Empirical Ethical Analysis Research Articles

Global gas flaring and energy justice: An empirical ethics analysis of stakeholder perspectives

Global gas flaring harms human and non-human health and well-being while contributing to climate change. Flaring activity in the global oil and gas sector is a significant matter of energy justice – concerning the distribution of risks, benefits and harms, recognition of rights, and decision-making influence within gas-flaring-affected communities. This mixed method empirical ethical analysis of gas flaring and energy justice combines Q-methodology and stakeholder interviews with representatives of 14 gas-flaring-affected countries (n = 35) to evaluate the context-sensitivity of distributive, procedural, recognition, and cosmopolitan justice principles to gas-flaring governance. Four dominant normative perspectives emerge around this topic. These perspectives concern: a) government-led zero flaring policy; b) multi-scalar economic governance; c) business responsibility and social license; and d) localism and community empowerment. We find that: first, there is strong stakeholder support for zero-flaring globally. Second, coordinated multi-scalar governance from international-national-local regulatory authorities is desired to protect marginalised communities. Third, egalitarian rights-based approaches are prioritised over utilitarian approaches in planning for oil and gas extraction. Fourth, business responsibility necessitates transparent communication of flaring activities and impacts and the Polluter Pays Principle of environmental redress to affected communities. Finally, stakeholder disagreement centres upon the practical mechanisms to achieve just outcomes - including compensation, the role of local authorities, regulatory agencies, Environmental Impact Assessment, and efforts to tackle rent-seeking and corruption. We conclude that further stakeholder engagement is needed on the implementation processes for gas flaring elimination, rather than the goal itself, through carefully facilitated dialogue and negotiation.

Stakeholder perspectives on care robot users at the intersection of age and gender: Empirical-ethical analysis

Stakeholder perspectives on care robot users at the intersection of age and gender: Empirical-ethical analysis

Philosophers in research ethics committees\u2014what do they think they\u2019re doing? An empirical-ethical analysis

Research ethics committees in Germany usually don’t have philosophers as members and if so, only contingently, not provided for by statute. This is interesting from a philosophical perspective, assuming that ethics is a discipline of philosophy. It prompts the question what role philosophers play in those committees they can be found in. Eight qualitative semi-structured interviews were conducted to explore the self-perception of philosophers regarding their contribution to research ethics committees. The results show that the participants generally don’t view themselves as ethics experts. They are rather unanimous on the competencies they think they contribute to the committee but not as to whether those are philosophical competencies or applied ethical ones. In some cases they don’t see a big difference between their role and the role of the jurist member. In the discussion section of this paper I bring up three topics, prompted by the interviews, that need to be addressed: (1) I argue that the interviewees’ unwillingness to call themselves ethics experts might have to do with a too narrow understanding of ethics expertise. (2) I argue that the disagreement among the interviewees concerning the relationship between moral philosophy and applied ethics might be explained on a theoretical or on a practical level. (3) I argue that there is some lack of clarity concerning the relationship between ethics and law in research ethics committees and that further work needs to be done here. All three topics, I conclude, need further investigation.

What is the problem of dependency? Dependency work reconsidered.

Dependency is fundamental to caring relationships. However, given that dependency implies asymmetry, it also brings moral problems for nursing. In nursing theory and theories of care, dependency tends to be framed as a problem of self‐determination—a tendency that is mirrored in contemporary policy and practice. This paper argues that this problem frame is too narrow. The aim of the paper is to articulate additional theoretical ‘problem frames’ for dependency and to increase our understanding of how dependency can be navigated in practices of long‐term care. It does so by way of an empirical ethical analysis of how care professionals tackle the problem of dependency in group homes for people with intellectual disabilities. The paper refers to these practices of mitigating the problem of dependency as ‘dependency work’, a phrase borrowed from Eva Kittay. The analysis of dependency work suggests that for care professionals, dependency is a threefold problem: one of self‐determination, one of parity and one of self‐worth. These findings suggest that patient autonomy cannot be a full solution to the problem of dependency in long‐term care relations. But they also show that dependency as such is not a problem that can be solved, as attempts to mitigate it only serve to tighten the dependency relationship further. This is the paradox of dependency work.

Limiting treatment and shortening of life: data from a cross-sectional survey in Germany on frequencies, determinants and patients\u2019 involvement

BackgroundLimiting treatment forms part of practice in many fields of medicine. There is a scarcity of robust data from Germany. Therefore, in this paper, we report results of a survey among German physicians with a focus on frequencies, aspects of decision making and determinants of limiting treatment with expected or intended shortening of life.MethodsPostal survey among a random sample of physicians working in the area of five German state chambers of physicians using a modified version of the questionnaire of the EURELD Consortium. Information requested referred to the patients who died most recently within the last 12 months. Logistic regression was performed to analyse associations between characteristics of physicians and patients regarding limitation of treatment with expected or intended shortening of life.ResultsAs reported elsewhere, 734 physicians responded (response rate 36.9%) and of these, 174 (43.2%) reported a withholding and 144 (35.7%) a withdrawal of treatment. Eighty one physicians estimated that there was at least some shortening of life as a consequence. In 25.9% of these cases hastening death had been discussed with the patient at the time or immediately prior to this action. Types of treatment most frequently limited was artificial nutrition (n = 35). Bivariate analysis indicates that limitation of treatment with possible or intended shortening of life for patients aged > 75 years is performed significantly more often (p = 0.007, OR 1.848). There was significantly less limitation of treatment in patients who died from cancer compared to patients with other causes of death (p = 0.01, OR 0.486). There was no significant statistical association with physicians’ religion, palliative care qualification or frequencies of limiting treatment.ConclusionsIn comparison to recent research from other European countries, limitation of treatment with expected or intended shortening of life is frequently performed amongst the investigated sample. The role of clinical and non-medical aspects possibly relevant for physicians’ decision about withholding or withdrawal of treatment with possible or intended shortening of life and reasons for non-involvement of patients should be explored in more detail by means of mixed method and interdisciplinary empirical-ethical analysis.

An empirical ethical analysis of community treatment orders within mental health services in England

Community treatment orders are a legal mechanism to extend powers of compulsion into outpatient mental health settings in certain circumstances. Previous ethical analyses of these powers have explored a perceived tension between a duty to respect personal freedoms and autonomy and a duty to ensure that patients with the most complex needs are able to receive beneficial care and support that maximises their welfare in the longer-term. This empirical ethics paper presents an analysis of 75 interviews with psychiatrists, patients and family carers to show how these ethical considerations map onto the different ways that community treatment orders are used and experienced in practice. A complex and nuanced account of how the requirements to respect patients’ autonomy, to respect patients’ liberty and to act beneficently should be interpreted in order to make judgements about the ethics of community treatment orders is presented. The article argues that, due to such complexity, no general ethical justification for community treatment orders can be provided, but a justification on the basis of the promotion of patients’ autonomy could provide an ethical reason for community mental health practitioners to make use of a community treatment order in some limited circumstances.

Research participants’ perceptions and views on consent for biobank research: a review of empirical data and ethical analysis

BackgroundAppropriate information and consent has been one of the most intensely discussed topics within the context of biobank research. In parallel to the normative debate, many socio-empirical studies have been conducted to gather experiences, preferences and views of patients, healthy research participants and further stakeholders. However, there is scarcity of literature which connects the normative debate about justifications for different consent models with findings gained in empirical research. In this paper we discuss findings of a limited review of socio-empirical research on patients’ and healthy research participants’ experiences and views regarding consent to biobank research in light of ethical principles for appropriate information and consent.MethodsReview question: Which empirical data are available on research participants’ perceptions and views regarding information and elicitation of consent for biobank research? Search of articles published till March 1st 2014 in Pubmed. Review of abstracts and potentially relevant full text articles by two authors independently. As categories for content analysis we defined (i) understanding or recall of information, (ii) preferences regarding information or consent, and (iii) research participants’ concerns.ResultsThe search in Pubmed yielded 337 abstracts of which 10 articles were included in this study. Approaches to information and consent varied considerably across the selected studies. The majority of research participants opted for some version of limited consent when being informed about such possibility. Among the factors influencing the type of preferred consent were information about sponsoring of biobank research by pharmaceutical industry and participants’ trade-off between privacy and perceived utility. Studies investigating research participants’ understanding and recall regarding the consent procedure indicated considerable lack of both aspects. Research participants’ perceptions of benefits and harms differ across those studies.ConclusionThe knowledge, perceptions and views of research participants who have undergone a consent procedure within the context of biobank research raise several questions on the issue of how to inform and elicit consent in an ethically acceptable way. In our empirical-ethical analysis we develop suggestions on how the practice of eliciting consent in the biobank context should be improved.

Knowledge, Experiences and Views of German University Students Toward Neuroenhancement: An Empirical-Ethical Analysis

Across normative and empirical disciplines, considerable attention has been devoted to the prevalence and ethics of the non-medical use of prescription and illegal stimulants for neuroenhancement among students. A predominant assumption is that neuroenhancement is prevalent, in demand, and calls for appropriate policy action. In this paper, we present data on the prevalence, views and knowledge from a large sample of German students in three different universities (n = 1,026) and analyze the findings from a moral pragmatics perspective. The results of our study indicate that neuroenhancement is a well-known phenomenon among German students, but not prevalent. 2.2 % of our sample reported having used a prescription medication for neuroenhancement. Exams and competitive situations were predominant motivators of use. Students were unenthusiastic and critical about neuroenhancement in the academic context and disapproved of neuroenhancement for professionals. The majority of respondents agreed that neuroenhancing substances should be regulated by the state. These stances were based on strong beliefs in resisting peer pressure, avoiding the creation of injustice and valuing of hard work. From a moral pragmatics standpoint, these results challenge the assumption that policy on neuroenhancement is necessary in academic environments.

Washing the patient: dignity and aesthetic values in nursing care

Dignity is a fundamental concept, but its meaning is not clear. This paper attempts to clarify the term by analysing and reconnecting two meanings of dignity: humanitas and dignitas. Humanitas refers to citizen values that protect individuals as equal to one another. Dignitas refers to aesthetic values embedded in genres of sociality that relate to differences between people. The paper explores these values by way of an empirical ethical analysis of practices of washing psychiatric patients in nursing care. Nurses legitimate the washing of reluctant patients with reference to dignity. The analysis shows the intertwinement of humanitas and dignitas that gives dignity its fundamental meaning.

Moral Leadership in Medicine – Building Ethical Healthcare Organizations

What are the moral challenges that confront doctors as they manage healthcare institutions? How do we build trust in medical organisations? How do we conceptualize moral action? Based on accounts given by senior doctors from organisations throughout the UK, this book discusses the issues medical leaders find most troubling and identifies the moral tensions they face. Moral Leadership in Medicine examines in detail how doctors protect patients' interests, implement morally controversial change, manage colleagues in difficulty and rebuild trust after serious medical harm. The book discusses how leaders develop moral narratives to make sense of these situations, how they behave while balancing conflicting moral goals and how they influence those around them to do the right thing in difficult circumstances. Based on empirical ethical analysis, this volume is essential reading for clinicians in leadership roles and students and academics in the fields of healthcare management, medical law and healthcare ethics.

Limitation of treatment at the end of life: an empirical-ethical analysis regarding the practices of physician members of the German Society for Palliative Medicine

ObjectivesTo determine the frequencies and types of limitation of medical treatment performed by physician members of the German Society for Palliative Medicine and to analyse the findings with respect to...