Dilemmas Of Practice Research Articles

Ethical, Psychological and Social Un/certainties in the Face of Deemed Consent for Organ Donation in England.

Deemed consent legislation for deceased organ donation was introduced in England in 2020, and is considered a vital part of the new UK NHS Blood and Transplant's 10-year strategy to increase consent for organ donation. Despite the legislation containing safeguards to protect the public, the introduction of deemed consent creates ethical, psychological and social un/certainties for healthcare professionals in their practice. In this paper, we offer insights into healthcare professionals' perspectives on deemed consent, drawn from interview data with 24 healthcare professionals in an NHS Trust in England, prior to the introduction of the legislation. Whilst participants supported deemed consent in principle, they were concerned that it would present a threat to the nature of donation as a 'gift'; the notion of informed consent (or non-consent); and the autonomy of donors, their relatives, and their own roles as health professionals, posing dilemmas for practice. We argue that healthcare professionals present themselves as guardians of potential (non)donors and thus as having ethics and integrity in their own practice. We draw conclusions around the values and principles that matter to healthcare professionals when contemplating consent in deceased donation which will be useful for organ donation committees and ethics forums.

Psychiatrists’ experiences of involuntary care in South Africa: dilemmas for practice in challenging contexts

Providing for people with psychosocial conditions in crisis is a complex and controversial endeavour that has gained significant attention over the past decade. This increased focus is driven by global...

The ethical and legal dilemmas of Telepsychiatry

This paper was written in the framework of my internship at the National Commission for Bioethics and Technoethics of the Hellenic Republic. It constitutes an attempt at exploring the ethical and legal dilemmas of the medical practice of telepsychiatry. Telepsychiatry, as well as other forms of telemedicine, has become a prevalent way through which patients gain access to healthcare and with many research papers reporting on its effectiveness and advantages, telepsychiatry has gained a lot of proponents in the scientific and healthcare community. However, several questions regarding the ethical and legal nature of the practice remain unanswered and this can put patients and other users of telemental health services under risk for basic rights violations. In this paper, at first the scientific data supporting the use of telepsychiatry will be cited. In addition to that, there will be discussion of several ethical dilemmas that have been reported concerning the use of telemedicine in psychiatry during the past few years and there will be reference to the medical code of ethics. Following that, there will be reference to the existing legislation for telepsychiatry in Greece and the legal issues that can arise will be analyzed. In spite of the fact that the advantages and ethical pitfalls of telepsychiatry are common in many countries, the focus of this paper will be on Greece’s code of medical ethics and legislation due to the lack of relevant bibliography on the matter, even though telepsychiatry is widely used by Greek patients. Finally some suggestions will be made on what ought to be ameliorated in regards to the current conditions, so as to make sure telepsychiatry is in line with the basic principles of bioethics.

Voluntary Discharge and Therapeutic Refusals in Pediatrics: Dilemmas of Clinical Practice

En la práctica clínica, los pediatras se pueden llegar a enfrentar a situaciones que ponen a prueba nuestro conocimiento legal y ético, y que terminan generando dilemas como lo que sucede cuando unos papás solicitan el egreso voluntario de un servicio de salud, o cuando rechazan un tratamiento, o incluso cuando son los mismos pacientes quienes dicen “no” a una intervención médica. Desde el nacimiento de la Declaración de los Derechos de los Niños, se han generado nuevas normas que regulan la toma de decisiones en torno a la salud de niñas, niños y adolescentes y que requieren de la enseñanza masiva para que las conductas tomadas sean acordes con la protección de todos los derechos fundamentales. Es así que la educación en estas normas y el diálogo con las familias y los pacientes se convierten en la clave fundamental para la atención de estas situaciones complejas.

Participant Experience of a Modified Sports Program—A Curriculum Investigation in Gaelic Games

Modified sports programs aim to encourage children’s participation in sport and develop the skills required for future participation, with existing research supporting their positive influence on participants’ enjoyment, skill performance, and learning. However, limited research in this area and potential difficulties in contextual application underscore the need to understand stakeholders’ perceptions and the dilemmas of practice. Therefore, this study aimed to explore stakeholders’ perceptions of the Gaelic games modified sports program, Go Games, utilising the intended–enacted–experienced curriculum model as a framework. Short semi-structured interviews were conducted with 180 participants, including players (n = 92), parents (n = 62), and coaches (n = 26). Data were analysed using qualitative content analysis. The findings indicate a strong coherence between the experiences and perceptions of coaches and parents with the intended curriculum, but a disparity in understanding the purpose and objectives of modifications amongst parents. This study underscores the role of enjoyment for participants, but also highlights the high variability in the sources of this enjoyment. Prominently, coaches faced a range of dilemmas of practice based on the need to juggle often competing sources of motivation and enjoyment. This study suggests the need for greater parental understanding and significant support for coaches to manage these dilemmas of practice.

Ethical reflections on groundwater in contaminated areas

Groundwater science has a well-known relationship with social issues when dealing with risk assessment, yet there is a lack of case studies on the topic. Here, we present reflections for dealing with two ethical challenges: (i) the access and use of public domain monitoring data and (ii) the dissemination of scientific research data and its controversial character. The case study is a long-term collaborative research project aiming to bridge the social and natural sciences to tackle ethical questions and their implications for technical reporting and scientific production in a highly contaminated area situated in Portugal. The method included comprehensive interviews with hydrogeologists within the common project, the consulting of documents and the collaborative analysis of situations in online meetings between sociologists and hydrogeologists. The interviews and formal discussions were recorded, transcribed and analysed. In the two cases related to groundwater assessment in contaminated areas we found that researchers refer to emotions and moral dilemmas when they come into regular contact with social actors. Results also show that a different kind of knowledge is produced in these cases and point to three types of researchers’ positionality. The significance of this paper is to encourage reflection and action on ethical issues in the scientific community and specifically in geoethics. Bringing researchers together to share their practice will help to disentangle some of the negative emotions and moral dilemmas of scientific practice and increase the attention researchers pay to other people’s points of view and interests so as to improve the robustness of scientific data.

The Impact of Covid-19 on Academic Practice: A Dilemma-Driven Self-Study Inquiry at an Institution of Higher Learning

This inquiry was a dilemma-driven, object-inquiry self-study. The study followed visual methodologies in unpacking the impact of Covid-19 on the practices of a practitioner at a rural university. During the Covid-19 pandemic, I was becoming increasingly dissatisfied with my daily practice as an academic because I struggled to locate my footing in what has been dubbed the ‘new normal’ about online student teaching and assessment. In my bid to investigate the dissatisfactions I faced due to Covid-19, I followed the self-study methodology, which entailed my engagement in reflexivity cycles, and feedback from critical friends. My critical friends played a crucial validation role during my data collection, analysis, and drawing of conclusions from multiple data forms that included journal entries and discussions with others. The collected data was thematically and analyzed from deductive to inductive perspective through the process of coding. This inquiry established that the outbreak of Covid-19 led to dilemmas of practice that stemmed from my being deskilled, techno and Covid-phobic; poor individual adaptability; inadequate TPKC; and the shortcomings of working as an isolated silo. It emerged that these dilemmas of practice escalated into professional traumas through working in isolated silos in virtual platforms. Thus, through making our challenges of practice public, we tend to benefit from the pool of probing expertise of others. Whilst the advent of Covid-19 posed unwelcome professional traumas, it was through the probing power of ‘the second voice’ that the over-shadowed professional growth opportunities in this pandemic induced ‘new normal’ was unveiled.

Teaching Myanmar students under the Gaokao policy in a borderland school: Teachers’ challenges and agency

This study examines the classroom interactions and agentive practices of a cohort of Chinese teachers when teaching Myanmar students under the Gaokao policy at a borderland high school in China. The complexities of teaching Myanmar students of diverse backgrounds are manifested in the context of the constraints of professional accountability and working conditions. The study reveals these teachers’ classroom norms and interactions are an outcome of negotiations between their agency and structural power. The teachers’ expectations of the international students’ abilities and prospects are constrained by the limitations of the current curriculum. The paper argues that internal and external conditions contribute to restricting the students’ access to educational resources and employment prospects. This paper draws attention to tensions and dilemmas of pedagogic practice in a borderland setting and calls for setting up a hybrid, inclusive third space for students and teachers in international education.

Dialogic teacher inquiry: The case of a preservice teacher learning to facilitate class discussion

Developing knowledge and practice for high-quality K-12 class discussion remains challenging, especially for new teachers juggling other classroom responsibilities. Our study reports the case of a preservice teacher learning to lead discussions while enrolled in a teacher education inquiry course, simultaneous with semester-long supervised practice teaching in a seventh-grade class (12-13-year-olds) in a high-poverty urban community. The work is guided by a complex teacher learning process for developing complex practice of facilitating discussions in culturally and linguistically diverse high school English classes. Countering popular approaches to “talk moves” as useful but often generic facilitation practices, the teacher education pedagogical innovation we describe positions teachers as knowledge-generating, agentive professionals. Our conceptual framework for teacher learning features dialogic teacher inquiry, with three domains. The first domain involves moving beyond methods texts to dialoguing analytically with and among multiple print, online, and mentor resources for supporting development of a dialogic teaching stance. The second domain intentionally guides new teachers to explore classroom data and consider students as knowledge resources in shaping instruction. The third domain sustains dialogue about discussion processes and evolving conceptions of dialogism in small groups of preservice teacher collectives, enabling sharing of inquiry data, emerging findings, and dilemmas of practice. Drawing upon a larger database, we present a case study demonstrating one preservice teacher’s inquiry work with deep analysis of student talk, detailed memoing processes featuring challenges and benefits of developing dialogic teaching practices, thoughtful criticism of long-established discussion practices, and discoveries about nuances of dialogic teaching. Our case contributes to the literature by presenting an example of dialogic pedagogy for teacher education, in service of preservice teachers learning to lead classroom discussions. Additional innovative pedagogical designs are needed to assist teachers in gaining complex knowledge and practice for teaching and promoting meaningful and learning-rich talk in K-12 classrooms.

Educators’ narratives about everyday work of early childhood education and care in the culturally diverse North

ABSTRACT The aim of the study is to deepen understanding of educators’ daily practices in the Northern ECEC through the lenses of culturally responsive teaching. The research material consists of two-staged peer interviews with 10 educators, which were selected from the whole research material for detailed analysis. The main finding of this study is ethical balancing, which permeates the work of educators in the culturally diverse North. Ethical balancing is presented through four dimensions: (1) educators’ struggles between equality and cultural diversity in everyday ECEC life, (2) educators’ values confronting the requirements of culturally responsive teaching and diverse educational communities, (3) educators balancing between diverse perspectives in collaboration with families and (4) educators’ experiences of inadequacy in culturally diverse settings. In addition to new empirical knowledge, the study provides a new methodological approach to the ECEC research field. The peer interview method has the potential to support educators with the dilemmas of everyday practice, and the method can also be extended to teacher education to support student teachers during their studies. The study challenges educators, education providers and policymakers to engage more deeply with the aims and practices of culturally responsive teaching to respond better to the needs of a diversifying society.

Learning to be ethical: the role of ethical capability in community development education

AbstractIn the complex practices of development, ethical decisions are continually demanded of practitioners. This paper addresses the process of teaching ethics, within a framework of applied ethics and with an emphasis on the development of an understanding of ethics-in-practice in current and future practitioners. Building on recent work in the area of ethics in development and humanitarian practice, it addresses approaches to teaching professional ethics in community development and other fields, and debates about the value of teaching ethics. In particular, this article discusses how students develop what we call ‘ethical capability’—the cognitive and emotional resources needed to negotiate the contradictions and dilemmas of everyday practice, and to apply ethical decision-making models. Analysing a current post-graduate applied development ethics course and experience of similar courses in undergraduate business, we investigate how these can prepare students for the messy reality of community development practice. With very few courses teaching ethics in development, we propose that it is important to enhance ethical capability in community development students and practitioners, and that doing so supports their work and wellbeing.

Changing Police Personal Safety Training Using Scenario-Based-Training: A Critical Analysis of the ‘Dilemmas of Practice’ Impacting Change

This paper outlines an analysis of using Scenario-Based-Training (SBT) to change officer Personal Safety Training (PST) based on existing research evidence and reflections from supporting a National Police Agency attempting to change PST practice. SBT is interrogated in light of its underlying assumptions and situated within the ambiguities, tensions and compromises inherent within police training cultures. Using Windschitl’s framework of conceptual, pedagogical, cultural, and political dilemmas this paper analyses the forces impacting using SBT to change PST. An alternative agenda for change is presented to develop skilled officers and trainers equipped with innovative pedagogies to ‘re-culture’ PST.

Leveraging dilemmas as a pedagogical tool for novice youth worker learning

Youth workers are educators who play an essential role in the social, emotional, and academic development of youth in afterschool contexts (Fusco and Gannett, 2012; Pozzoboni and Kirshner, 2016). They build expertise on the job, learning implicit know-how through contextualized and relationally constructed practice and reflection (Polanyi, 1966; Taylor, 2007). The field, however, has under conceptualized how to foster implicit knowledge development in youth workers. Most youth workers learn experientially throughout their time in-service as they gain the skills and knowledge necessary to navigate complex dilemmas that arise in the field. I build on other scholars of youth work to argue that dilemmas crack open for the learner – who in the case of this paper are novice youth workers – tensions that exist at the nexus of their personal and professional identities. Structuring learning around “dilemmas” offers us a key pedagogical move that affords the field a framework from which to build novice youth workers' implicit skills. I take a case study approach to present how and what four novice youth workers learned in their experience with dilemmas of practice , which were leveraged as a pedagogical in a higher education course called Adolescent Development and Educational Psychology (ADEP).

Towards an educational humanities for teacher education: Building the relational, emotional, and ethical bases of teaching practice

ABSTRACT In medicine, concern about preserving the humanity, empathy, and moral reasoning of prospective doctors during their medical education has spawned the field of medical humanities. Building on the logic of the medical humanities, I propose an educational humanities to support the relational, emotional, and ethical bases of teaching practice. After a brief review of other attempts to bring the humanities into the preparation of educational professionals, I illustrate two main ways that such a field could contribute to teacher education, using poems as examples. Drawing on the way in which the medical humanities expand dominant discourses about medicine, I show how poems can highlight alternative narratives about students’ experiences, particularly through the use of metaphor. Those alternatives may offer better foundations for fruitful and satisfying relationships between teachers and students. Second, I illustrate the use of poems as emotive case examples of ethical dilemmas of practice. I show how discussion of such poems offers a substantive, theoretically grounded approach to the teaching of values, rooted in recognition of the complexity of ethical decision-making in practice.

Ethics education for contemporary clinical pharmacy practice in Africa.

The paradigm shift to a patient-centred pharmacy practice model has resulted in dramatic increases in the number and variety of ethical and other dilemmas that confront pharmacists in their routine practice. However, ethical problems may go undetected by many pharmacists in most developing countries. Hence, there is a huge need for sound educational preparation of future pharmacists before they are faced with an urgent decision. This paper highlights the urgent need for pharmacy ethics to be adequately taught in schools of pharmacy, especially at the undergraduate and professional levels, so that future pharmacists can begin their professional careers with adequate ethical knowledge, skills, competencies and experience to detect and resolve ethical dilemmas of the contemporary patient-centred pharmacy practice.

Frenemies: Marine Turtle Conservation and Economic Development in the Rushikulya Coast, Eastern India

The discourse on biodiversity conservation often presents this domain as an antithesis to economic development. However, in practice, the relation between conservation and development is far more complex because conservationists possess limited powers and must give serious consideration to the economic aspirations of others in any given region, such as local communities and industries. Moreover, conservationists are themselves a heterogeneous group with diverse ways of working. Therefore, although the relation between conservation and development is often described in binary terms such as conflict—co-operation, this does not adequately capture the nuances and dilemmas of actual conservation practice. In this article, I present an ethnographic study of marine turtle conservation in Rushikulya (eastern India), to argue that the relation between the two domains is essentially ambivalent and uncertain and hence, best understood as one of being ‘frenemies’ i.e. friendly enemies, rather than as allies or antagonists. From fieldwork conducted over three years (2012–2015), I describe how actors in both domains opportunistically borrow tools and concepts from each other, which blurs the boundaries between them and results in both connections and contestations. To conclude, I suggest we need more ethnographic studies to understand the realities of practice and provoke reflection on current approaches to both conservation and development.

Artificial intelligence and robots in individuals' lives: how to align technological possibilities and ethical issues

PurposeThis paper reports the panel discussion on the topic of artificial intelligence (AI) and robots in our lives. This discussion was held at the Digitization of the Individual (DOTI) workshop at the International Conference on Information Systems in 2019. Three scholars (in alphabetical order: Ting-Peng Liang, Lionel Robert and Suprateek Sarker) who have done AI- and robot-related research (to varying degrees) were invited to participate in the panel discussion. The panel was moderated by Manuel Trenz.Design/methodology/approachThis paper introduces the topic, chronicles the responses of the three panelists to the questions the workshop chairs posed and summarizes their responses, such that readers can have an overview of research on AI and robots in individuals' lives and insights about future research directions.FindingsThe panelists discussed four questions with regard to their research experiences on AI- and robot-related topics. They expressed their viewpoints on the underlying nature, potential and effects of AI in work and personal life domains. They also commented on the ethical dilemmas for research and practice and provided their outlook for future research in these emerging fields.Originality/valueThis paper aggregates the panelists' viewpoints, as expressed at the DOTI workshop. Crucial ethical and theoretical issues related to AI and robots in both work and personal life domains are addressed. Promising research directions to these cutting-edge research fields are also proposed.

Principles of foster care system – dilemmas of practice

The article shows problems that have appeared in recent years in the changing system of foster care. Referring to the key principles of foster care, the dilemmas, that arise during their practical implementation (double institutionalization, rotation of children in the system ...) and the needs, that become visible when introducing new forms – professional foster families and small care and educational institutions, were shown.

Hotspots and Touchstones: From Critical to Ethical Spatial Practice

This essay starts with an event – what I have come to call “an ethical hotspot” – a moment in which my value systems were challenged and I found myself unable to continue to act as before, until I undertook some critical reflection. Marilys Guillemin and Lynn Gillam (2004) describe what they call “ethically important moments,” 1 which for them mark the “ethical dimension” of decision-making around the day to day dilemmas of research practice. For Guillemin and Gillam negotiating these dilemmas and their relation to institutional ethical procedures requires a degree of reflexivity on the part of the researcher. In this essay, I start by describing the ethical hot-spot that occurred in my life and then discuss how, by reflecting on these issues and the practices that I developed out of them, it might be possible to develop modes of ethical practice that I call – following Foucault – basanic.

Control Shift: European Industrial Heritage Reuse in review

The legacy of industrialisation counts only a few decades of being accepted as cultural heritage. The change of perceptions over its connotation and significance, from a menace to historic landscapes to an outstanding historical resource, took place in an era of massive sociocultural and economic upheavals. Those far-reaching developments reshaped both the theory and the practice of heritage conservation. Since the 1970s, new conservation approaches started emerging and being employed, next to the long established strategies of preservation and restoration. Adaptive reuse was included in the repertoire of conservation and quickly gained ground, as a strategy which allowed both the preservation of heritage values and sustainable development. The incorporation of adaptive reuse as an alternative conservation approach marked a noteworthy shift in heritage care. Contemporary conservation seized aiming at the prevention of change. Instead, it embraced it, following the new axiom: ‘Managing change’. This dissertation, positioned in the crossroads of the heritage conservation, architectural and spatial planning fields, focuses on Industrial Heritage Reuse practice in Europe. Despite widely employed in the last half century, Industrial Heritage Reuse still remains particularly challenging and highly confusing, hiding internal and external risks. Those resonate from the conditions of present times, the ambiguities of the contemporary framework of conservation, the embedded dilemmas of the Reuse practice as well as from the particularities of this special heritage group. This vastly complex yet fascinating topic has not yet been studied holistically under the circumstances dictated by the contemporary era. A deeper and broader understanding of the practice has assumed greater urgency in the 21st century, as it is the stepping stone for the enhancement of the practice -a demand that is increasingly stressed by academic and professional circles. The aim of this dissertation is to explore the potential of enhancement of the Industrial Heritage Reuse through the identification and analysis of its influencing Aspects, under the light of the contemporary theoretical conservation concepts, the current demands of the field of practice and the rising challenges of the 21st century context. This research addresses a topical issue, drawing from the concepts of the contemporary theory of conservation, challenging outdated theoretical notions and conventional practical and methodological applications. Furthermore, it sheds light to a hazy and confusing subject, addressing the tensions and the unresolved issues, highlighted by the existing literature on multiple disciplines. It revisits and reinterprets the standing axiom ‘Managing Change’, providing the scientific community with missing answers on the way, the Actors and the criteria based on which this can be achieved. Drawing upon both theory and practice on an international level, this inquiry gives a holistic and multileveled view on the subject under investigation, stimulating further thought and debate. Apart from extending the academic body of knowledge, the intention of this doctoral research is also to become a useful springboard for the practitioners that engage with Industrial Heritage Reuse. In order to achieve that, this dissertation presents an international and retrospective review of Industrial Heritage care, allowing experience drawn from one country to inform approaches on safeguarding via Reuse on other countries. Furthermore, it offers inspiration and raises awareness through the ‘ReIH’ online knowledge platform (http://reindustrialheritage.eu/projects) and the analysis of twenty cases studies of best practice. Lastly, taking into account the pressing issues of sustainability, equality and multilateralism, it offers guidance, providing a much needed alternative framework for the conservation of Industrial Heritage. This framework is capable of practical implementation and can contribute to an enhanced, more responsive, more sustainable, more inclusive, more value-driven and more holistic practice.