Browsing by Subject "ETHICS"

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  • REAPPROPRIATE Study Grp; Druwe, Patrick; Benoit, Dominique D.; Nurmi, Jouni; Piers, Ruth; Hallikainen, Juhana; Suonsyrja, Timo; Kaartinen, Johanna (2020)
    OBJECTIVES To determine the prevalence of clinician perception of inappropriate cardiopulmonary resuscitation (CPR) regarding the last out-of-hospital cardiac arrest (OHCA) encountered in an adult 80 years or older and its relationship to patient outcome. DESIGN Subanalysis of an international multicenter cross-sectional survey (REAPPROPRIATE). SETTING Out-of-hospital CPR attempts registered in Europe, Israel, Japan, and the United States in adults 80 years or older. PARTICIPANTS A total of 611 clinicians of whom 176 (28.8%) were doctors, 123 (20.1%) were nurses, and 312 (51.1%) were emergency medical technicians/paramedics. RESULTS AND MEASUREMENTS The last CPR attempt among patients 80 years or older was perceived as appropriate by 320 (52.4%) of the clinicians; 178 (29.1%) were uncertain about the appropriateness, and 113 (18.5%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the "appropriate" subgroup was 8 of 265 (3.0%), 1 of 164 (.6%) in the "uncertain" subgroup, and 2 of 107 (1.9%) in the "inappropriate" subgroup (P = .23); 503 of 564 (89.2%) CPR attempts involved non-shockable rhythms. CPR attempts in nursing homes accounted for 124 of 590 (21.0%) of the patients and were perceived as appropriate by 44 (35.5%) of the clinicians; 45 (36.3%) were uncertain about the appropriateness; and 35 (28.2%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the nursing home patients was 0 of 107 (0%); 104 of 111 (93.7%) CPR attempts involved non-shockable rhythms. Overall, 36 of 543 (6.6%) CPR attempts were undertaken despite a known written do not attempt resuscitation decision; 14 of 36 (38.9%) clinicians considered this appropriate, 9 of 36 (25.0%) were uncertain about its appropriateness, and 13 of 36 (36.1%) considered this inappropriate. CONCLUSION Our findings show that despite generally poor outcomes for older patients undergoing CPR, many emergency clinicians do not consider these attempts at resuscitation to be inappropriate. A professional and societal debate is urgently needed to ensure that first we do not harm older patients by futile CPR attempts.
  • Vehviläinen, Sanna; Löfström, Erika; Nevgi, Anne (2018)
    This article deals with the demands that plagiarism places on academic communities, and with the resources staff possess in dealing with these demands. It is suggested that plagiarism ought to be placed in the context of network of intertwining communities (scholarly, pedagogical and administrative), to which participants are engaged to a different extent. The relationship to the ethical issue of plagiarism is related to the subject’s engagement in these communities. The article examines the way teachers deal with plagiarism from the point of view of work engagement and work-related wellbeing. In particular, we analyse job demands created by episodes of dealing with plagiarism as well as job resources teachers possess that aid them in coping with these demands. We used thematic analysis of semi-structured interviews of teachers in two universities. Our results show that the demands fall on five thematic categories: 1. rupture in the personal pedagogical relationship, 2. challenge on the supervisory “gatekeeping” responsibility; 3. a breach of the “everyday normality”; 4. ambivalence in explaining plagiarism and 5. the strain of performing the act of accusation. A key job demand in dealing with plagiarism is that teachers must balance both rule-ethical and care-ethical orientations in their reactions and actions. The resources teachers draw upon when dealing with these demands are: 1) dialogue and reflection in collegial dialogue 2) support from superiors and administration 3) shared protocols, procedures and plagiarism detection software. Our analysis shows that there are various demands that make dealing with plagiarism a strenuous task, but university environments also provide teachers with resources to cope with them.
  • Järvinen, Teppo; Valtonen, Jussi; Jokihaara, Jarkko; Aarnio, Aulis; Saarni, Samuli (2021)
    Luotettavasti laaditut hoitosuositukset ovat työväline, jolla tarjotun hoidon laatua voidaan tutkitusti parantaa. Hoitosuositusten laatiminen on kuitenkin moniulotteinen prosessi, johon ei ole yhtä yksiselitteisesti oikeaa menetelmää ja joka sisältää näytön tulkinnan lisäksi myös monenlaisia arvovalintoja. Siksi hoitosuositusten laatimisprosessi on altis myös päätöksenteon systemaattisille vinoumille. Koska ne eivät johdu yksilöiden tietoisista valinnoista, niiden tehokkaat ehkäisykeinot ovat rakenteellisia. Käsittelemme tässä katsausartikkelissa mekanismeja, joilla päätöksenteko saattaa vinoutua, ja esitämme rakenteellisia ratkaisuja niiden ehkäisemiseksi. Kaksi erityisen merkittävää tekijää, jotka altistavat hoitosuositukset systemaattisille vinoumille, ovat taloudelliset sidonnaisuudet ja ammattikuntaedut. Vinoumien ehkäisykeinoiksi esitämme puolueettomien asiantuntijoiden käyttöä, metodologisen osaamisen vahvistamista ja moniammatillisia työryhmiä.
  • Chesterman, Andrew (2019)
    Six cases or case types are briefly presented, illustrating a number of loose ends in translation ethics. These cases are related to reactions by different agents or voices to a clear error, and the ethical implications of these reactions. Case 1 is invented; it raises questions of accountability. Case 2 concerns reactions to errors in the source text, and official guidelines in this respect. Case 3 problematizes a literary translator’s refusal to correct certain errors. Case 4 discusses the descriptivist scholar’s problem of how to deal with clear errors. Case 5 is about a creative reaction to a serious problem in court interpreting. And case 6 analyses the ethical dilemma of trying to change traditional interpretations of passages in a sacred text, for good utilitarian reasons. Loose ends include: the need to revise codes of ethics; the clash between contractual and utilitarian ethics; clashes between voices; and the relation between personal and professional ethics (e.g. in interventionist translation).
  • Nyirenda, Deborah; Sariola, Salla; Kingori, Patricia; Squire, Bertie; Bandawe, Chiwoza; Desmond, Nicola (2020)
    Background While community engagement is increasingly promoted in global health research to improve ethical research practice, it can sometimes coerce participation and thereby compromise ethical research. This paper seeks to discuss some of the ethical issues arising from community engagement in a low resource setting. Methods A qualitative study design focusing on the engagement activities of three biomedical research projects as ethnographic case studies was used to gain in-depth understanding of community engagement as experienced by multiple stakeholders in Malawi. Data was collected through participant observation, 43 In-depth interviews and 17 focus group discussions with community leaders, research staff, community members and research participants. Thematic analysis was used to analyse and interpret the findings. Results The results showed that structural coercion arose due to an interplay of factors pertaining to social-economic context, study design and power relations among research stakeholders. The involvement of community leaders, government stakeholders, and power inequalities among research stakeholders affected some participants' ability to make autonomous decisions about research participation. These results have been presented under the themes of perception of research as development, research participants' motivation to access individual benefits, the power of vernacular translations to influence research participation, and coercive power of leaders. Conclusion The study identified ethical issues in community engagement practices pertaining to structural coercion. We conclude that community engagement alone did not address underlying structural inequalities to ensure adequate protection of communities. These results raise important questions on how to balance between engaging communities to improve research participation and ensure that informed consent is voluntarily given.
  • Wolff, Lili-Ann; Skarstein, Tuula; Skarstein, Frode (2020)
    During the last century, the human way of life has begun to transgress many of the Earth’s biophysical boundaries in an alarming way. The consequences of this are more dramatic and long lasting than ever before. Many researchers even argue that humanity has created a new geological epoch, which they call Anthropocene. Education, even in early childhood (EC), is often presented as a remedy for these complex problems. Yet, how can anyone prepare young children to deal with such tremendous changes? The primary aim of our study is to define and outline what the mission of early childhood education (ECE) might be in the epoch of the Anthropocene. Through a comprehensive review of the literature, we have tried to find answers about how the Anthropocene could be addressed in ECE. We have searched for answers in the natural science literature, policy documents, educational research articles and philosophy, and discuss the various standpoints we have identified. We argue that the Anthropocene demands a new, more authentic education; a change towards a more holistic, transformative, sustainability-oriented approach. At the same time, children, as always, have a right to a safe, positive and encouraging childhood.
  • Kuusisto, Arniika; Gearon, Liam (2019)
    Acknowledging recent research literature on professionalism and religious education across Europe, the article examines the scholars' and senior professionals' views on the curricula aims and objectives in religious education in Finland. Through asking the professionals' views on the aims of RE in relation to supporting of child's growth and development on one hand and the societal aims of RE on the other, the findings were thematically classified into the following categories. Firstly, the aims regarding the supporting of child's growth and development were focused on literacy on religions and worldviews, increasing the understanding on oneself and others, personal growth, and the skills for global citizenship. From the societal perspective, RE was seen important for supporting the understanding as literacy, understanding as empathy, and competences for global citizenship. Finally, as regards the educational model of teaching about religions, these professionals held somewhat varied views. Some favoured an RE model based on teaching groups reflecting children's own worldview affiliations, others supported whole-class instruction, and still others a hybrid model combining elements of both. However, the way in which the instruction is implemented and the position from which religions are examined in education were perceived to be in a key role in this, whatever the formal structures for instruction.