Browsing by Subject "Ethics"

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  • Coccolini, Federico; Cicuttin, Enrico; Cremonini, Camilla; Tartaglia, Dario; Viaggi, Bruno; Kuriyama, Akira; Picetti, Edoardo; Ball, Chad; Abu-Zidan, Fikri; Ceresoli, Marco; Turri, Bruno; Jain, Sumita; Palombo, Carlo; Guirao, Xavier; Rodrigues, Gabriel; Gachabayov, Mahir; Machado, Fernando; Eftychios, Lostoridis; Kanj, Souha S.; Di Carlo, Isidoro; Di Saverio, Salomone; Khokha, Vladimir; Kirkpatrick, Andrew; Massalou, Damien; Forfori, Francesco; Corradi, Francesco; Delibegovic, Samir; Machain Vega, Gustavo M.; Fantoni, Massimo; Demetriades, Demetrios; Kapoor, Garima; Kluger, Yoram; Ansari, Shamshul; Maier, Ron; Leppaniemi, Ari; Hardcastle, Timothy; Vereczkei, Andras; Karamagioli, Evika; Pikoulis, Emmanouil; Pistello, Mauro; Sakakushev, Boris E.; Navsaria, Pradeep H.; Galeiras, Rita; Yahya, Ali I.; Osipov, Aleksei V.; Dimitrov, Evgeni; Doklestic, Krstina; Pisano, Michele; Malacarne, Paolo; Carcoforo, Paolo; Sibilla, Maria Grazia; Kryvoruchko, Igor A.; Bonavina, Luigi; Kim, Jae Il; Shelat, Vishal G.; Czepiel, Jacek; Maseda, Emilio; Marwah, Sanjay; Chirica, Mircea; Biancofiore, Giandomenico; Podda, Mauro; Cobianchi, Lorenzo; Ansaloni, Luca; Fugazzola, Paola; Seretis, Charalampos; Gomez, Carlos Augusto; Tumietto, Fabio; Malbrain, Manu; Reichert, Martin; Augustin, Goran; Amato, Bruno; Puzziello, Alessandro; Hecker, Andreas; Gemignani, Angelo; Isik, Arda; Cucchetti, Alessandro; Nacoti, Mirco; Kopelman, Doron; Mesina, Cristian; Ghannam, Wagih; Ben-Ishay, Offir; Dhingra, Sameer; Coimbra, Raul; Moore, Ernest E.; Cui, Yunfeng; Quiodettis, Martha A.; Bala, Miklosh; Testini, Mario; Diaz, Jose; Girardis, Massimo; Biffl, Walter L.; Hecker, Matthias; Sall, Ibrahima; Boggi, Ugo; Materazzi, Gabriele; Ghiadoni, Lorenzo; Matsumoto, Junichi; Zuidema, Wietse P.; Ivatury, Rao; Enani, Mushira A.; Litvin, Andrey; Al-Hasan, Majdi N.; Demetrashvili, Zaza; Baraket, Oussama; Ordonez, Carlos A.; Negoi, Ionut; Kiguba, Ronald; Memish, Ziad A.; Elmangory, Mutasim M.; Tolonen, Matti; Das, Korey; Ribeiro, Julival; O'Connor, Donal B.; Tan, Boun Kim; Van Goor, Harry; Baral, Suman; De Simone, Belinda; Corbella, Davide; Brambillasca, Pietro; Scaglione, Michelangelo; Basolo, Fulvio; De'Angelis, Nicola; Bendinelli, Cino; Weber, Dieter; Pagani, Leonardo; Monti, Cinzia; Baiocchi, Gianluca; Chiarugi, Massimo; Catena, Fausto; Sartelli, Massimo (2021)
    On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.
  • de Hulster, Izaak J.; Nicolet, Valérie; Nikolsky, Ronit; Silverman, Jason M (2021)
  • Kangasniemi, Heidi; Setälä, Piritta; Huhtala, Heini; Olkinuora, Anna; Kämäräinen, Antti; Virkkunen, Ilkka; Tirkkonen, Joonas; Yli-Hankala, Arvi; Jamsen, Esa; Hoppu, Sanna (2022)
    Background We investigated paramedic-initiated consultation calls and advice given via telephone by Helicopter Emergency Medical Service (HEMS) physicians focusing on limitations of medical treatment (LOMT). Methods A prospective multicentre study was conducted on four physician-staffed HEMS bases in Finland during a 6-month period. Results Of all 6115 (mean 8.4/base/day) paramedic-initiated consultation calls, 478 (7.8%) consultation calls involving LOMTs were included: 268 (4.4%) cases with a pre-existing LOMT, 165 (2.7%) cases where the HEMS physician issued a new LOMT and 45 (0.7%) cases where the patient already had an LOMT and the physician further issued another LOMT. The most common new limitation was a do-not-attempt cardiopulmonary resuscitation (DNACPR) order (n = 122/210, 58%) and/or 'not eligible for intensive care' (n = 96/210, 46%). In 49 (23%) calls involving a new LOMT, termination of an initiated resuscitation attempt was the only newly issued LOMT. The most frequent reasons for issuing an LOMT during consultations were futility of the overall situation (71%), poor baseline functional status (56%), multiple/severe comorbidities (56%) and old age (49%). In the majority of cases (65%) in which the HEMS physician issued a new LOMT for a patient without any pre-existing LOMT, the physician felt that the patient should have already had an LOMT. The patient was in a health care facility or a nursing home in half (49%) of the calls that involved issuing a new LOMT. Access to medical records was reported in 29% of the calls in which a new LOMT was issued by an HEMS physician. Conclusion Consultation calls with HEMS physicians involving patients with LOMT decisions were common. HEMS physicians considered end-of-life questions on the phone and issued a new LOMT in 3.4% of consultations calls. These decisions mainly concerned termination of resuscitation, DNACPR, intubation and initiation of intensive care.
  • Janket, Sok-Ja; Meurman, Jukka; Diamandis, Eleftherios P. (2020)
    We teach and practice ethical behavior with all clinical and research activities. Notably, we are well educated to treat the subjects participating in research studies with high ethical standards. However, the ethics of interacting with colleagues, or with junior faculty members, are neither well defined nor taught. Dealing with junior faculty has parallels to dealing with vulnerable research subjects such as children, mentally or physically challenged groups, prison inmates or army recruits. Like any other vulnerable population, lower-ranking faculty members are often at the mercy of department chairs or other higher-ranked faculty members. Herein we present some potentially unethical or unfair examples related to academic research. Our goal is to educate the academic community of conceptual paths and to prevent similar untoward occurrences from happening in the future. Unethical behaviors related to sexual misconduct have already been described elsewhere and are not included in this manuscript. © 2020 Janket SJ et al.
  • Nurmi, Suvielise (2009)
  • CENTER-TBI Investigators; van Veen, Ernest; van der Jagt, Mathieu; Cnossen, Maryse C.; Maas, Andrew I. R.; de Beaufort, Inez D.; Menon, David K.; Citerio, Giuseppe; Stocchetti, Nino; Rietdijk, Wim J. R.; van Dijck, Jeroen T. J. M.; Kompanje, Erwin J. O.; Raj, Rahul (2018)
    BackgroundWe aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation.MethodsInvestigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%).ResultsRegarding practices around brain death, we found agreement on the clinical evaluation (prerequisites and neurological assessment) for brain death determination (BDD) in 100% of the centers. However, ancillary tests were required for BDD in 64% of the centers. BDD for nondonor patients was deemed mandatory in 18% of the centers before withdrawing life-sustaining measures (LSM). Also, practices around postmortem organ donation varied. Organ donation after circulatory arrest was forbidden in 45% of the centers. When withdrawal of LSM was contemplated, in 67% of centers the patients with a ventricular drain in situ had this removed, either sometimes or all of the time.ConclusionsThis study showed both agreement and some regional differences regarding practices around brain death and postmortem organ donation. We hope our results help quantify and understand potential differences, and provide impetus for current dialogs toward further harmonization of practices around brain death and postmortem organ donation.
  • Tammeleht, Anu; Rodriguez-Triana, Maria Jesus; Koort, Kairi; Lofstrom, Erika (2019)
    The increasing concern about ethics and integrity in research communities has brought attention to how students and junior academics can be trained on this regard. Moreover, it is known that ethical behaviour and integrity not only involve individual but also group norms and considerations. Thus, through action research and participant observation, this research investigates the learning processes through which 64 students collaboratively develop research ethics and integrity competencies. The aim was to understand how bachelor, master and PhD students approach ethical dilemma cases through a collaborative process. The data consisted of recorded group work on ethics cases, student group reports, and post-training questionnaires. Later, the analyses considered groups as the unit of analysis. These data were analysed through content analysis utilizing the SOLO taxonomy to identify levels of understanding and assess evolvement of ethical sensitivity during a casebased training session. The results show that all groups reached the level of understanding where the groups demonstrated that concepts had been understood appropriately, but occasionally struggled to make connections between them. Students perceived working collaboratively as beneficial. The results help teachers of research ethics and integrity to make pedagogically justified choices in their teaching. Drawing on the results of this study, we propose a tool for the formative assessment of student learning of research ethics and integrity.
  • Team Dynamics Study Grp; Cobianchi, Lorenzo; Dal Mas, Francesca; Massaro, Maurizio; Leppäniemi, Ari (2022)
    Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures.
  • Radun, Igor; Radun, Jenni; Kitti, Mitri; Kaupi, Heikki; Lajunen, Timo; Olivier, Jake (2022)
    We investigated the preference between transport policies aiming at extending vs. saving lives. In a 2 x 2 experimental survey study participants randomly received one of four possible policy combinations. The saving lives policy included saving five (250 life-years saved) or ten (500 life-years saved) lives of cyclists who are about 30 years of age. The extending lives policy through the promotion of cycling and associated health benefits was set to extend lives by two ratios (10:1 or 20:1) in relation to life-years saved of the life-saving strategy. Participants were representative of Finnish-speaking residents older than 15 years (N = 1025). In total, 45.5% of the participants preferred a policy aimed at saving lives, 36% preferred an extending lives policy, and 18.2% were undecided. These figures remained essentially the same independent of the benefit-to-cost ratio of cycling (in terms of saved life years) and whether the saving life policy meant saving five or ten lives. Women and the elderly preferred a policy aimed at saving lives, while cyclists preferred an extending lives policy. The results are discussed in the context of Vision Zero and a new transport paradigm called Vision Plus.
  • Tirri, Kirsi (Springer Science+Business Media, 2019)
    Springer Nature
  • Halme, Erika; Agbese, Mamia; Antikainen, Jani; Alanen, Hanna Kaisa; Jantunen, Marianna; Khan, Arif Ali; Kemell, Kai Kristian; Vakkuri, Ville; Abrahamsson, Pekka (2022)
    In Port terminals a progressive change is underway in digitalizing traditional systems to SMART systems with the aid of AI. This study follows one of such progressions, the SMARTER project. SMARTER is a sub research and development project of the Sea for Value program of DIMECC company, Finland to create replicable models for digitalization for future terminals which involves the use of AI enabled tools. AI and Autonomous Systems (AS) are the direction that software systems are taking today. But due to ethical challenges involved in the use of AI systems and increased emphasis on ethical practices in the use and design of AI systems, our study provides an ethical angle, Ethical User Stories (EUS). We use an ethically aligned design tool the ECCOLA method to transfer ethical requirements into EUS for non-functional requirements for an aspect of the logistics system, passenger flow. Over the span of six months, 125 EUS using the ECCOLA method were collected through a series of workshops for the passenger flow use case and the findings are revealed in this paper. This project is in the field of maritime industry and concentrates on digitalization of port terminals and this particular paper focuses on the passenger flow. Results are positive towards the practice of Ethical User Stories.
  • Helenius, Timo (Helsingin yliopisto, 2020)
    The philosophical problem explored in this thesis concerns the metaethical demand of impartiality as a condition for ethics. The thesis holds its focus on impartiality while approaching it through an ethico-political set-up concerning the ethics of nationality and its demands. In order to provide a framing for the exploration, the thesis adopts a restricted view to the issue by way of studying leadership that could be called ethical. Moreover, a case study pertaining to the current U.S. Presidential Administration binds the questions together and provides material for conclusions regarding the issue of impartiality as a metaethical demand. In sum, the thesis adopts multiple levels of exploration albeit in the final analysis remaining to be focused in the philosophical question pertaining to the conditions of ethics itself. The thesis is executed in four stages. Chapter one studies some relevant theories of nationality, the relating demands of impartiality, and pins these questions on ethical leadership. The argument is that David Miller’s claim about the plausibility of the ethics of nationality can be challenged due to a tension that remains in stances espousing universalist particularism. This results in the challenge for ethically concerned (national) leaders to not adopt a mistaken cognitive stance in moral reasoning regarding the justified scope of moral worth as theorized by Terry L. Price. On this basis, chapter two outlines a case study in order to concretize the particular challenges that can be met in terms of the reviewed theories. Drawing from Walter Fluker, environmental concern should be an integral aspect of any conception of ethical leadership that itself, however, appears in the same analysis more as a quest rather than a readily executable stance of moral reasoning. Counter to Fluker’s insight, the current U.S. Presidential Administration has wilfully executed policies that aggravate the environmental impacts of climate change. This observation results in the need to clarify the administration’s stance. By way of attempting to comprehend the undercurrents of the case study, chapter three probes into the potential moral and intellectual justifications that would grant some legitimation for the hard-line nationalistic policy-stances as exposed by the case study. The theories by Thomas Malthus and Samuel Huntington as well as the matching applicative ideologization by Steve Bannon provides a framing that would justify the current U.S. Presidential Administration’s nationalistic “America First” program that also covers the field of environmental policymaking. Finally, chapter four ties the analyses together by re-examining un/ethical leadership, the aporia of im/partiality, and the viability of nationalist universalism. As a result, the thesis observes that David Miller’s and Yael Tamir’s respective attempts at defending nationalism fail as in the end they are not able to overcome the evident tension regarding the scope of moral obligations pertaining to im/partiality. Such failures point out an inherent difficulty for any ethical thought in that insofar as there seems not to be an uncontestable justification for defining a restricted scope of moral demands, then all models of normative ethics but pure universalism have been left without proper legitimatization.
  • Clarke, Angus J.; Wallgren-Pettersson, Carina (2019)
    Difficult ethical issues arise for patients and professionals in medical genetics, and often relate to the patient’s family or their social context. Tackling these issues requires sensitivity to nuances of communication and a commitment to clarity and consistency. It also benefits from an awareness of different approaches to ethical theory. Many of the ethical problems encountered in genetics relate to tensions between the wishes or interests of different people, sometimes even people who do not (yet) exist or exist as embryos, either in an established pregnancy or in vitro. Concern for the long-term welfare of a child or young person, or possible future children, or for other members of the family, may lead to tensions felt by the patient (client) in genetic counselling. Differences in perspective may also arise between the patient and professional when the latter recommends disclosure of information to relatives and the patient finds that too difficult, or when the professional considers the genetic testing of a child, sought by parents, to be inappropriate. The expectations of a patient’s community may also lead to the differences in perspective between patient and counsellor. Recent developments of genetic technology permit genome-wide investigations. These have generated additional and more complex data that amplify and exacerbate some pre-existing ethical problems, including those presented by incidental (additional sought and secondary) findings and the recognition of variants currently of uncertain significance, so that reports of genomic investigations may often be provisional rather than definitive. Experience is being gained with these problems but substantial challenges are likely to persist in the long term.
  • Löfström, Erika; Pyhältö, Kirsi (2017)
    This study explored the perceptions of ethical issues in supervision among doctoral students and supervisors. The nature of ethical issues identified by doctoral students (n = 28) and their supervisors (n = 14) is explored and the degree of fit and misfit between their perceptions in two cases representing the natural and behavioural sciences is analysed. Supervisors and students identified different ethical issues, which suggest that there are aspects in the supervisory relationship about which there is no shared understanding. There were also differences between the ethical issues emphasised in the natural sciences from those emphasised in the behavioural sciences, suggesting differences between the domains.
  • de Hulster, Izaak J.; Nikolsky, Ronit; Nicolet, Valérie; Silverman, Jason M (2021)
  • CENTER-TB1 Investigators; van Wijk, Roel P. J.; van Dijck, Jeroen T. J. M.; Timmers, Marjolein; Palotie, Aarno; Piippo-Karjalainen, Anna; Pirinen, Matti; Raj, Rahul; Ripatti, Samuli (2020)
    Purpose: Enrolling traumatic brain injury (731) patients with an inability to provide informed consent in research is challenging. Alternatives to patient consent are not sufficiently embedded in European and national legislation, which allows procedural variation and bias. We aimed to quantify variations in informed consent policy and practice. Methods: Variation was explored in the CENTER-TBI study. Policies were reported by using a questionnaire and national legislation. Data on used informed consent procedures were available for 4498 patients from 57 centres across 17 European countries. Results: Variation in the use of informed consent procedures was found between and within EU member states. Proxy informed consent (N = 1377;64%) was the most frequently used type of consent in the ICU, followed by patient informed consent (N 426;20%) and deferred consent (N 334;16%). Deferred consent was only actively used in 15 centres (26%), although it was considered valid in 47 centres (82%). Conclusions: Alternatives to patient consent are essential for TBI research. While there seems to be concordance amongst national legislations, there is regional variability in institutional practices with respect to the use of different informed consent procedures. Variation could be caused by several reasons, including inconsistencies in clear legislation or knowledge of such legislation amongst researchers. (C) 2020 Published by Elsevier Inc.
  • Soininen, Paivi; Putkonen, Hanna; Joffe, Grigori; Korkeila, Jyrki; Valimaki, Maritta (2014)
  • Thomas, Suzie (2017)
    Many professional archaeologists will engage with television. There seems to be little guidance- other than trial and error and personal communications - for navigating interactions with media production companies. Here, through a series of informal questions and answers, I present some issues with which one might be confronted in such engagements. I base my discussions on personal experience, literature, and conversations with experienced colleagues. A key point is that media production companies' agendas and priorities often differ from those of archaeologists. While the article draws on experiences from Europe and North America, it has relevance for archaeologists working with television everywhere.