Applied Ethics Research Articles

Artificial intelligence and the situational rationality of diagnosis: Human problem‐solving and the artifacts of health and medicine

AbstractWhat is the problem‐solving capacity of artificial intelligence (AI) for health and medicine? This paper draws out the cognitive sociological context of diagnostic problem‐solving for medical sociology regarding the limits of automation for decision‐based medical tasks. Specifically, it presents a practical way of evaluating the artificiality of symptoms and signs in medical encounters, with an emphasis on the visualization of the problem‐solving process in doctor‐patient relationships. In doing so, the paper details the logical differences underlying diagnostic task performance between man and machine problem‐solving: its principle of rationality, the priorities of its means of adaptation to abstraction, and the effects of seeking optimization in the problem‐solving process. Using these parameters as a heuristic for evaluating the capacity of AI to address issues of diagnostic error through design, the paper presents a conceptual review of the discipline of AI in medicine. Studies relying on procedural rationality describe models that treat diagnosis as a “natural artifact” by employing symbolic methods designed to simulate human problem‐solving. Research adhering to probabilistic rationality describes models that treat diagnosis as a “natural artifact” of an ecological image by utilizing sub‐symbolic methods designed to simulate neural networks. Research guided by situational rationality describes models that require treating diagnosis as a “socio‐cognitive artifact,” the artificiality of which is organized in discourses of patient‐centered decision‐making. The paper concludes with a commentary on the ethical application of AI in health and medicine, given the logical differences underlying diagnostic task performance.

Penerapan Etika Berbusana Muslimah pada Siswi Kelas VIII SMPN 1 Danau Kembar Kabupaten Solok

This research was motivated by the presence of students who violated the dress code, their hair was visible when wearing the hijab, and deliberately did not give a needle to the hijab that fell down in front of the chest so that it showed their chest when their headscarf was blown by the wind. VIII at SMPN1 Danau Kembar, Solok Regency. The purpose of this study was to determine the application of Muslim dress ethics for class VIII students at SMPN1 Danau Kembar, Solok Regency. The type of research that the author uses is descriptive qualitative research. For data collection techniques the authors conduct participatory observation, in-depth interviews and documentation. The data that has been collected is then analyzed with data analysis techniques with data reduction activities, data display and conclusion drawing. To prove that this research is scientific and to test the data obtained, the author uses a data validity test with triangulation techniques. The results of the research and discussion revealed that the application of ethics in Muslim female attire at SMPN 1 Danau Kembar were: (1) functioning as a cover for genitalia, (2) not being tight, (3) not transparent, (4) not resembling men's clothes, (5 ) does not resemble the clothing of pagan women, (6) not for popularity.

COVID-19-DRIVEN SOCIETAL SUSTAINABILITY IN THE APPAREL SUPPLY CHAIN: INSIGHT FROM MUSLIM-MAJORITY COUNTRIES

The current COVID-19 epidemic unveils the vulnerability in the apparel supply chain (ASC). Many workforces are facing future uncertainty due to pandemic-driven job losses. This study aims to comprehend the causes of societal sustainability deficiency in the ASC in Muslim-majority countries and propose strategies supporting a suitable improvement.� Information gathered from experts using a qualitative research method; reveals that the primary cause of the lack of societal sustainability is the dominating power of several brands in the ASC. The usage of contract workforce and illegal subcontracting of apparel production also disrupt the protocol of societal compliance. Besides, the lack of application of Islamic ethics in business operations leads to poor labor conditions causing disruption in labor-societal security. The study proposes that it is imperative to adopt a sustainable procurement framework that integrates the sharing of disturbance risks among suppliers and brands post-COVID-19 crisis. It is also crucial to prohibit suppliers operate illegal subcontracting of apparel manufacture. Besides, brands� order allocation plans and supplier selection must be adjusted to enable the workforce�s societal security. Contribution from labor unions and NGOs must be urged to achieve the grassroots level in community development schemes. As this study involves the Muslim-majority context, mitigation strategies from the Islamic ethics perspective are also considered helpful for solving societal sustainability issues in the ASC.

Idea of justice as a social trap for Russia

This article is a result of its authors’ participation in the round table “Justice and Lawmaking” of the subproject “Ethics and Law: Mechanisms of Mutual Influence” of the HSE project “Applied Ethics” in the State Duma on December 1, 2021. The article considers social issues associated with the justice institutions, which are conditionally named institutional traps (an economic term). The authors focus on how these ‘traps’ work in contemporary Russia and how it is possible to get out of them. The article presents the contemporary discourse on social justice, which is characterized by a variety of concepts and a wide thematic field, and provides a definition of the institutional trap modified for the article’s tasks - a combination of social institutions, which being implemented leads to the results radically different or even opposite to the expected when designing such institutions. The authors argue that a trap is a result of the institution or a combination of institutions created to ensure justice of a certain kind or in accordance with a certain idea, when such an institution or combination leads to both justice (or other comparable public good) and clear injustice. This is a trap for society, because its expectations are deceived, and for the state, because it gets new social problems to be solved. The authors believe that what makes institutions an institutional trap is not only the fact that they do not cope with their tasks, but also do not meet social expectations determined by the system of previous values or inherited from it. The authors conclude that institutional solutions (creation of new institutions, modernization of existing ones) do not guarantee the desired result; we need a single educational program for promoting justice and mercy (taking into account cultural differences), which would explain their fundamental importance for society and its every member.

P72 Research experience across the paediatric rheumatology multi-disciplinary team

P72 Research experience across the paediatric rheumatology multi-disciplinary team

SupportiNg operAtive Photographic documentation in ileocolonic CROHN's disease surgery: The SNAPCROHN study.

There are reported variations in the intraoperative management of Crohn's disease. This consensus statement aimed to develop a standardised protocol for photographic documentation of intraoperative findings and critical procedural steps in ileocolonic Crohn's disease surgery. Colorectal surgeons with a specialist interest in minimally invasive surgery and inflammatory bowel disease were invited as committee members to develop a survey on the use of photo-documentation in Crohn's disease surgery. A 15 item survey was developed on ethical considerations and applications of photo-documentation in audit and quality control, research, and training. There was strong agreement on the potential application of intraoperative photo-documentation in Crohn's disease for training, research, quality control and tertiary referrals. Reviewers agreed that intraoperative staging required photo-documentation of strictures, skip lesions, perforations, fat wrapping and mesenteric disease. The necessary steps to be photo-documented were very specific to Crohn's disease surgery, such as views of anastomosis and strictureplasties, and extent of resection(s). Our consensus statement identified several items for appropriate intraoperative photo-documentation in Crohn's disease surgery, to be used as an adjunct to accurate annotation of intraoperative findings and procedures.

Implementation of Islamic Business Ethics in Persis Banjaran Jam'iyah Enterprises

This study aims to determine the application of Islamic business ethics and dimensions based on four traits of the Apostle (Shiddiq, Amanah, fathonah, and Tabligh) to Jam'iyyah Persis Banjaran business actors. The research method is a descriptive qualitative analysis method carried out on independent variables without making comparisons or connecting with other variables to obtain an overview of the research variables. The results showed that the four qualities of the Apostle had been applied very well, especially in Shiddiq and Amanah. The results of processed data showed that the highest average score in Islamic business ethics was 4.58. Judging from the four qualities of the Apostle applied by business actors in Persis Banjaran, the Shiddiq dimension value is the highest, 4.68. Meanwhile, the value of the Amanah dimension is 4.59.

Nursing Students and the Human Body: Application of an Ethics Pilot Project.

This manuscript offers findings from a pilot project which prepares nursing students for embodied professional practice through the lens of ethics. Four undergraduate nursing students were mentored by two nursing faculty in the Dundon-Berchtold Institute Faculty Fellowship Program in the Application of Ethics through an exploration on the ethics of embodiment using an arts pedagogy across one academic year. Inspired by the intersection of nature and health, this project explores the impact of an arts-integrated pedagogy on the human body. The findings from this project provide a natural first step for nursing students to consider multiple interpretations of the human body and to facilitate the students’ development of an embodied ethical practice that is perceptive, empathic, and attuned to themselves as natural beings as well as diverse individuals and populations. The findings from this pilot project presents a pivotal opportunity to guide future nursing curricular development toward holistic, nature-inspired, and mindful-based interventions in order to increase resilience, decrease risk factors of compassion fatigue and burnout, and support nursing students to develop strength-based skills to use in their professional nursing practice.

Volunteer Tourism: Reflections from Applied Ethics

This article aims to use the applied ethics perspective to reflect on the ethical complexities that may appear in the context of volunteer tourism. In this tourist typology, volunteers come into contact with the local culture by establishing a dialogue between their motivations (diverse and not always markedly altruistic) and the morals and needs of the host community. In this dialogue, difficulties arise that may put these volunteer projects at risk since interactions between people with different values and morals can generate distrust, frustration, and even open conflicts between the host community and visitors. In this context, this article exposes and applies ethics concepts to specific cases and reaffirms the need to train volunteers before their trips to encourage critical self-reflection on their behavior when they are in societies with a different system of morality.

GamReg Sweden-Protocol for a systematic cohort data collection for improved clinical knowledge in specialized gambling disorder treatment.

BackgroundGambling disorder is the first non-substance-related addiction which is recognized as a diagnostic entity and assessed in treatment settings. However, in many clinical settings, assessment, and structured treatment for this condition is severely under-developed, and treatment seeking in many settings is low. This is a protocol paper describing the rationale and structure of a recently established quality register, allowing for structured monitoring of treatment seeking, treatment needs and treatment provision in Swedish health care settings, for gambling disorder and associated conditions.MethodsSince 2019, a Swedish quality register is in use for the systematic data collection from patients receiving treatment in specialized health care. The register is held by Region Skåne, and approved for national use. Swedish quality registers allow for the clinical monitoring of treatment uptake and needs, for quality improvement purposes, and collect systematic cohort data for these purposes. In addition, these quality registers potentially allow for future research projects, after separate ethics applications, allowing for clinical follow-up studies based on non-identified quality register data. Clinical challenges and research knowledge gaps are addressed in the present register, including mental health comorbidity, history of suicidal behavior, comorbid alcohol, drugs and gaming behaviors, and fundamental psycho-social variables such as violence victimization, concerned significant others including children's situation in families of problem gamblers, and main income and involvements with social services and enforcement agency. In addition, patient flows, including rates of referral from primary care and other treatment settings, can be followed. The overall quality register project is registered at clinicaltrials.gov (NCT05276193).DiscussionThe present protocol paper will allow for systematic reporting and future projects addressing knowledge gaps in clinical treatment for gambling disorder, and highlight the importance for evidence-based treatment in a behavioral addiction. Importantly, the current data will contribute to a better understanding of which patient groups may be less likely to seek or to be referred to treatment, and thereby may shape future initiatives to increase screening and referral in targeted, vulnerable groups.

The Effect of Application of Islamic Business Ethics and Islamic Service Quality on Customer Satisfaction of Bank Syariah Indonesia Madiun Branch Offices

Islamic banks are closely related to customers. The existence of a bank is determined by the customer. So it becomes important to create customer satisfaction. In this case, the Indonesian Islamic Bank (BSI) Branch Office (KC) Madiun has tried to apply Islamic business ethics and Islamic service quality to the maximum, but there are customers who are not satisfied with this. The purpose of this study is to determine the effect on the application of Islamic business ethics, Islamic service quality, the effect of the application of Islamic business ethics and Islamic service quality on customer satisfaction. This type of research is quantitative associative. The data collection method used a questionnaire given to BSI KC Madiun customers. The sampling technique is incidental sampling with a sample size of 97 respondents. The data obtained were processed using SPSS 16. The analysis used was the classical assumption test, multiple regression test. The results of this study are the application of Islamic business ethics does not partially affect customer satisfaction BSI KC Madiun, Islamic service quality variable has a partial influence on customer satisfaction BSI KC Madiun. The variables of the application of Islamic business ethics and Islamic service quality have a simultaneous influence on customer satisfaction at BSI KC Madiun, which has a contribution of 47.5% and the rest is influenced by other variables that are not included in the model.

Synthetic Biology for Human Space Missions: Ethical Issues and Practical Applications

ABSTRACT Synthetic biology is a new and promising way of managing challenges which may be faced by astronauts during human space missions. Due to specific constraints, which include long term travel and future settlement where in-situ resources are limited, synthetic biology provides a rational solution. In this paper, we start from an evaluation of ethics of synthetic biology, and propose application of a systematic consequentialist approach for deployment. We discuss possible applications of synthetic biology in resource utilization and life support, which have direct applications to sustaining human-kind both on Earth and in space.

34504 Mixed methods validation of a patient-centered educational atopic dermatitis mobile health application

Atopic dermatitis (AD) has a complex disease course and treatment landscape; bidirectional exchange of disease and patient information is challenging within short a dermatology encounter. Patients often turn to digital resources to seek guidance for self-management, yet many current eczema apps insufficiently support evidence-based guidelines and lack patient engagement in their development. EczemaQ was co-developed with patients as an evidence-based mobile health educational tool to address this gap. In order to validate EczemaQ’s use with AD patient and clinician end-users, ethics approval was granted by the McGill University Center for Applied Ethics for an iterative, explanatory sequential mixed methods (QUAN-QUAL) study. First, quantitative (QUAN) data will be collected through Technology Acceptance Model 2 and Patient Activation Measure questionnaires to obtain preliminary app usability information, and analyzed via descriptive statistics. This data will then inform qualitative (QUAL) data collection via semi-structured focus groups to gain a deeper understanding of end-user priorities, analyzed via thematic analysis. Two QUAN-QUAL arms will occur simultaneously: one arm for patients (eligible patients diagnosed with AD), and one arm for clinicians (AD experts including dermatologists, nurses, pharmacists, and general physicians). A Beta version of the EczemaQ app will be created based on the first iteration of the two arms of the QUAN-QUAL model; EczemaQ Beta will then undergo a second iteration of the process to obtain a finalized EczemaQ app. We offer an example of an integrated knowledge translation tool, featuring genuine patient and clinician partnership, towards bettering AD patient care.

‘What’s next?’ The journey from hospital to community engagement from the perspectives of adults following severe acquired brain injury: a scoping review protocol

IntroductionCommunity integration and social participation remain a challenge for many individuals following acquired brain injury (ABI) and the transition from hospital to home is a complex journey. It is important...

Negotiating the ethical-political dimensions of research methods: a key competency in mixed methods, inter- and transdisciplinary, and co-production research

Methods are often thought of as neutral tools that researchers can pick up and use to learn about a reality ‘out there.’ Motivated by growing recognition of complexity, there have been widespread calls to mix methods, both within and across disciplines, to generate richer scientific understandings and more effective policy interventions. However, bringing methods together often reveals their tacit, inherently contestable, and sometimes directly opposing assumptions about reality and how it can and should be known. There are consequently growing efforts to identify the competencies necessary to work with multiple methods effectively. We identify the ability to recognise and negotiate the ethical-political dimensions of research methods as a key competency in mixed methods, inter- and transdisciplinary, and co-production research, particularly for researchers addressing societal challenges in fields like environment, health and education. We describe these ethical-political dimensions by drawing on our experiences developing an ethics application for a transdisciplinary sustainability science project that brings together the photovoice method and controlled behavioural experiments. The first dimension is that different methods and methodological approaches generate their own ethical standards guiding interactions between researchers and participants that may contradict each other. The second is that these differing ethical standards are directly linked to the variable effects that methods have in wider society (both in terms of their enactment in the moment and the knowledge generated), raising more political questions about the kinds of realities that researchers are contributing to through their chosen methods. We identify the practices that helped us—as two researchers using different methodological approaches—to productively explore these dimensions and enrich our collaborative work. We conclude with pointers for evaluating the ethical-political rigour of mixed methods, inter- and transdisciplinary, and co-production research, and discuss how such rigour might be supported in research projects, graduate training programmes and research organisations.

Promoting nurses' and midwives' ethical responsibilities towards vulnerable people: An alignment of research and clinical practice.

To stimulate discussion and debate about the inclusion of vulnerable populations in primary research to inform practice change and improve health outcomes. Current research practices to safeguard vulnerable people from potential harms related to power imbalances may in fact limit the generation of evidence-based practice. The authors draw on their experience working and researching with a recognized group of vulnerable people, incarcerated pregnant women, to provide insight into the application of ethics in both research and clinical practice. In a novel approach, the ethical principles are presented in both contexts, articulating the synergies between them. Suggestions are presented for how individuals, managers and organizations may improve research opportunities for clinical practitioners and enhance the engagement of vulnerable people to contribute to meaningful practice and policy change. Ethical practice guidelines may limit the ability to create meaningful change for vulnerable populations, who need authentic system change to achieve good health outcomes. Inclusive research and practice are essential to ensuring a strengths-based approach to healthcare and addressing health needs of the whole population. Health systems and models of care recognizing the diverse lives and health needs of the broader population demand practical, sustainable support from clinical managers. Practical suggestions for clinical managers to support point of care research is provided, embedding vulnerable voices in policy, practice development and care provision.

Social work research ethics in China: A scoping review of research involving human subjects during COVID-19.

As the first review to systematically explore the scope and application of Chinese social work research ethics, this study incorporated web-crawling technology in the scoping review process and identified 18 eligible studies from 1168 publications from January 2020 to July 2021. Findings suggest that social work scholars are aware of research ethics when conducting human subjects research in the Chinese population. Yet, many failed to fully demonstrate practical considerations of internationally accepted ethical principles (e.g. respect for persons). We discuss education on research ethics, new challenges of the digital age, and considerations of Chinese culture in developing ethical protocols for social work research in China.

Navigating the dynamics of trust, rapport and power while conducting social health research with people in prison

This paper critically reflects on conducting research with people in prison, including gaining trust and building rapport, and the power imbalances of conducting research in the prison setting. Navigating trust and power is key to successful prison-based research, but these navigations are not confined to the researcher–participant interaction and extend to include researcher entry into the prison and earlier processes such as the ethics application submission. Existing ‘how-to’ guides for prison-based research often draw on ethnographic studies which allow substantial time for the interviewer to build rapport with key prison contacts, including officers, as well as opportunity for people in prison to become familiar with the ethnographer’s presence prior to data collection. Drawing on prison-based research experience from three qualitative health studies pertaining to people in prison living with hepatitis C and/or history of injecting drug use (the primary risk factor for hepatitis C transmission), I consider challenges of access and strategies for on-the-spot rapport building with people in prison. The approaches outlined may be applicable to research with other population groups in which power imbalances may exist.

Access to unpublished protocols and statistical analysis plans of randomised trials

BackgroundAccess to protocols and statistical analysis plans (SAPs) increases the transparency of randomised trial by allowing readers to identify and interpret unplanned changes to study methods, however they are often not made publicly available. We sought to determine how often study investigators would share unavailable documents upon request.MethodsWe used trials from two previously identified cohorts (cohort 1: 101 trials published in high impact factor journals between January and April of 2018; cohort 2: 100 trials published in June 2018 in journals indexed in PubMed) to determine whether study investigators would share unavailable protocols/SAPs upon request. We emailed corresponding authors of trials with no publicly available protocol or SAP up to four times.ResultsOverall, 96 of 201 trials (48%) across the two cohorts had no publicly available protocol or SAP (11/101 high-impact cohort, 85/100 PubMed cohort). In total, 8/96 authors (8%) shared some trial documentation (protocol only [n = 5]; protocol and SAP [n = 1]; excerpt from protocol [n = 1]; research ethics application form [n = 1]). We received protocols for 6/96 trials (6%), and a SAP for 1/96 trial (1%). Seventy-three authors (76%) did not respond, 7 authors responded (7%) but declined to share a protocol or SAP, and eight email addresses were invalid (8%). A total of 329 emails were sent (an average of 41 emails for every trial which sent documentation). After emailing authors, the total number of trials with an available protocol increased by only 3%, from 52% in to 55%.ConclusionsMost study investigators did not share their unpublished protocols or SAPs upon direct request. Alternative strategies are needed to increase transparency of randomised trials and ensure access to protocols and SAPs.

The Parent's Dilemma: Pediatric Assent in Research.

The Parent's Dilemma: Pediatric Assent in Research.