of the corruption existing in the Ukrainian society; 2) social factors of corruption behavior - historical, economic, political, cultural, collective-psychological and individual psychological; 3) socio-cultural aspects of the formation of anticorruption consciousness.There are several motives of corruption behavior: game, social, monetary etc. This is due to the existence of the most common frames of mass consciousness, which are recorded in the Ukrainian society regarding the perception of corruption. The determining factors of the occurrence of corruption behavior in the professional activities of public servants are the psychological dependencies of the person, which leads to the use of the concept of psychological research.Corruptive behavior is defined as deviant one and causes the perception of the responsibilities of the public service as an opportunity to obtain satisfaction from the prospect of receiving unlawful benefits and privileges for violating official moral and ethical requirements (the formation of dependence). The types of psychological dependencies of public servants (on power, money, etc.) are distinguished. It is shown that a painful manifestation of such a person’s psychological dependency is kleptomania. In order to prevent corruption in the professional activities of public servants, it is proposed to apply scientifically substantiated psychological and diagnostic support, in particular special methods for determining the propensity for kleptomania and corruption behavior.
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CLAVIEN, CHRISTINE, and SAMIA HURST. "The Undeserving Sick? An Evaluation of Patients’ Responsibility for Their Health Condition." Cambridge Quarterly of Healthcare Ethics 29, no. 2 (March 11, 2020): 175–91. http://dx.doi.org/10.1017/s0963180119000975.
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The recent increased prevalence of diseases related to unhealthy lifestyles raises difficulties for healthcare insurance systems traditionally based on the principles of risk-management, solidarity, and selective altruism: since these diseases are, to some extent, predictable and avoidable, patients seem to bear some responsibility for their condition and may not deserve full access to social medical services. Here, we investigate with objective criteria to what extent it is warranted to hold patients responsible for their illness and to sanction them accordingly. We ground our analysis on a series of minimal conditions for ‘practical’ and for ‘moral’ responsibility attribution. By applying these criteria consistently, we highlight that individual responsibility applies to risk-taking life choices rather than stigmatized sickness. We explain that responsibility is a matter of degree, that it varies across life-history, and can be affected by factors beyond the patients’ grasp. We point out that scientific knowledge about the effect of these factors generates responsibilities for other parties such as public health agencies and private industry. The upshot of our analysis is that health policies targeting the ‘liable’ undeserving sick are mostly unwarranted, and tend to increase unequal treatment of already vulnerable groups: the unlucky sick.
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Hussein Kakembo, Ssemambo, Muhamad Abduh, and Pg Md Hasnol Alwee Pg Hj Md Salleh. "Adopting Islamic microfinance as a mechanism of financing small and medium enterprises in Uganda." Journal of Small Business and Enterprise Development 28, no. 4 (April 29, 2021): 537–52. http://dx.doi.org/10.1108/jsbed-04-2019-0126.
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PurposeDespite the fact that small and medium enterprises (SMEs) play a crucial role in strengthening the financial sector within developing and emerging economies through providing employment opportunities to the rural and urban population, capacity building in the form of skills training and economic empowerment, they still face a plethora of challenges that continue to threaten their existence, performance and growth. Access to operational and administrative funds needed to execute their activities effectively is a significant challenge and detrimental to the growth of SMEs in Uganda. Conversely, Islamic microfinance has been noted as a panacea to the challenges of financial inaccessibility among SMEs, especially in developing countries. The purpose of this paper is therefore to investigate how the adoption of Islamic microfinance can play a fundamental role in enhancing the sustainability of microfinance institutions (MFIs) while meeting the financing challenges of SMEs in Uganda.Design/methodology/approachIn this study, a review of existing literature was carried out to critically examine relevant information (literature sources) and empirical studies on SMEs, their performance and challenges. The study being conceptual tries to understand how Islamic microfinance could be adopted as an alternative scheme of financing to bridge the gap and mitigate the financial challenges facing SMEs.FindingsThe study finds that the existing MFIs have failed to achieve their objectives of providing financial services to the poor and SMEs while remaining sustainable. This has left the majority of SMEs within Uganda's informal sector financially handicapped, thus leading to their failure in meeting their expectations and eventually collapsing even before celebrating their third or fourth birthdays. However, the enactment into law of the Financial Institutions Amendment Act 2016 that paved the way for the introduction of Islamic finance in Uganda, and the Tier 4 Microfinance Institutions and Money Lenders' Act, 2016 that incorporated the aspects of Islamic microfinance within the existing microfinance framework as seen and is perceived as a key factor in addressing the financial challenges faced by MFIs and the SMEs if fully adopted.Research limitations/implicationsThis study is conceptual with no empirical investigation and discussion of key theories. On the contrary, it will be imperative and useful when carrying out more extensive hypothetical studies by future researchers, specifically in the area of Islamic microfinance that is relatively new in Uganda.Practical implicationsPractically, this paper will serve as a guide to policymakers and practitioners in the field of microfinance by adding a flair that could enable in bridging the challenges associated with inadequate financing of SMEs in Uganda.Social implicationsSocially, the social aspects of charity (Zakah and Sadaqah) will help to improve the livelihood of the poorest of the poor who cannot engage in active business through meeting their basic needs of life without begging thereby preventing them from being social outcasts.Originality/valueThe study establishes Islamic microfinance (IMF) as a promising and unexplored viable option potentially needed in intensifying the financing needs of SMEs in Uganda. The paper provides an entirely new dimension in nature and way microfinance products should be structured with a view of ensuring that there is sustainable provision of financial services to SMEs. The paper adds real value to the existing conventional microfinance products and services in Uganda, given the ethical and moral attributes of Islamic microfinancing practices that are assumed to efficiently and effectively motivate SME owners and other small entrepreneurs to thrive.
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SERRANO, Pablo Jiménez, and Regina Célia MARTINEZ. "A EDUCAÇÃO PARA O CONSUMO CONSCIENTE: UM COMPONENTE BÁSICO PARA A CONCRETIZAÇÃO DA EFICACIA DO DIREITO DO CONSUMIDOR BRASILEIRO." Revista Juridica 2, no. 59 (April 12, 2020): 311. http://dx.doi.org/10.21902/revistajur.2316-753x.v2i59.4093.
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RESUMO Objetivo: O objetivo deste artigo é investigar o papel da educação como um elemento chave para o consumo no processo de edificação de uma consciência consumerista, tendo como pilar a edificação da eficácia social das normas do Código de Defesa do Consumidor brasileiro, abordando conceitos de consumidor, fornecedor e práticas abusivas adotadas pelos fornecedores contra consumidores. Metodologia: A metodologia eleita foi o método dedutivo, por meio de pesquisa bibliográfica, doutrinária e normativa brasileiras acerca das relações de consumo, tendo como marcos teóricos a obra de Cavalieri Filho e de Cláudia Lima Marques. Resultados: Concluiu-se que as práticas comerciais abusivas são imorais e opressoras, indo contra os padrões de ética da sociedade, ressaltando-se que as mesmas não necessariamente têm de produzir um dano para serem consideradas abusivas. Importa, assim, a educação dos fornecedores, que possibilite a edificação moral e a consequente informação dos consumidores sobre as empresas majoritariamente reclamadas, possibilitando, com isso, a tomada de consciência consumerista em face da não contratação de serviços e produtos dos fornecedores infratores. Contribuições: Demonstrar a importância da educação para o consumo através da consciência sobre deveres e direitos do consumidor frente aos produtos e serviços diuturnamente ofertados pelos fornecedores, além de definir as causas dos abusos cometidos pelos fornecedores contra os consumidores, bem como destacar os aspectos que definem a correlação existente entre a negação dos direitos básicos à educação, informação e tutela jurídica em vista da eficácia do Código de Defesa do Consumidor, mesmo passados trinta anos de sua edição. Palavras-chave: direito do consumidor; educação; informação; eficácia do direito. RESUMEN Objetivo: El objetivo de este artículo es investigar el papel de la educación como elemento clave para el consumo en el proceso de sensibilización del consumidor, teniendo como pilar la construcción de la efectividad social de las normas del Código de Protección al Consumidor de Brasil, abordando los conceptos del consumidor, proveedor y prácticas abusivas adoptadas por proveedores contra consumidores. Metodología: La metodología elegida fue el método deductivo, por medio de la investigación bibliográfica, doctrinal y normativa sobre las relaciones con los consumidores brasileños, teniendo como marco teórico el trabajo de Cavalieri Filho y Cláudia Lima Marques. Resultados: Se concluyó que las prácticas comerciales abusivas son inmorales y opresivas, van en contra de los estándares éticos de la sociedad y enfatizan que no necesariamente tienen que producir daño para ser consideradas abusivas. Por lo tanto, la educación de los proveedores es importante, lo que permite la edificación moral y la consecuente información de los consumidores sobre las empresas en su mayoría reclamadas, lo que permite sensibilizar a los consumidores frente a no contratar los servicios y productos de los proveedores infractores. Contribuciones: Demostrar la importancia de la educación para el consumo a través de la conciencia de los deberes y derechos de los consumidores en relación con los productos y servicios ofrecidos diariamente por los proveedores, además de definir las causas de abuso por parte de los proveedores contra los consumidores, así como destacar los aspectos que definen la correlación entre la negación de los derechos básicos a la educación, la información y la protección legal en vista de la efectividad del Código de Protección al Consumidor, incluso después de treinta años de su edición. Palabras-clave: derecho del consumidor; educación; información; eficacia del derecho. ABSTRACT Objective: To investigate the role of education as a key element for consumption in the process of building a consumer awareness, having as a pillar the building of the social effectiveness of the rules of the Brazilian Consumer Protection Code, addressing consumer concepts , supplier and abusive practices adopted by suppliers against consumers. Methodology:The deductive method, through bibliographic, doctrinal and normativeresearch on Brazilian consumer relations, having as theoretical framework the work of Cavalieri Filho and Cláudia Lima Marques. Results: It was concluded that the abusive commercial practices are immoral and oppressive, going against society's ethical standards, emphasizing that they do not necessarily have to produce harm to be considered abusive. The education of suppliers is important, which enables moral edification and the consequent information of consumers about the companies mostly claimed, making it possible to raise consumer awareness for not contracting the services and products of the offending suppliers. Contributions: Demonstration of the importance of education for consumption through awareness of the duties and rights of consumers in relation to products and services offered daily by suppliers, in addition to defining the causes of abuse by suppliers against consumers, as well as highlighting the aspects that define the existing correlation between the denial of basic rights to education, information and legal protection in view of the effectiveness of the Consumer Protection Code, even after thirty years of its edition. Keywords: consumer law; education; information; effectiveness of law.
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Gazzard, B. G. "AIDS a Moral Issue -- Ethical, Legal and Social Aspects." Journal of Medical Ethics 18, no. 1 (March 1, 1992): 51–52. http://dx.doi.org/10.1136/jme.18.1.51-a.
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Amantova-Salmane, Liene. "ETHICAL ASPECTS OF REGIONAL ECONOMY." Latgale National Economy Research 1, no. 3 (June 23, 2011): 18. http://dx.doi.org/10.17770/lner2011vol1.3.1803.
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In the beginning of economic history, economics as a social science was closely related to ethics and had a moral dimension. The works of Aristotle and Adam Smith show that the science of economics has evolved taking into consideration the ethical stand. However, during the twentieth century, ethics was not considered in the economic analysis, but this situation transformed and ethics became a part of economics. Removing ethics from economics also removes social responsibility and critical awareness. This research analyzes the ethical aspects of regional economy. Regional economy has an ethical dimension because its main goal is to reduce the disparities between regions. There is carried out a brief reference to the relationship between ethics and economy. In the following article there are analysed ethical aspects of regional policy.
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Kulju, Kati, Riitta Suhonen, and Helena Leino-Kilpi. "Ethical problems and moral sensitivity in physiotherapy." Nursing Ethics 20, no. 5 (January 17, 2013): 568–77. http://dx.doi.org/10.1177/0969733012468462.
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This study identified and described ethical problems encountered by physiotherapists in their practice and physiotherapists’ moral sensitivity in ethical situations. A questionnaire-based survey was constructed to identify ethical problems, and the Moral Sensitivity Questionnaire Revised version was used to measure moral sensitivity. Physiotherapists (n = 116) working in public health services responded to the questionnaire. Based on the results, most of the physiotherapists encounter ethical problems weekly. They concern mainly financial considerations, equality and justice, professionalism, unethical conduct of physiotherapists or other professions and patients’ self-determination. The dimension of moral strength was emphasised in physiotherapists’ self-evaluations of their moral sensitivity. As a conclusion, ethical problems do occur not only at individual level but also at organisational and society level. Physiotherapists seem to have moral strength for speaking on behalf of the patient. Scarce resources make them feel insufficient but much could still be done to provide quality care in co-operation with other health-care professionals.
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Mareková, HermĂna. "ETHICAL ASPECTS OF SOCIAL WORK IN MODERN SOCIETY." CBU International Conference Proceedings 5 (September 23, 2017): 710–16. http://dx.doi.org/10.12955/cbup.v5.1012.
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The basic principle for the exercise of professional social work is the respect for human rights and social justice. The social worker's activity is associated with high expectations on the part of society, although the moral standards of society are typically on a lower level. The legislative environment or norms governing the decisions of social workers are determined by legislation as well as generally applicable ethical norms. In practice, this creates ethical dilemmas consisting in the acceptance of a hierarchy or priorities of individual norms, whereas the adopted and applied values and norms can be counterproductive. This situation may cause a conflict between professional ethics and valid social norms. The following article tackles the issues in social work arising from the stereotypes surviving in society and a lack of competence of many social workers.
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Visse, Merel, Guy A. M. Widdershoven, and Tineke A. Abma. "Moral Learning in an Integrated Social and Healthcare Service Network." Health Care Analysis 20, no. 3 (August 31, 2011): 281–96. http://dx.doi.org/10.1007/s10728-011-0187-7.
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Hunt, Geoffrey. "Moral Crisis, Professionals and Ethical Education." Nursing Ethics 4, no. 1 (January 1997): 29–38. http://dx.doi.org/10.1177/096973309700400104.
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Western civilization has probably reached an impasse, expressed as a crisis on all fronts: economic, technological, environmental and political. This is experienced on the cultural level as a moral crisis or an ethical deficit. Somehow, the means we have always assumed as being adequate to the task of achieving human welfare, health and peace, are failing us. Have we lost sight of the primacy of human ends? Governments still push for economic growth and technological advances, but many are now asking: economic growth for what, technology for what? Health care and nursing are caught up in the same inversion of human priorities. Professionals, such as nurses and midwives, need to take on social responsibilities and a collective civic voice, and play their part in a moral regeneration of society. This involves carrying civic rights and duties into the workplace.
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Krajnovic, Dusanka. "Ethical and social aspects on rare diseases." Filozofija i drustvo 23, no. 4 (2012): 32–48. http://dx.doi.org/10.2298/fid1204032k.
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Rare diseases are a heterogenic group of disorders with a little in common except of their rarity affecting by less than 5 : 10.000 people. In the world is registered about 6000-8000 rare diseases with 6-8% suffering population only in the European Union. In spite of rarity, they represent an important medical and social problem due to their incidence. For many rare diseases have no treatment, but if it exists and if started on time as being available to patients, there is a good prognosis for them to be able for normal life. The problems of patients affected by rare diseases are related to the lack of diagnosis and timely undergoing as well as their treatment or prevention. Orphan drugs are products intended for treatment, diagnosis or prevention of rare diseases, but for their development and marketing the industry has not been interested in yet because of their marketing reasons. Patients suffering from a rare disease although belonging to the vulnerable group for their specific health needs, is becoming invisible in the health care system due to their additional needs un properly recognized. Ethical problems faced by patients, but also health care professionals are related to the allocation of medical diagnostics, unequal approach to health care, inappropriately specialized social services as well as therapy and rare orphan drugs unavailability. Ethical questions related to clinical trails on orphan drugs, population screening and epidemiology testing on rare diseases will also be discussed in this paper.
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Asgari, Sharareh, Vida Shafipour, Zohreh Taraghi, and Jamshid Yazdani-Charati. "Relationship between moral distress and ethical climate with job satisfaction in nurses." Nursing Ethics 26, no. 2 (July 18, 2017): 346–56. http://dx.doi.org/10.1177/0969733017712083.
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Background: Moral distress and ethical climate are important issues in the workplace that appear to affect people’s quality of work life. Objectives: This study was conducted to determine the relationship of moral distress and ethical climate to job satisfaction in critical care nurses. Materials and methods: This descriptive-correlation study was conducted on 142 critical care nurses, selected from five social security hospitals in north Iran through census sampling. Data were collected using a demographic questionnaire, the Moral Distress Scale–Revised, the Olson’s Hospital Ethical Climate Survey, and the Brayfield and Rothe Job Satisfaction index. Ethical considerations: The research project was approved by the Ethics Committee of Mazandaran University of Medical Sciences and the Medical Deputy of the Social Security Organization. Findings: The mean scores obtained by the critical care nurses for moral distress, ethical climate, and job satisfaction were 87.02 ± 44.56, 3.51 ± 0.53, and 62.64 ± 9.39, respectively. Although no significant relationships were observed between moral distress and job satisfaction, the relationship between ethical climate and job satisfaction was statistically significant (p < 0.05). Conclusion: Identifying ethical stressors in the workplace and giving proper feedback to the authorities to eliminate these factors and improve the ethical climate in these workplaces can help enhance job satisfaction in nurses and lead to higher quality care.
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Samek, Toni. "Finding Human Rights in Library and Information Work." Bilgi Dünyası 9, no. 2 (October 31, 2008): 527–40. http://dx.doi.org/10.15612/bd.2008.316.
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This discussion paper touches on aspects of the philosophy of librarianship, moral and ethical aspects of librarianship, human rights, social action, social justice, citizen participation in social change, and professional ethics of librarianship.
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Rennó, Heloiza Maria Siqueira, Flávia Regina Souza Ramos, and Maria José Menezes Brito. "Moral distress of nursing undergraduates: Myth or reality?" Nursing Ethics 25, no. 3 (May 18, 2016): 304–12. http://dx.doi.org/10.1177/0969733016643862.
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Introduction: During their education process, nursing undergraduates experience ethical conflicts and dilemmas that can lead to moral distress. Moral distress can deprive the undergraduates of their working potential and may cause physical and mental health problems. Objective: We investigated the experiences of the undergraduates in order to identify the existence of moral distress caused by ethical conflict and dilemmas experienced during their nursing education. Ethical considerations: This study was designed according to the principles of research with human beings and was approved by the Human Research Ethics Committee. Method: A qualitative multiple-case study. Two federal higher education institutions were surveyed, from which 58 undergraduates in nursing participated in the study. The undergraduates were undergoing their professional training. The data were collected through focus groups and were submitted to thematic content analysis, with the resources of the ATLAS TI 7.0 software. Results: Moral distress in undergraduates is a reality and was identified in three axes of analysis: (1) moral distress is experienced by undergraduates in the reality of healthcare services, (2) the teacher as a source of moral distress, and (3) moral distress as a positive experience. Conclusion: The undergraduates in nursing manifest moral distress in different stages of their education, particularly during their professional training. The academic community should reflect and seek solutions for the reality of moral distress in undergraduates.
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Iurcov, Raluca, Magdalena Iorga, and Beatrice Gabriela Ioan. "Ethical Dilemma in Dentistry Practice During COVID 19 Pandemic." Studia Universitatis Babeş-Bolyai Bioethica 65, no. 1-2 (December 30, 2020): 33–48. http://dx.doi.org/10.24193/subbbioethica.2020.03.
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"The dental medical services were forced to follow the decisions of the various national governments that declared a state of emergency and consequently the dental offices were closed for long periods. The present theoretical paper focuses on the moral and ethical aspects related to the patients’ access to dental services and to dentists’ activity (from interdiction of practice to re-opening, with strict preventive rules to combat de spread of infection). The article presents the situation of Romanian dentists during the first six weeks of the pandemic, and it analyses the struggles of patients and doctors to access and to provide dental services during COVID 19 pandemic. Keywords: ethics, dentistry, Romania, pandemic, medicine, COVID 19. "
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Schipper, Karen, Elleke Landeweer, and Tineke A. Abma. "Living with end-stage renal disease: Moral responsibilities of patients." Nursing Ethics 25, no. 8 (January 18, 2017): 1017–29. http://dx.doi.org/10.1177/0969733016687154.
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Background: Living with a renal disease often reduces quality of life because of the stress it entails. No attention has been paid to the moral challenges of living with renal disease. Objectives: To explore the moral challenges of living with a renal disease. Research design: A case study based on qualitative research. We used Walker’s ethical framework combined with narrative ethics to analyse how negotiating care responsibilities lead to a new perspective on moral issues. Participants and research context: One case was chosen from 20 qualitative interviews with renal patients in the Netherlands. Ethical considerations: Several actions have been taken to ensure the informed consent, privacy, anonymity and confidentiality of the patient in this article. More details are offered in this article. The study has been conducted in line with the recommendations of the Medical Ethical Committee of the VU Medical Center. Findings: A renal disease can force people to change their identity, relationships, values and responsibilities. The case study illustrates the moral challenges confronting renal patients. Discussion and conclusion:: Moral issues can be raised by the changes to identities, relationships, values and responsibilities caused by renal disease. Support services for renal patients and their relatives should pay more attention to these issues in order to promote self-management.
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Cheng, Chia-Yi, and Tzu-Ping Ho. "Financial services and ethical hazards: antecedents of repeated ethical violation." European Journal of Marketing 53, no. 4 (April 8, 2019): 758–84. http://dx.doi.org/10.1108/ejm-05-2017-0345.
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Purpose Prior studies have extensively explored individual examples of unethical behavior in sales organizations but focused little on repeated violation (RV) of ethical codes, particularly when managers develop salesforces. Based on social learning theory (SLT), the authors propose a multilevel model of RV antecedents and suggest that organizational influence (social cues and modeling) and individual factors (observer characteristics and behavioral outcomes) affect RV, especially with increasing recruitment of salespeople. Design/methodology/approach Using data from a leading financial company in Taiwan, the authors analyzed 1,231 records of salespeople’s misbehavior through logistic regression and average marginal effects. Findings Modeling in the organization (i.e. peer misconduct), observer characteristics (i.e. experience concerning job tenure and prior violations) and behavioral outcomes (i.e. information concealment violations) were all found to affect the likelihood of RV, and the interactional effect of organizational size was confirmed. Research limitations/implications This study contributes to ethical decision-making theory by explaining aspects of RV through SLT. Its multilevel model, integrated with organizational strategy theories, adds an SLT-focused paradigm into unethical behavior research by considering vicarious learning and self-learning, alongside the reciprocal determinism of cognition, behavior, and environment. Practical implications Managers should consider socially based patterns of violation when initiating a sales business plan. The chances of RV are increased by unethical models in the organization and offenders’ potential for violations, which is reinforced by social environment. Originality/value This study clarified the key drivers of RV decision-making using SLT and identified an effective sales development strategy to maintain an ethically responsible salesforce.