Empirical Ethics Research Research Articles

Translational bioethics: Reflections on what it can be and how it should work.

Translational ethics (TE) has been developed into a specific approach,which revolves around the argument that strategies for bridging the theory-practice gap in bioethics must themselves be justified on ethical terms. This version of TE incorporates normative, empirical and foundational ethics research and continues to develop through application and in the face of new ethical challenges. Here, I explore the idea that the academic field of bioethics has not yet sufficiently analysed its own philosophical foundation for how it can, and should, be practically relevant; neither has it comprehensively discussed the limitations on what impacts bioethicists should pursue. As a result, there has not been adequate training on how to suitably and appropriately impact real-world practices. Moreover, bioethical perspectives are often competing with other strong interests, for example, economic and political, which may weaken their impact on policy-making. The TE approach I propose can not only facilitate practical impacts of academic bioethics by being better informed by real-world ethical issuesbut it also supports targeted and ethical justifications of the actual impact of academic work in real-world contexts. In this paper, I clarify the premises for this TE approach, identify further challenges and sketch out potential solutions for the implementation of this methodological framework.

A systematic review of ethical leadership studies in educational research from 1990 to 2022

The purpose of this review was to provide an overview of the scholarly publications on ethical leadership in educational research, drawing on a database of 151 articles published between 1990 and 2022. Descriptive statistics and content analysis methods were used to identify trends in the ethical leadership literature in terms of volume and growth trajectory of ethical leadership research, geographic and journal distribution, types of articles, authorship trends, citation impact, research methods, key themes and findings associated with empirical ethical leadership research in education. The results revealed that 28% of the articles were conceptual, while the rest was empirical 72%. Within the subset of empirical articles, 61% of the studies adopted qualitative methods, followed by quantitative studies (31%), and mixed methods articles (8%). The analysis found that the ethical leadership research adapting qualitative methodology focused on four major themes: the practices of school ethical leadership; the dilemmas/challenges of ethical leadership; the leadership development of ethical educational leaders; and overlapping issues. The analysis also identified the antecedents, mediators, moderators, and outcomes associated with quantitative ethical leadership research in educational research. Recommendations were provided to strengthen future ethical leadership research.

Empirical Economic Ethics Research: Evidence Regarding Accounting and Statistics

Empirical Economic Ethics Research: Evidence Regarding Accounting and Statistics

Bringing Excitement to Empirical Business Ethics Research: Thoughts on the Future of Business Ethics

To commemorate 40 years since the founding of the Journal of Business Ethics, the editors-in-chief of the journal have invited the editors to provide commentaries on the future of business ethics. This essay comprises a selection of commentaries aimed at creating dialog around the theme Bringing Excitement to Empirical Business Ethics Research (inspired by the title of the commentary by Babalola and van Gils). These editors, considering the diversity of empirical approaches in business ethics, envisage a future in which quantitative business ethics research is more bold and innovative, as well as reflexive about its techniques, and dialog between quantitative and qualitative research nourishes the enrichment of both. In their commentary, Babalola and van Gils argue that leadership research has stagnated with the use of too narrow a range of perspectives and methods and too many overlapping concepts. They propose that novel insights could be achieved by investigating the lived experience of leadership (through interviews, document analysis, archival data); by focusing on topics of concern to society; by employing different personal, philosophical, or cultural perspectives; and by turning the lens on the heroic leader (through “dark-side” and follower studies). Taking a provocative stance, Bal and Garcia-Lorenzo argue that we need radical voices in current times to enable a better understanding of the psychology underlying ethical transformations. Psychology can support business ethics by not shying away from grander ideas, going beyond the margins of “unethical behaviors harming the organization” and expanding the range of lenses used to studying behavior in context. In the arena of finance and business ethics, Guedhami, Liang, and Shailer emphasize novel data sets and innovative methods. Significantly, they stress that an understanding the intersection of finance and ethics is central to business ethics; financial equality and inclusion are persistent socio-economic and political concerns that are not always framed as ethics issues, yet relevant business policies and practices manifest ethical values. Finally, Charles Cho offers his opinion on the blurry line between the “ethical” versus “social” or “critical” aspects of accounting papers. The Journal of Business Ethics provides fertile ground for innovative, even radical, approaches to quantitative methods (see Zyphur and Pierides in J Bus Ethics 143(1):1–16, https://doi.org/10.1007/s10551-017-3549-8, 2017), as part of a broad goal of ethically reflecting on empirical research.

Cancer and COVID-19: ethical issues concerning the use of telemedicine during the pandemic

The lockdown imposed in France during the first wave of the COVID-19 pandemic wreaked havoc with access to healthcare. From March 2020 onwards, the oncologists of Foch Hospital, like many others at hospitals throughout the world, were obliged to adapt to the new conditions, including, in particular, the impossibility of seeing patients in classic consultations for the diagnosis and treatment of cancer. Patients with cancer are particularly susceptible to this new virus, due to their immune status, and this made it difficult to carry out standard hospital visits for these patients. Some patients refused to come to the hospital, whereas the doctors decided, for others, that consultation conditions at the hospital were not sufficiently safe, with sanitary measures that had yet to be precisely defined. Telemedicine was one of the adaptations adopted during this period. This mode of consultation was little used before the pandemic, for various reasons, and reimbursement was not automatic. This new approach proved to have limitations as well as advantages, as demonstrated by our empirical ethics research study, a retrospective qualitative survey of the doctors of the oncology and supportive care departments of Foch Hospital, performed during July 2021. The interview grid was based on the studies on telemedicine, oncology, COVID-19 and empirical ethics available at the time. Based on the experience gained in this domain during the first wave of the epidemic, which hit France between March and June 2020, we identified three eligibility criteria for consultations in telemedicine: the consultation concerned should not be the first consultation, the patient should be a known patient that the doctor trusts not to minimize the description of symptoms, and the results of the patient’s evaluations and examinations must be good. It may be appropriate to continue the use of teleconsultation in the future, provided that these criteria are respected.

Preserving client autonomy when guiding medicine taking in telehomecare: A conversation analytic case study.

Background: Enhancing client autonomy requires close coordination of interactional practices between nurse and client, which can cause challenges when interaction takes place in video-mediated settings. While video-mediated services have become more common, it remains unclear how they shape client autonomy in telehomecare. Research aim: To analyse how video mediation shapes client autonomy when nurses guide medicine taking remotely through video-mediated home care. Research design: This is a conversation analytic case study using video recordings of telehomecare encounters. The theoretical approach draws on ethnomethodology and empirical ethics. Participants and research context: Four home-dwelling older adults and three nurses participated in the data collection; data extracts include one client and two nurses. The study was conducted in Finland. Ethical considerations: Special attention was given to protect the rights of home care clients. An ethical statement for the study was given by the Ethics Committee of the Tampere Region Findings: Video mediation complicates interacting remotely with care-relevant artefacts because of nurses’ limited visual access to the medicine and client’s need to simultaneously engage in vocal interaction and medicine taking. This can be overcome by dividing the guidance into manageable steps which invite the client to explicate their readiness to take the medicine and situating the video-mediation equipment and medicine close together. Different interactional practices and ways of situating video-mediation equipment and medicine have consequences for client autonomy. Discussion: Understanding client autonomy in digitalised settings demands empirical examination that recognises the importance of different human and non-human aspects of care that shape client autonomy. Conclusions: To harness the benefits of video-mediated home care, communication technologies’ reliance on home space and interactional practices should be recognised. Empirical ethics research is needed in order to make normative suggestions that fit a wide variety of care situation.

Model for developing context-sensitive responses to vulnerability in research: managing ethical dilemmas faced by frontline research staff in Kenya

Health research in low-resource settings often involves individuals and populations defined as ‘vulnerable’. There is growing attention in the literature to the ethical dilemmas that frontline research staff face while...

Socially Assistive Robots in Aged Care: Ethical Orientations Beyond the Care-Romantic and Technology-Deterministic Gaze.

Socially Assistive Robots (SARs) are increasingly conceived as applicable tools to be used in aged care. However, the use carries many negative and positive connotations. Negative connotations come forth out of romanticized views of care practices, disregarding their already established technological nature. Positive connotations are formulated out of techno-deterministic views on SAR use, presenting it as an inevitable and necessary next step in technological development to guarantee aged care. Ethical guidance of SAR use inspired by negative connotations tends to be over-restrictive whereas positive connotations tend to provide over-permissive guidance. To avoid these extremes, we report on the development and content of 21 ethical orientations regarding SAR use in aged care. These orientations resulted from a multi-phased project, which consisted of empirical-ethical research focusing on older adults' intuitions regarding SAR use and philosophical-ethical research focusing on philosophical-ethical argumentations regarding SAR use. This project led to the Socio-historical contextualization of the ethics of SAR use, in which the ethical impact of SAR use is localized on three interrelated analysis levels: societal, organizational, and individual-relational. The 21 novel orientations regarding SAR use are structured according to these levels and further categorized into foundational and applied orientations. The first category leads to critical reflection on SAR use while the latter category inspires decision-making processes regarding this use. While going beyond the care-romantic and techno-deterministic gaze of SAR use in aged care, the described orientations balance themselves between their over-restrictiveness and over-permissiveness.

Empirical research in clinical ethics: The 'committed researcher' approach.

After the 'empirical turn' in bioethics, few specific approaches have been developed for doing clinical ethics research in close connection with clinical decision-making on a daily basis. In this paper we describe the 'committed researcher' approach to research in clinical ethics that we have developed over the years. After comparing it to two similar research methodological approaches, the 'embedded researcher' and 'deliberative engagement', we highlight its main features: it is patient-oriented, it is implemented by collegial and multidisciplinary teams, it uses an ethical grid to build the interview guide, and it is geared towards bringing the results to bear on the public debate surrounding the issue at stake. Finally, we position our methodological approach with respect to the 'is vs. ought' distinction. We argue that our 'commitment researcher' approach to clinical ethics research takes concerned people's life-building values as the main data, and compares them to the larger normative framework underlying the medical practice at stake.

Using Insights in Sen’ Capability Approach to Overcome Empirical Development Ethics Research Designing and Execution Challenges

In this paper, we support the adoption of an empirical approach in development ethics research and show that the theoretical insights and methodological guidelines in Sen’s capability approach (CA) can offer helpful guidance to development ethicists on designing and execution of such research. To this end, we show how specific insights in the CA guide one to identify and engage with relevant stakeholders in extensive dialogues about the ethical issues underlying their development practices and in gathering empirical data for further ethical reflections. Drawing on an empirical development ethics research project we conducted in the fisheries sector of Ukerewe District in Tanzania, we illustrate how the CA supported us in identifying 310 representatives of various categories of small-scale fishers and stakeholders, and in designing and executing empirical development ethics research in the form of progressive stages of dialogues in stakeholder groups. The participants in these stakeholder groups reflected on and assessed their individual and collective values, capacities, roles and interests in the fisheries sector. In turn, we gathered empirical data on (i) the nature and causes of the poverty of small-scale fishers and ways to overcome it, (ii) the moral roots of the prevalence of institutional and professional apathy, and (iii) stakeholders’ motivations and concrete actions to support the redressing of the challenges facing small-scale fishers. Later, we used these empirical data to theorise about moving small-scale fishers from poverty to prosperity, and about the development ethic best suited to guide future initiatives in combatting poverty and generating wealth through the fisheries sector in Ukerewe District. 
 Keywords: Empirical Ethics, Development Ethics, Capability Approach, Small-scale Fisheries, Poverty, Ukerewe District, Tanzania

Commentary 2: From Observation to Joint Normative Analysis-Dialogical Empirical Ethics Research.

Commentary 2: From Observation to Joint Normative Analysis-Dialogical Empirical Ethics Research.

Physician-Assisted Suicide and the Perils of Empirical Ethical Research

Physician-Assisted Suicide and the Perils of Empirical Ethical Research

Instrumentalist analyses of the functions of ethics concept-principles: a proposal for synergetic empirical and conceptual enrichment.

Bioethics has made a compelling case for the role of experience and empirical research in ethics. This may explain why the movement for empirical ethics has such a firm grounding in bioethics. However, the theoretical framework according to which empirical research contributes to ethics-and the specific role(s) it can or should play-remains manifold and unclear. In this paper, we build from pragmatic theorystressing the importance of experience and outcomes in establishing the meaning of ethics concepts. We then propose three methodological steps according to which the meaning of ethics concepts can be refined based on experience and empirical research: (1) function identification, (2) function enrichment, and (3) function testing. These steps are explained and situated within the broader commitment of pragmatic ethics to a perspective of moral growth and human flourishing (eudaimonia). We hope that this proposal will give specific direction to the bridging of theoretical and empirical research in ethics and thus support stronger actualization of ethics concepts.

Highlights in this issue

Collaborative networks are playing an increasing role in improving neonatal care. An editorial by Shah and Lehtonen 1 praise Kiechl-Kohlendorfer et al. 2 for developing a robust, national cohort study of preterm infants born at 23–31 weeks in Austria. The overall survival of the cohort, who were born from 2011 to 2016, was 91.6% and 78.2% survived without major neonatal morbidities. Not surprisingly, lower gestational age, lower birth weight, male sex and multiple pregnancies were associated with adverse outcomes. Shah and Lehtonen also comment on the Swedish Neonatal Quality Register, which is described by Norman et al. 3 in this issue. Its completeness and agreement with other registers, especially for preterm infants, was judged to be excellent. Ear tube placements are the most common paediatric surgical procedure in high-income countries. Eythorsson et al. report that the incidence of ear tube insertions increased in Iceland after the introduction of the pneumococcal vaccine into the paediatric vaccination programme in 2011 4. The reasons for these findings are speculative. However, children in the 2011–2015 birth cohorts were less likely to be diagnosed with otitis media or receive antimicrobials before the placement procedure than children in the 2005-2010 cohorts. Administering paediatric drugs remains a challenge, due to the lack of age-appropriate formulations. A study from the Netherlands by van der Vossen et al. found that nurses and parents frequently manipulated oral medication and that 45% of these changes were not in line with the summary of product characteristics or patient information leaflets 5. The results showed that there is a need for age-appropriate medicines that can deliver correct dosages. A cohort study from Gothenburg, Sweden, showed that boys born at term with metabolic acidosis had worse perinatal symptoms and less favourable neurodevelopmental outcomes at 6.5 years of age than girls 6. The findings were seen in those who appeared healthy during the neonatal period. Readers may also be interested in the Evidence-Based Neonatology commentary by Lohmann and Wright, which asks Does permissive hypercapnia carry increased risk for neurodevelopmental sequelae? 7. Medical advances mean that critically ill neonates who eventually die are surviving longer. This has raised concerns that neonatal intensive care units are overtreating patients and unnecessarily subjecting them to expensive and burdensome treatment. Prentice et al. have developed a neonatal intervention score to measure how clinicians treat neonates during their admission, in contrast to other tools that only focus on the time around delivery 8. A validation study on preterm babies born at less than 28 weeks indicated that the score was useful and reliable and may facilitate rigorous empirical ethics research and optimise communication between providers and parents. Figures 1, 3–5: istockphoto.com, 2: Alamy.com

Partnering with patients in translational oncology research: ethical approach

BackgroundThe research program CARPEM (cancer research and personalized medicine) brings together the expertise of researchers and hospital-based oncologists to develop translational research in the context of personalized or “precision” medicine for cancer. There is recognition that patient involvement can help to take into account their needs and priorities in the development of this emerging practice but there is currently no consensus about how this can be achieved. In this study, we developed an empirical ethical research action aiming to improve patient representatives’ involvement in the development of the translational research program together with health professionals. The aim is to promote common understanding and sharing of knowledge between all parties and to establish a long-term partnership integrating patient’s expectations.MethodsTwo distinct committees were settled in CARPEM: an “Expert Committee”, gathering healthcare and research professionals, and a “Patient Committee”, gathering patients and patient representatives. A multidisciplinary team trained in medical ethics research ensured communication between the two committees as well as analysis of discussions, minutes and outputs from all stakeholders.ResultsThe results highlight the efficiency of the transfer of knowledge between interested parties. Patient representatives and professionals were able to identify new ethical challenges and co-elaborate new procedures to gather information and consent forms for adapting to practices and recommendations developed during the process. Moreover, included patient representatives became full partners and participated in the transfer of knowledge to the public via conferences and publications.ConclusionsEmpirical ethical research based on a patient-centered approach could help in establishing a fair model for coordination and support actions during cancer research, striking a balance between the regulatory framework, researcher needs and patient expectations. Our approach addresses the concept of translational ethics as a way to handle the main remaining gap between combining care and research activities in the medical pathway and the existing framework.

A aplicação da deliberação moral na pesquisa empírica em bioética

The article presents an integrated empirical ethics research project that used the moral deliberation, according to the theoretical and philosophical conception, and methodical proposal of Diego Gracia, as a theoretical and methodological framework. The application showed the potential to realize the dynamics of the studied object in real life, making it possible, from the situation presented in the vignettes, for participants to include what they considered for dealing with the conflict of values. It also made the integration of philosophical and empirical approaches in bioethics research possible. The analytical category of prudence allowed the results to be assessed in a critical and comprehensive way.

The Usefulness of Social Norm Theory in Empirical Business Ethics Research: A Review and Suggestions for Future Research

In response to recent calls to extend the underlying theories used in the literature (O’Fallon and Butterfield in J Bus Ethics 59(4):375–413, 2005; Craft in J Bus Ethics 117(2):221–259, 2013), we review the usefulness of social norm theory in empirical business ethics research. We begin by identifying the seeds of social norm theory in Adam Smith’s (in: Raphael and Macfie (eds) The Theory of Moral Sentiments, the Glasgow Edition, Oxford University Press, Oxford, 1759/1790) seminal work, The Theory of Moral Sentiments. Next, we introduce recent theory in social norm activation by Bicchieri (The grammar of society: The nature and dynamics of social norms, Cambridge University Press, New York, 2006) and compare the new theory to two theoretical frameworks found in the literature: Kohlberg’s (in: Goslin (ed) Handbook of socialization theory and research, Rand McNally, Chicago, IL, 1969; in: Lickona (ed) Moral development and behavior, Holt, Rinehart & Winston, New York, 1976) theory of moral development and Cialdini and Trost’s (in: Gilbert et al. (eds) The handbook of social psychology, Oxford University Press, Boston, 1998) taxonomy of social norms. We argue that the new theory provides useful insights by emphasizing the ability of situational cues and information to generate common expectations for social/moral norms. The theory is particularly useful for empirical research in business ethics because it gives both organizational and individual factors a role in motivating norm-based behavior. To demonstrate this usefulness, we present examples where the theory has been effectively applied in experimental accounting research to generate new insights. We conclude by citing specific examples where the theory may prove useful in empirical business ethics research.

What Is Everyday Ethics? A Review and a Proposal for an Integrative Concept

"Everyday ethics" is a term that has been used in the clinical and ethics literature for decades to designate normatively important and pervasive issues in healthcare. In spite of its importance, the term has not been reviewed and analyzed carefully. We undertook a literature review to understand how the term has been employed and defined, finding that it is often contrasted to "dramatic ethics." We identified the core attributes most commonly associated with everyday ethics. We then propose an integrative model of everyday ethics that builds on the contribution of different ethical theories. This model proposes that the function of everyday ethics is to serve as an integrative concept that (1) helps to detect current blind spots in bioethics (that is, shifts the focus from dramatic ethics) and (2) mobilizes moral agents to address these shortcomings of ethical insight. This novel integrative model has theoretical, methodological, practical, and pedagogical implications, which we explore. Because of the pivotal role that moral experience plays in this integrative model, the model could help to bridge empirical ethics research with more conceptual and normative work.

The Usefulness of Social Norm Theory in Empirical Business Ethics Research: A Review and Suggestions for Future Research

In response to recent calls to extend the underlying theories used in the empirical ethical decision-making literature (O’Fallon and Butterfield 2005; Craft 2013), we review the usefulness of social norm theory in empirical business ethics research. We begin by identifying the seeds of social norm theory in Adam Smith’s (1759/1790) seminal work, The Theory of Moral Sentiments. Next, we review recent theory in social norm activation by Bicchieri (2006) and compare the new theory to two theoretical frameworks found in the empirical business ethics literature: Kohlberg’s (1969, 1976) theory of moral development and Cialdini and Trost’s (1998) taxonomy of social norms. We argue that the new theory is capable of providing useful insights by emphasizing the ability of contextual cues to alter behavior by forming common expectations for social norm behavior. To demonstrate this usefulness, we present examples where the theory has been effectively applied in experimental accounting research. Finally, we provide specific examples where the theory may prove useful in empirical business ethics research.

The normative background of empirical-ethical research: first steps towards a transparent and reasoned approach in the selection of an ethical theory.

BackgroundEmpirical-ethical research constitutes a relatively new field which integrates socio-empirical research and normative analysis. As direct inferences from descriptive data to normative conclusions are problematic, an ethical framework is needed to determine the relevance of the empirical data for normative argument. While issues of normative-empirical collaboration and questions of empirical methodology have been widely discussed in the literature, the normative methodology of empirical-ethical research has seldom been addressed. Based on our own research experience, we discuss one aspect of this normative methodology, namely the selection of an ethical theory serving as a background for empirical-ethical research.DiscussionWhereas criteria for a good ethical theory in philosophical ethics are usually related to inherent aspects, such as the theory’s clarity or coherence, additional points have to be considered in the field of empirical-ethical research. Three of these additional criteria will be discussed in the article: (a) the adequacy of the ethical theory for the issue at stake, (b) the theory’s suitability for the purposes and design of the empirical-ethical research project, and (c) the interrelation between the ethical theory selected and the theoretical backgrounds of the socio-empirical research. Using the example of our own study on the development of interventions which support clinical decision-making in oncology, we will show how the selection of an ethical theory as a normative background for empirical-ethical research can proceed. We will also discuss the limitations of the procedures chosen in our project.SummaryThe article stresses that a systematic and reasoned approach towards theory selection in empirical-ethical research should be given priority rather than an accidental or implicit way of choosing the normative framework for one’s own research. It furthermore shows that the overall design of an empirical-ethical study is a multi-faceted endeavor which has to balance between theoretical and pragmatic considerations.