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The somatoform disorders are a diverse group of conditions that are extremely common in primary and secondary care, but are only rarely seen by psychiatrists. Two important reasons for this are patient opposition to psychiatric diagnosis and the lack of convincing psychiatric models and treatments. Doctors managing these disorders will often find themselves in ethical conflict over the wish to provide treatment while respecting the patient’s autonomy. This is highlighted at the time of diagnosis, where doctors may be tempted to collude in giving a model they do not believe in order to create a therapeutic alliance. Though a path between these may be successfully negotiated, there are risks of harm to the patient, both through unnecessary investigations and by reinforcing the patient’s somatizing.

Currently, the Ebola virus has been classified by the WHO as “an international public health emergency” that has highlighted among other things, the enormous importance of proper and timely medical care. However, the complexity of this new health scenario, mainly due to personal risk in the event of infection, means that professionals are directly faced with situations of great ethical conflict since there is a competition between their duties to patients, colleagues, society and those directed to their own safety. The reasons given by those professionals who respond positively to the duties of their patients have been categorized into three items, namely: professional ethics, the need to help and work ethics. The philosophical foundations of these responses find their roots in the compassion and sense of responsibility that arise when we face helplessness.

Summary Objectives To analyse the level of exposure of nurses to ethical conflict and determine the relationship between this exposure, sociodemographic variables and perceptions of the clinical environment. Design and setting Prospective and descriptive correlational study conducted at 10 intensive care units in two tertiary hospitals affiliated to the University of Barcelona. Sociodemographic and professional data were recorded from a questionnaire and then the previously validated Ethical Conflict in Nursing Questionnaire-Critical Care Version was administered to obtain data regarding experiences of ethical conflict. Results Two hundred and three nurses (68.6%) participated in the study, of whom only 11.8% had training in bioethics. Exposure to ethical conflict was moderate with a x ¯ = 182.35 (SD = 71.304; [0–389]). The realisation that analgesia is ineffective and the administration of treatment without having participated in the decision-making process were the most frequently reported ethical conflicts. Professionals who perceived their environment as supportive for dealing with ethical conflicts reported lower levels of these events (p = 0.001). Conclusions Ethical conflict is an internal problem but it is strongly influenced by certain variables and environmental conditions. The involvement of nurses in the decision-making processes regarding the care of critically ill patients emerges as a factor that protects against ethical conflicts.

When a social worker incurs professional obligations in two different actions, but cannot do both, this is termed “an ethical conflict concerning expectations in concurrently affected arenas” (Levy, 1976, p. 113). This article addresses an ethical dilemma that is centered in one of the most complex and controversial issues within Jewish life today: the question of “who is a Jew.” A case is presented which depicts the complexity of ethical conflicts which may arise from this unanswered question. The values at issue are explored and the process used to clarify, legitimate, and operationalize a plan of action is articulated. Ethical dilemmas invariably arise in social work practice. Resolutions that are clear, easily applied, internally consistent, and that consider the values of all concerned should help in reaching an ethical solution.

This study evaluates management accountants' susceptibility to inappropriate obedience pressure to create budget slack in violation of corporate policy. We also evaluate links between pressure effects and perceived responsibility, decision justifications, and underlying ethical dimensions. The results of an experiment with 77 management accountants reveal that despite pervasive perceptions of ethical conflict, almost half of the participants violated explicit policy and created budgetary slack when faced with obedience pressure from an immediate superior. The results also indicate that participants who added slack to their initial budget recommendation found themselves less responsible for their budget decision than did participants who refused to add slack. In addition, a majority of the participants indicated that the creation of budgetary slack was unfair, unjust, and/or contrary to their duties.

The role of medical and mental health professionals in the provision of treatment for mentally incompetent inmates facing execution has remained a subject of great debate in both psychological literature and practice for years. For some professionals, treating and restoring competence to a condemned inmate is inherently problematic on both legal and ethical grounds, as successful treatment may ultimately translate into the individual's re-eligibility for execution and subsequent death. The underlying ethical conflict of fulfilling the treatment needs of an individual awaiting execution, while simultaneously protecting the person from harm was recently highlighted in the 2003 decision of Singleton v. Norris. In a case of first impression, a divided United States Court of Appeals for the Eighth Circuit held the forcible administration of antipsychotic medication to treat and restore competence to a condemned inmate constitutional. Furthermore, the court held that the execution of an inmate chemical...

• Summary: Social workers cannot avoid ethical dilemmas. This qualitative research investigated the question ‘who do I tell?’, exploring who the people are that social workers approach for advice when a course of action is ethically uncertain. Thirty Australian social workers discussed how they managed a serious ethical dilemma, whether they sought support, and reasons for not seeking support. • Findings: All respondents had access to supervision, and regarded supervision as critical. However, less than half discussed the incident in organizational supervision, and supervision was more likely to be used if external to the organization. In many cases, ethical dilemmas were discussed with colleagues, and to a lesser extent with friends or family. Respondents referred to ethical, practical, organizational, and relationship reasons for not using potential sources of support. Typical issues were: availability; the perceived ethical priorities of the supervisor; the benefits and costs of seeking or not seeking support; behaviour of colleagues, managers or supervisors as the problem at issue; the ethics of discussing work with family and friends. • Applications: The study provides empirical data about support for social workers facing an ethical dilemma. Organizational supervision, ostensibly functioning to ensure standards and ethical practice, appeared the least satisfactory in doing so in critical situations. If relationships are not prioritized, no amount of monitoring of service outputs will create effective practice.

Objective: The main objective of this study was to identify and classify the most common ethical conflicts faced by health professionals working in outpatient and inpatient services. Material and method: a) Expert opinions gathered through semistructured meetings; b) opinions gathered through a questionnaire distributed after a presentation by an ethics committee in health and social services’ centers; and c) an exploratory study with 4 focus groups in which distinct professionals with recognized experience from home and hospital care services participated. Results: The most frequent conflicts faced by health and social services professionals, most of which were common to outpatient and inpatient care, concerned the relationship among health professionals, the appropriateness of therapeutic activities, the relationship with the patient’s family, respect for patients’ preferences, and conflicts arising from the management of social resources and organizational issues. Conclusions: Identifying ethical conflicts through exploratory studies allows topics likely to pose ethical dilemmas to be differentiated in a specific therapeutic area such as healthcare. The presence of one type of ethical conflict or another depends on the type of healthcare provided.

An exploratory study investigated ethical conflicts over access to services for elderly patients and social work practice activities within the context of the Medicare Prospective Payment System (PPS) in home health care. Questionnaires (n = 77) were distributed to attendees at the annual conference of the American Network of Home Health Care Social Workers in October, 2001 (response rate = 43%). A majority of the respondents rated the impact of the ethical conflict on elderly patients as “somewhat” or “very” negative. A decrease in the number of social work home visits since the implementation of PPS was reported by 63% of respondents. Implications for practice, education, and research are discussed.

Assisted suicide has achieved an increasing importance in the international discussion of euthanasia. Developments in the Netherlands have resulted in vehement and passionate discussions. Questions of the patient's autonomy and last will have to be considered as well as the doctor's responsibility and care of the patient. When treating patients who are suicidal or express their request for an assisted suicide, the physician has to deal with a basic ethical conflict as well as his own attitudes towards suffering, disease, old age, suicide, death and the process of dying. Legal permission for a doctor's assistance with suicide is out of the question. Not even exceptional circumstances will make a difference.

This paper empirically examines the relationship between salespeople’s ethical conflict and their job performance. Results suggest that ethical conflict, resulting from an incongruence in ethical values between salespeople and their organizations’ top management, has a negative affect on one element of job performance, meeting sales objectives. Implications and directions for future research are provided.

Medical students are increasingly using electronic health records (EHRs) in clerkships, and medical educators should seek opportunities to use this new technology to improve training. One such opportunity is the ability to "track" former patients in the EHR, defined as following up on patients in the EHR for educational purposes for a defined period of time after they have left one's direct care. This activity offers great promise in clinical training by enabling students to audit their diagnostic impressions and follow the clinical history of illness in a manner not possible in the era of paper charting. However, tracking raises important questions about the ethical use of protected health information, including concerns about compromising patient autonomy, resulting in a conflict between medical education and patient privacy. The authors offer critical analysis of arguments on both sides and discuss strategies to balance the ethical conflict by optimizing outcomes and mitigating harms. They observe that tracking improves training, thus offering long-lasting benefits to society, and is supported by the principle of distributive justice. They conclude that students should be permitted to track for educational purposes, but only with defined limits to safeguard patient autonomy, including obtaining permission from patients, having legitimate educational intent, and self-restricting review of records to those essential for training. Lastly, the authors observe that this conflict will become increasingly important with completion of the planned Nationwide Health Information Network and emphasize the need for national guidelines on tracking patients in an ethically appropriate manner.

The high visibility, importance and degree of ethical conflict associated with the sales function has resulted in increased levels of attention being paid to the area of ethics in sales. This paper presents the ethical beliefs of 377 sales managers operating in South Africa. Results reported are based on a ranking of 50 ethical scenarios with responses ranging from highly unethical to not at all unethical. Analysis of responses according to age was also performed. The authors call for company policy to address ethical issues so that deviant sales behavior can be monitored and controlled.

Resumen: Introducción: La atrofia muscular espinal tipo 1 (AME-1) suele ser mortal en el primer año de vida sin soporte ventilatorio. La decisión de iniciar dicho soporte o no supone un conflicto ético para los profesionales sanitarios. Material y métodos: Se incluyó un escenario de fracaso respiratorio agudo en un lactante con AME-1 en un programa de formación mediante simulación avanzada para pediatras de atención primaria (PAP). Se analizaron de forma sistemática las actuaciones de 34 grupos de 4 pediatras que participaron en 17 cursos. Se valoraron los aspectos clínicos, éticos y de comunicación con los padres. Resultados: La asistencia técnica inicial (administración de oxígeno y soporte ventilatorio inmediato) fue realizada correctamente por el 94% de los equipos. Sin embargo, los PAP tuvieron problemas al abordar los aspectos éticos del caso. Del 85% de los equipos que plantearon el conflicto ético a los padres, lo hizo por iniciativa propia el 29%, el 23% los excluyó de forma activa y solo el 6% los implicaron y tuvieron en cuenta su opinión en la toma de decisiones. Solo el 11,7% preguntó por la calidad de vida del niño y el 12% por su conocimiento del pronóstico de la enfermedad. Ninguno les explicó las alternativas de tratamiento ni trató de contactar con el pediatra de referencia. Conclusiones: Ante un caso simulado de AME-1, los PAP tienen dificultades para interactuar con la familia e implicarla en la toma de decisiones. La formación práctica de todos los pediatras debería incluir problemas de ética clínica. Abstract: Introduction: Spinal muscular atrophy type 1 (SMA-1) tends to be fatal in the first year of life if there is no ventilatory support. The decision whether to start such support is an ethical conflict for healthcare professionals. Material and methods: A scenario of acute respiratory failure in an infant with SMA-1 has been included in a training program using advanced simulation for Primary Care pediatricians (PCP). The performances of 34 groups of 4 pediatricians, who participated in 17 courses, were systematically analyzed. Clinical, ethical and communication aspects with parents were evaluated. Results: The initial technical assistance (Administration of oxygen and immediate ventilatory support) was correctly performed by 94% of the teams. However, the PCP had problems in dealing with the ethical aspects of the case. Of the 85% of the teams that raised the ethical conflict with parents, 29% did so on their own initiative, 23% actively excluded them, and only 6% involved them and took their opinion into account in making decisions. Only 11.7% asked about the quality of life of children and 12% for their knowledge of the prognosis of the disease. None explained treatment alternatives, nor tried to contact the pediatrician responsible for the child. Conclusions: When faced with a simulated SMA-1 infant with respiratory failure, PCP have difficulties in interacting with the family, and to involve it in the decision making process. Practical training of all pediatricians should include case scenarios with an ethical clinical problem.

本稿では, 複数の意思決定主体 (DM) の間で利害の対立があって社会的ジレンマに遭遇し, 競合解消のための合意形成が必要な場合を対象にして, 集団意思決定を数理的にモデル化する方法を示す. そこでは, 各DMが社会的倫理性からお互いの立場をよく考え,「どのようにすれば集団全体 (社会) がよりよい状態に移行するか?」といった倫理感と社会的な眼をもった柔軟性に富んだ選好構造をとらえてモデル化し, 凸依存性に基づいたグループ効用モデルを示す. これによって, 集団を構成する複数のDMに関して, 自己主張が強く利己的な態度を示すDM, 協調性があって柔軟な態度を示すDMなど, 各DMの様々な行動パターンをモデル化することができる.

This paper discusses ethical dilemmas in early childhood education as identified by kindergarten and elementary school teachers ( n = 26). Ethical dilemmas are investigated in the theoretical framework of virtue epistemology. The moral stances of care and responsibility are identified as basic elements in teachers' professional morality. The empirical findings present conflicts between teachers and parents, collegial conflicts between teachers, and inter-institutional conflicts in the community. The method used in the study is a relational reading of teachers' narratives. Interpretative accounts are created to give room for both care and responsibility voices in teachers' written reports. The analysis of the data reveals that the ethical dilemmas in early childhood education are very relational and deal with competing interpretations of 'the best interest of the child'. Teachers have taken the moral stance of care by identifying the ethical conflict. However, the responsible professional action has been m...

En el presente artículo se presentan los resultados de una investigación que analiza dos grandes temas interconectados entre ellos: por un lado, cuáles son los principales tipos de conflicto ético que experimentan los profesionales de la educación social y del trabajo social; en segundo lugar, cuáles son las formas más frecuentes de gestión. A partir de los datos obtenidos, se identifican los elementos que determinan la forma como los profesionales abordan los conflictos de valor y se sugieren criterios para implementar políticas de formación más efectivas para abordar situaciones de complejidad, como es el caso de los conflictos de valor. This paper presents the results of an investigation that analyses two important and interrelated issues: firstly, what are the main types of ethical conflict that social education and social work professionals experiment with; and secondly, which are the most prevalent management forms. From the data obtained, the elements that determine the way the professionals tackle value conflicts are identified, and criterion are suggested in order to implement more effective training policies to approach situations of complexity, as in the case of value conflict. O presente artigo apresenta os resultados de uma pesquisa que analisa dois grandes temas interligados: primeiramente, quais são os principais tipos de conflitos éticos vividos pelos profissionais da educação social e de serviço social; em segundo lugar, quais são as formas mais frequentes de gestão. A partir dos dados obtidos, identificam-se os elementos determinantes das formas como os profissionais abordam os conflitos de valor. Também são sugeridos critérios de implementação de políticas de formação mais efetivas para a resolução de situações de complexidade, como é o caso dos conflitos de valor.

Mental health nursing occurs within a legal and ethical framework that presents conflicts between a paternalistic custodial role and an ethical commitment to autonomy. This paper considers the ethical conflict for nurses posed by acting as second health professional at judicial reviews under Section 16 of the Mental Health (Compulsory Treatment and Assessment) Act. Issues of advocacy and paternalism are discussed in light of the conflict between therapeutic and legislated roles. Strategies aimed at protecting the therapeutic relationship are outlined as a response to the current lack of guidelines in this area. Participation in legal processes of committal requires that nurses reflect carefully and critically on the ethical issues raised.

Patents for genetic material in theindustrialized North have expandedsignificantly over the past twenty years,playing a crucial role in the currentconfiguration of the agricultural biotechnologyindustries, and raising significant ethicalissues. Patents have been claimed for genes,gene sequences, engineered crop species, andthe technical processes to engineer them. Mostcritics have addressed the human and ecosystemhealth implications of genetically engineeredcrops, but these broad patents raise economicissues as well. The Catholic social teachingtradition offers guidelines for critiquing theeconomic implications of this new patentregime. The Catholic principle of the universaldestination of goods implies that genes, genesequences, and engineered crop varieties areineligible for patent protection, although theprocesses to engineer these should be eligible.Religious leaders are likely to make a moresubstantive contribution to debates aboutagricultural biotechnology by addressing theselife patents than by speculating that geneticengineering is ``playing God.''

As sales organizations increase their global operations, there is a need for creating organizational guidelines to establish standards of conduct. This article provides evidence from research, practice and government initiatives that support the need for guidelines to promote legal and ethical conduct in a global sales organization. The sales function of most organizations has a unique set of risks and responsibilities when interacting with customers and often confronts ethical conflict in a cross-cultural setting. Sales organizations with international operations could use the recommended guidelines for initiating structure to improve and facilitate their legal and ethical performance.

Ethical conflicts related to the issues of informed consent, due process, competence, confidentiality, and dual relationships in supervision are discussed. Two strategies are proposed as ways to minimize the potential for ethical conflict in post-master's supervision: the use of professional disclosure statements by supervisors and the development of formal plans for supervision.

This study examined whether perioperative nurses (n = 40) were able to perceive and identify selected ethical issues occurring within their practice setting. The nurses described ethical conflicts and identified factors influential to their ethical decision making. The issues reported were organized into five categories: consent/advocacy, impaired provider/potential for unsafe practice, misrepresentation by care provider, disrespect for patient, and provider judgment/competency. The results of this study support that perioperative nurses both perceive and identify specific ethical issues in the surgical environment. Analysis of their reported actions revealed that the most common methods used for ethical conflict resolution were reporting to the immediate supervisor or personally confronting those directly involved.

This paper analyzes responses to a recent survey of credit union managers who were asked to provide their views of ethical conflicts and practices within their industry. Results indicate that more than half of credit union managers (60%) have some ethical conflict with their individual customers, and (55%) said that there are “a few” industry practices that they considered unethical. “Misleading advertising” and “honesty in internal communications among coworkers” are the situations that most often generate ethical conflicts. About one third of respondents felt that ethical standards in the credit union profession are lower today compared with those 10 years ago, while another third perceived they are higher. Finally, more than half of respondents (58%) said their institutions have formalized rules and standards. Conclusions and implications are outlined and future research needs are described.

Background: Ethical conflicts in nursing have generally been studied in terms of temporal frequency and the degree of conflict. This study presents a new perspective for examining ethical conflict in terms of the degree of exposure to conflict and its typology. Objectives: The aim was to examine the level of exposure to ethical conflict for professional nurses in critical care units and to analyze the relation between this level and the types of ethical conflict and moral states. Research design: This was a descriptive correlational study. Central and dispersion, normality tests, and analysis of variance were carried out. Participants and research context: A total of 203 nurses were from two third-level teaching hospitals in Spain. Both centers are part of the University of Barcelona Health Network. Participants filled out the Ethical Conflict in Nursing Questionnaire–Critical Care Version. Ethical considerations: This investigation received the approval of the ethical committees for clinical investigation of the two participating hospitals. Participants were informed of the authorship and aims of the study. Findings: The index of exposure to ethical conflict was [Formula: see text]. The situations involving analgesic treatment and end-of-life care were shown to be frequent sources of conflict. The types of ethical conflict and moral states generally arranged themselves from lesser to greater levels of index of exposure to ethical conflict. Discussion: The moderate level of exposure to ethical conflict was consistent with other international studies. However, the situations related with family are infrequent, and this presents differences with previous research. The results suggest that there is a logical relationship between types of conflict and levels of exposure to ethical conflict. Conclusion: The types of ethical conflict and moral states were related with the levels of exposure to ethical conflict. The new perspective was shown to be useful for analyzing the phenomenon of ethical conflict in the nurse.

Losing sleep and deciding your administrative job is not worth the pressures you feel could be symptoms that you are struggling with a political ethical conflict. The authors describe a variety of political ethical conflicts and how they can arise, giving examples of dilemmas experienced by nurse managers and offering suggestions for developing successful coping strategies.

As transnational interactions increase, cross-cultural conflict concerning ethical issues is inevitable. This article presents a model for assisting decision makers in selecting appropriate strategies for addressing cross-cultural ethical conflict. A theoretical framework for the model is developed based on the literature on international business ethics and on conflict resolution. The model is illustrated through several case examples. Implications for future research and practice are discussed.

This article summarizes the body of research about ethical conflicts described by nurses in variousfields ofpractice and recommends direction for the use and extension of this information. Twenty-three studies that fit criteria for inclusion were located. As a group, studies use inconsistent terminology, pay little attention to measurement characteristics of the instruments used, and do not use explanatory theory about how and why ethical conflicts develop or are experienced. Several studies of nurses practicing in community and home care settings, in intensive care units, and in administrative roles show some common areas of ethical conflict. Studies of ethical conflicts can be used as a basis for improving practice.

Several leading models of ethical decision making include factors contributing to an organization’s ethical climate as significant determinants affecting ethical choice. The relationship of ethical climate to ethical conflict and role conflict is examined in a salesperson context. Results suggest that salespersons’ perceptions of a positive ethical climate are negatively associated with their perceived ethical conflict with sales managers. Implications and directions for future research are provided.

The journalistic investigation of France's contaminated blood affair achieved unprecedented results, comparable to the Watergate affair. In attempting to counter the investigation and calm the scandal, medical reporters for Le Monde paradoxically legitimized the former and extended the latter. In the process, they faced an ethical quandary:To betray the health system or to allow themselves to be betrayed by its leaders.

The virtue approach to business ethics is a topic of increasing importance within the business world. Focusing on Aristotle's theory that the virtues of character, rather than actions, are central to ethics, Edwin M. Hartman introduces readers of this book to the value of applying Aristotle's virtue approach to business. Using numerous real-world examples, he argues that business leaders have good reason to take character seriously when explaining and evaluating individuals in organisations. He demonstrates how the virtue approach can deepen our understanding of business ethics, and how it can contribute to contemporary discussions of character, rationality, corporate culture, ethics education and global ethics. Written by one of the foremost Aristotelian scholars working in the field today, this authoritative introduction to the role of virtue ethics in business is a valuable primer for graduate students and academic researchers in business ethics, applied ethics and philosophy.

Professionals who interact with a colleague who has violated an ethical standard are faced with a dilemma that includes cultural and professional considerations. As large numbers of rehabilitation counselors indicate an awareness of unethical behavior, it appears that a reluctance to report may exist in the profession. A reporting method is suggested to help resolve conflicts associated with reporting a colleague, while at the same time enhancing concern for victims.

This essay explores ethical conflicts underlying the discourse of the policy debate about transracial adoption, focusing on the adoption of Black children by whites. Three underlying conflicts are analyzed, namely, the values of equality versus community, interracial community versus mukiculturalism, individuality versus racial-ethnic community. The essay concludes with observations on multicultural families.

Medical ethics and professionalism have come to play an increasingly important role in medical practice since the 1980s, but there still is widespread concern about unethical and unprofessional behavior. This survey, based on in-depth interviews held in 2001 with 31 internal medicine residents in 1 traditional and 1 primary care residency at Yale University, was intended to identify the work-related ethical conflicts experienced by these medical house officers. The interviews, which took 18 to 60 minutes, used a standardized guide with probes for clarification and additional detail. Without exception, the participants reported having uncomfortable, improper, unethical, or unprofessional experiences with patients. In 90% of cases, the respondent had been directly involved. These experiences were classified into 5 broad categories: 1) Telling the truth. Many ways of manipulating information were used to avoid telling patients the truth, including delaying or omitting information and, in some instances, lying. These behaviors were variably ascribed to pressure from attending physicians, families, peers, or patients themselves. Relevant topics were diagnoses, prognoses, and statements about how experienced residents were with specific procedures. 2) Respecting patients' wishes. Residents sometimes were unable to ensure that the patient's wishes were respected because of disagreement on the part of the medical team, the patient, or the family about what the patient truly wished and what was in the patient's best interest. 3) Preventing harm. Several residents were distressed by having to accept the risks inherent in needed treatments or procedures. Occasionally, there was concern about the risk arising from the resident's limited experience with a given procedure. 4) Managing the limits of one's competence. Some residents felt inadequately prepared to perform their duties and were uncertain of what to do about it. They often were concerned about how their attending physician, peers, and patients would perceive the situation. Some residents felt it necessary to act as if they were more experienced than they believed they actually were. Some had trouble acknowledging their shortcomings. 5) Addressing the performance of others that is perceived as inappropriate. Residents experienced conflict when they viewed a peer's or an attending physician's performance as inadequate or inappropriate. They were uncertain about whether to challenge, intervene, or report the behavior while at the same time being accepted and approved by their colleagues. Hopefully, the challenges faced by medical residents will lead to better education in ethics and professionalism. Ultimately, residents must learn when compromising ethical standards might be acceptable and when it is not.

The work deals the terms probation, mediation, probation officer and ethical conflict. The diploma is trying to describe the work the probation with clients of Probation and mediation service. What it task of the probation officers, what knowledge have to for performance ones profession. Distance describe, what kind of ethical conflicts he needs to solve while working with clients. I highlight the posibility of connection to the law number 257/2000 about probation and mediation service. This it in the theoretical part. In the practical part I descrie the ethical conflicts occur in the practice of the probation officers.

Objective: To describe the ethical concept of the fetus as a patient and identify its implications for the deliberative practice of perinatal medicine.Methods: We describe secular medical ethics and its two fundamental principles, beneficence and respect for autonomy. We articulate the ethical concept of the fetus as a patient on the basis of the ethical principle of beneficence.Results: In the deliberative practice of perinatal medicine guided by the ethical concept of the fetus as a patient, the perinatologist should always identify and balance beneficence-based obligations to the fetal patient and beneficence-based and autonomy-based obligations to the pregnant patient. Directive counseling is appropriate when the fetus is a patient. Non-directive counseling is appropriate when the fetus is not a patient.Conclusion: Counseling pregnant women about the clinical management of their pregnancies should always identify and balance beneficence-based obligations to the fetal patient and beneficence-based and autonomy-based obligations to the pregnant patient.

SUMMARYAlthough ethical reasoning and analysis may occasionally resolve or reduce ethical conflict, it cannot eliminate it. Some degree of rationally irreconcilable conflict among conscientious, reasonable individuals is unavoidable in free democratic societies. Under what circumstances, then, and for what reasons may individuals accept a compromise solution to an ethical conflict without compromising (or betraying) their moral integrity? After examining the concept of compromise, I show how and why compromise in ethics may, in some circumstances, be integrity-preserving. I conclude by indicating three ways in which this notion of integrity-preserving compromise may be applicable to the ethics of pharmaceutical care.

This paper looks at the national crisis of mass immigration to Israel between 1990 and 1992 as a large-scale laboratory for studying the responses of planners and decisionmakers to crises. Several planning theorists have expressed doubt that there are recognized planning approaches for handling crises, or that planning can be of much help. Can planning guide decisions when uncertainty and turbulence are of such magnitude, or are crises accompanied by “planning failure”? Or may the planning function, perhaps, be strengthened? Do crises show decision modes or trajectories different from noncrisis situations? And what roles do planners play? How do they face situations of heightened ethical conflict? This paper analyzes the modes of response of decisionmakers and planners in crisis, following its various phases, and then draws lessons that can enhance our understanding of planning practice in varied contexts and types of problems.

Research on business ethics is often characterized by a lack of continuity in the measures used in empirical studies. In other words, many investigators develop unique measures rather than use existing ones, a process which has produced a series of measures about which relatively little is known. This paper further explores an existing measure of ten survey items assessing the perceived acceptability of workplace behaviors of a dubious ethical nature. Self-report surveys were administered to two diverse samples of North American respondents (total N = 308). The acceptability scale continued to display adequate α reliability. Respondents who regarded the questionable activities described in the survey items as relatively acceptable tended also to score Machiavellian, to display an “entitled” pattern of equity sensitivity, and to report the existence of relatively little ethical conflict. The paper concluded by affirming the relevance and utility of both the acceptability measure and the ethical conflict scale. Researchers may wish to consider using existing scales when appropriate rather than creating their own measures.

This study assessed the understanding and application of ethical decision making principles by communication professionals in the treatment of communication apprehension (CAA). Data collected from 342 communication professionals suggested that professionals teach and practice with a high level of implicit ethical standards. Consistent with research in the psychotherapy field, it was found that communication professionals hold the highest standards in terms of what they believe they should do in comparison to what they believe they and other professionals would do when faced with particular ethical conflict situations. In addition, it was found that communication professionals discriminate among areas of ethical responsibility, generally holding the highest level of ethical response to informed consent issues as compared to competence limits and advertising practices issues. Communication professionals also hold high levels of ethical response to the intervention of CAA when utilizing therapeutic (as compa...

The contention of this paper is that the current ethical debate over embryonic stem cell research is polarised to an extent that is not warranted by the underlying ethical conflict. It is argued that the ethical debate can be rendered more nuanced, and less polarised, by introducing non-binary notions of moral rightness and wrongness. According to the view proposed, embryonic stem cell research--and possibly other controversial activities too--can be considered 'a little bit right and a little bit wrong'. If this idea were to become widely accepted, the ethical debate would, for conceptual reasons, become less polarised.

Ethical issues near the end of life arise because of concerns about how much and what kind of care makes sense for patients with a limited life expectancy. There is often physician-family conflict about what constitutes appropriate care. Understanding ethical framework in which such decisions are made can also transform what appear to be problematic questions into straightforward answers. Rapid medical advance over the last century ensured that more options are now available, even as the effectiveness of one wanes. Oncologists are facing ethical conflict while caring of include dealing with patient approaching end of their life. These dilemmas include nutritional support and hydration, truth-telling and disagreements over management plans. It would stand clinician in good stead to be aware of these issues and have an approach toward dealing with such conflicts.