Ethics Of Care Research Articles

Wearable Technology and Chronic Illness: Balancing Justice and Care Ethics

Wearable Technology and Chronic Illness: Balancing Justice and Care Ethics

Developing a Postpandemic Model for Hybrid Clinical Ethics Rotations in Postgraduate Medical Education.

Bioethics education in residency helps trainees achieve many of the Accreditation Council for Graduate Medical Education milestones and gives them resources to respond to bioethical dilemmas. For this purpose, The Providence Center for Health Care Ethics has offered a robust clinical ethics rotation since 2000. The importance of bioethics for residents was highlighted as the COVID-19 pandemic raised significant bioethical concerns and moral distress for residents. This, combined with significant COVID-19-related practical stressors on residents led us to develop a virtual ethics rotation. A virtual rotation allowed residents flexibility as they were called to help respond to the unprecedented demands of a pandemic without compromising high quality education. This virtual rotation prioritized flexibility to support resident wellbeing and ethical analysis of resident experiences. This article describes how this rotation was able to serve residents without overstraining limited bandwidth, and address the loci of resident pandemic distress. As pandemic pressures lessened, The Providence Center for Health Care Ethics transitioned to a hybrid rotation which continues to prioritize resident wellbeing and analysis of ongoing stressors while incorporating in-person elements where they can improve learning. This article provides a description of the rotation in its final form and resident feedback on its effectiveness.

Seduction and Fidelity: Cunning and Power Relationships an Ethnographic Exploration in an Intensive Care Unit During the Covid-19 Crisis.

Sedufidelity-the contraction of seduction and fidelity-offers an interesting perspective for reflecting on the role of relationships and the ethics of care in highly technical healthcare settings. Understanding sedufidelity could help mitigate the observed social ruptures and promote a more humane approach to healthcare. However, challenges remain regarding its implementation, particularly in terms of building trust and loyalty towards management and healthcare policymakers. Furthermore, initiatives such as the 'haie de déshonneur' ('hedge of dishonour') can highlight the need and form of recognition sought by caregivers, given their strong symbolism. However, other actions can also be considered to strengthen relationships and attention paid to caregivers, such as a prior consultation.

Caring for life in common: Care, diversity and the paradox of the commons

ABSTRACT Although urban theory has long championed the urban commons, it has said little about how the commons are to be sustained. This article argues for the centrality of an ethic of care in sustaining the commons. Drawing on ethnographic research with activists seeking to create an age-friendly neighborhood in Kilburn, London, I develop four interlinked claims about care and the commons: First, prevailing approaches to valuing the commons fall short of what is needed to ensure their survival. Second, there is an element of commoning that underwrites the value of all public resources in the city. Third, an ethic of care—involving an ethical orientation toward situated particularity alongside a commitment toward entangling diverse forms of care—is essential for sustaining such commoning. Lastly, just as the urban commons require care to create and sustain their value, care requires the urban commons to become sufficiently expansive and inclusive.

Enhancing medical students’ understanding of end-of-life care ethics and law through video-triggered expert-led debriefing: a two-stage study

BackgroundTaiwan enacted the Hospice Palliative Care Act in 2000 and the Patient Autonomy Act in 2016. However, medical education has emphasized palliative care skills over ethical and legal integration. This study developed a curriculum for pre-clinical students, focusing on applying these issues in end of life care.MethodsThe participants were fourth-year medical students enrolled in a 1-credit medical ethics and law course at a medical school in Taiwan. The study employed a two-stage design, combining quantitative pretests and posttests with qualitative data obtained through the Know-Want-Learn strategy. The curriculum, called the video-triggered expert-led debrief module, included a video scenario on end of life care, insights shared by three interprofessional experts, and students debrief. In 2021, 168 students participated, and a quantitative questionnaire using a pretest-posttest design was applied to assess the curriculum’s impact on students’ knowledge and attitudes toward end of life care. In 2022, 157 students participated, and the survey used open-ended questionnaires (the Know-Want-Learn strategy) to evaluate what students already knew and what they wanted to know before the module, as well as what they had learned afterward.ResultsIn 2021, we collected 166 (98.8%) valid responses in the quantitative questionnaire. Seven of the eight knowledge-based questions and four of the seven learning motivation items showed significant improvement in the posttest (P < 0.05). In 2022, 81 (51.6%) valid responses were obtained from the qualitative questionnaire. Before the module, students’ understanding was superficial and focused on literal meanings. Three themes emerged in what they wanted to know: medical decision-making, ethics and laws, and empathetic communication, with eight subthemes. After the module, three themes and six subthemes were identified in the “what I learned” section. Students reported gaining knowledge related to ethics and laws, and empathetic communication.ConclusionsThe video-triggered expert-led debrief module can effectively teach the application of medical ethics and laws in end of life care. This approach has shown positive results among young medical students. It enhances students’ learning motivation, deepens their understanding of ethics and laws, and empathetic communication. It further encourages them to reflect deeply on the meaning of healthcare.

Radiation induced liver injury (RILI) evaluation using longitudinal computed tomography (CT) in image‐guided precision murine radiotherapy

AbstractPurposeWe aim to perform image‐guided, dose‐escalated, well‐controlled liver‐irradiated animal studies and subsequently evaluate radiation induced liver injury (RILI) using longitudinal CT.MethodsEighteen 6–8 weeks mice were divided into three groups: control, 15Gy and 30Gy irradiated groups. The animal protocol was approved by the animal care ethics committee of our institution. Precision radiotherapy started with CT simulation, followed by treatment planning using volumetric modulated arc therapy (VMAT), image guidance with cone beam CT (CBCT) and radiation delivery on a medical linear accelerator. Weekly CT was conducted on the same CT simulator using same scanning parameters. At the end of fifth week, all mice were sacrificed, and histological staining was performed. Body weight, liver volume, HU values and histogram distributions were analyzed.ResultsBody weight of irradiation groups was significantly reduced compared to that of the control group (p&lt;0.05). Liver volume in irradiated groups was reduced too. The average liver HU was significantly reduced in irradiated groups (HU mean = 62±3, 48±6, and 36±8 for the control, 15Gy and 30Gy respectively; p control vs. 15Gy &lt; 0.05, p control vs. 30Gy &lt; 0.05). A linear relationship between liver HU and radiation dose was found. Furthermore, HU histogram changes with time and dose showed not only density but also structure might be affected by radiation. HE and Masson Trichrome staining confirmed histological change and increased collagen deposition in irradiated liver.ConclusionLongitudinal unenhanced CT is a useful imaging tool to evaluate the severity and progression of radiation induced liver injury.

Small Group Learning Communities as a Prototype for Intersectional Black Feminist Praxis in Higher Education

Through the creation and analysis of Small Group Learning Communities (SGLC) at a predominantly White university in the U.S. South, this study investigated how SGLCs operationalize intersectional Black feminist praxis via dialogue, liberation, and ethic of caring. The racialized and gendered organizational dynamics that govern institutions of higher education make it an ideal site for such an intervention. Through an instrumental case study of 13 SGLCs, we uncover how SGLCs served interrelated, but separate purposes: (1) affirmation, mentorship, and professional development among “Black women-focused” SGLCs; and (2) epiphanies of intersectional oppression and nuanced Black girl representation in educational settings among “Black women-affirming” SGLCs. Findings suggest that SGLCs are innovative prototypes for understanding, studying, and implementing intersectional Black feminist praxis. We submit that SGLCs can advance broader social justice and liberation agendas. Moreover, findings may inform efforts to center Black women in higher education.

This Course Is Ungraded: The Impact of Ungrading Practices on Students and Their Instructor

The researcher studied ungrading practices in an introductory course on emergent language and literacy in the early years for undergraduate students interested in pursuing careers as classroom teachers at an urban public college in the northeast United States. Based on the Scholarship of Teaching and Learning (SoTL), the researcher applied self-efficacy and reflective teaching theories to address how a course designed with ungrading practices impacted students' self-efficacy and the researcher as a reflective teacher. The researcher used mixed methods to analyze data. Findings show that students' participation presented a calibration of dynamic interaction between personal, behavioral, and environmental factors. Findings also show how integral it was to build a supportive learning community to develop students' self-efficacy. Ungrading practices created conditions for a humanizing pedagogy. The researcher applied an ethics of care that diminished power over students and instead emphasized power with students. This shift in power enabled dialogic discourse that informed responsive teaching and reflective practice. Rather than best practices, a course designed with ungrading practices is deeply contextual and requires an inquiry stance.

‘It's good what we're doing and it's scary what we're facing’: young people’s care-ful environmental action in the UK

ABSTRACT In this paper, we argue for greater recognition of young people’s contributions to environmental action through social and environmental justice. It draws on findings from research based on eleven organisations in the UK exploring young people’s connection with environment-related collective action and activism in the UK landscape. Building on theoretical arguments of ethics of care and implicit activism and capturing a range of practices of young people, the paper explores young people’s multiple framing(s) of activisms – towards the environment and each other. Drawing on the experiences of young people and facilitators within these organisations, we unpack the experiences and representation of minoritised groups in the climate movement and other forms of environmental engagement. The findings demonstrate thoughtful and effective approaches towards inclusion within the UK context and in terms of global climate justice but also highlight a need for more intersectional approaches and awareness of enduring barriers often relating to racialised identities.

Prosthesis Refusal and the Ethics of Care in J. M. Coetzee's Slow Man.

In The Ethics of Care: Personal, Political, and Global, Virginia Held asserts that those in the position to care should exercise power in ways that avoid violence and damage, and that trust and mutuality should be fostered in place of benevolent domination. With reference to Held's idea of relational care, this essay close reads J. M. Coetzee's depiction of prosthesis refusal in Slow Man as a nuanced critique of caring actions that are devoid of relationality. At the center of the novel is the character Paul Rayment's refusal to get fitted with a prosthetic leg after a cycling accident. He reasons that it is dishonest to give others the false impression that he is not without a leg, even if the price he must pay for "honesty" includes giving up the chance to cycle again and the quality of life he had before the accident. But Coetzee is at pains to highlight that Rayment is a confused character, and behind the confused narrative of "honesty" lies a subtext of rebellion. Specifically, this is a rebellion against care without relationality. It provokes the question, in the absence of ill intention toward the care recipient could caring actions be perfectly benign? In this article, I read the refused prosthetic leg as more than a phantasmagorical symbol of the depicted healthcare professionals' seemingly empty appearance of care; it foregrounds relationality as the critically missing substance that could render caring actions unethical in the novel.

Playing the Game Differently: How Women Leaders in Academia Are Challenging Neopatriarchy

AbstractDespite Australian and New Zealand Universities pledging to address gender inequities, the patriarchal history of universities continues to impact the careers of women in academia. Under-representation of women in senior leadership and a culture of masculinity can lead to a lack of resources for feminist leadership and a devaluing of women’s work. We investigate how women in academic leadership are playing the game differently, making strategic moves to navigate leadership in the neoliberal neopatriarchal academy. We explored the experiences of 22 women in academic leadership through online qualitative surveys and reflexive thematic analysis of the data, taking inspiration from Bourdieu’s work on habitus and doxa. Although women leaders were able to successfully make strategic moves to advance their careers, these were shaped by parenting status, race, culture, and age. The women’s leadership approaches were counter to the masculine doxa of the academic field, leading instead relationally. We do not suggest that there is a specific ‘female’ style of academic leadership, but that successful authentic leadership can be founded on a feminist ethics of care in contrast to neopatriarchy. Adoption of such approaches across the academy might unshackle academics across genders from their positioning in academic leadership hierarchies.

Nursing Care Experiences of People Living with HIV/AIDS (PLWHA): A Phenomenological Study from the West of Iran

IntroductionNursing care for people living with HIV/AIDS (PLWHA) can be challenging and is dependent on the context. However, there is a lack of information about nurses’ experiences in caring for PLWHA in the western region of Iran. Therefore, this study aimed to describe the experiences of nurses in caring for PLWHA in Kermanshah, Iran. MethodsIn this qualitative descriptive phenomenological study, data were gathered via semi-structured, in-depth interviews. The sample comprised 15 nurses employed at hospitals affiliated with Kermanshah University of Medical Sciences, selected through purposive sampling. Colaizzi's seven-step method was employed to analyze the data, and MAXQDA 10 software was used for data management. ResultsIn this study, we obtained 579 codes and four main themes of "caring with fear", "Care ethics", "protective precautions" and "duality of feeling ". ConclusionAccording to the results, nurses confront numerous difficulties, challenges, fears, and stress when dealing with PLWHA. Participants’ perceptions and practical experiences of AIDS patients enable patients to receive appropriate and high-quality care and provide valuable insights for nursing managers to enhance the preparedness of HIV ward nurses. To gain a comprehensive understanding of HIV nursing care, nurses require further education and awareness on this subject.

What's care go to do with it? Feminism and the uncertain radical potential of care

Feminist uses of the term ‘care’ actively contribute to ongoing debates about the kind of world we currently live in, as against the one we want to inhabit in the future – a contribution directed towards effecting positive change in the world. Unsurprisingly, the various ways feminists employ the term ‘care’ entail benefits and problems, as well as being the subject of intense debate. This paper aims to summarise and critically assess the main conceptual frameworks and associated debates within feminist perspectives on care. Analyses of care as labour, first- and second-generation feminist ‘ethics of care’, postmodern/poststructuralist and posthuman/new materialist uptakes and, finally, notions of ‘radical care’ are considered. In short, the paper explores the radical potential of care; specifically in feminist terms – that is, what is its potential for advancing progressive social change?

Undisciplining the Museum: Indigenous Relationality as Religion

What does it mean to decolonize or undiscipline the anthropology museum? What happens when the museum is confronted by Indigenous and descendant communities who demand an ethic of care rooted in relational ontologies and epistemologies? This article features Indigenous creativity as it has disrupted ‘business as usual’ in anthropology museums. This is primarily evidenced by Fork Peck Tribes who confronted the University of Montana to enact a long-overdue repatriation. Additional examples from The Metropolitan Museum of Art and Peabody Museum of Archaeology and Ethnology at Harvard demonstrate diverse expressions of relationality among Indigenous and descendant communities. These interventions are analyzed through Critical Indigenous Theory to specify the ways in which Indigenous religious traditions refuse the narratives and norms of settler colonial knowledge production and undermine the imperial museological practices of preservation. Instead, relationality is prioritized in the caretaking of and connection with more-than-human entities and materials in the museum. This article emphasizes relationality and repatriation as religious acts that challenge assumptions embedded in imperial and settler colonial approaches to history and science. From various social locations and through multiple strategies, we see the active undisciplining of the museum by Indigenous and descendant communities.

On coaching and the ethics of care: a psychodynamic approach

This paper is prompted by the intuition that the common ethical theories do not fully comprehend the (internal) psychological structures of the asymmetrical coach-athlete relationship. Through a few examples I attempt to investigate the ethically vulnerable coach-athlete relationships that often emerge. With a philosophical view taken from Nel Noddings’ theory of an ethics of care, I argue that we may need a broader perspective on the ethical issues which also include a psychoanalytic or psychodynamic perspective towards the relationships in question. Doing that would in itself be an ethical approach to take for a deeper understanding of the relationships between coaches and athletes.

How Does Empathy Become Morally Energising for Agents? ——Michael Slote Emotionalist Ethics of Care Study

In the face of the moral decline exacerbating problems such as “indifference” and “ignorance” in present times, this article takes into account the background of the times, starts from the perspective of stimulating the moral action of the agents, and takes the empathy of the contemporary ethicist Michael Slote’s affective caring ethics as the core of the study, and further clarifies and elaborates the operation mechanism and its superiority and limitations of the “empathy-caring” emphasised by Slote in the moral life from the individual to group, by comparing it with rationalism. Through a comparative study with rationalism, the paper further clarifies and elaborates the operation mechanism of “empathy-caring” emphasised by Slote in the moral life from individual to group, as well as its superiority and limitations, especially, the Stole’s ethics has absorbed and developed the concept of yin and yang in Chinese thought, and provides a new way of thinking for explaining moral behaviours, solving moral dilemmas, and improving moral literacy.

THE Moral Intuitions in Moral Decision-Making

Moral intuitions are strong, stable, immediate moral beliefs. Scholars have put forward many theories about the origin of moral intuition from different perspectives. Based on many scholars’ theoretical analysis of moral intuition, this paper takes Kant’s moral philosophy as the basic framework. It further introduces caring ethics and utilitarianism as supplements to analyze the role of moral intuition in moral decision-making. This essay argues that while moral intuitions can serve as valuable initial guides, they must be critically examined and refined through a Kantian framework that integrates the categorical imperative with reasoned emotions and utilitarianism, enhancing their trustworthiness by aligning them with rational moral principles.

Couples therapy and the challenges of building trust, fairness, and justice.

The cornerstone of the contextual family therapy model is predicated on the belief that all family members benefit from trustworthy relationships, which result from (a) acknowledging the contributions of deserving family members, (b) engaging in responsible interactions, and (c) ensuring a fair distribution of relational burdens and benefits. Nonetheless, conflicts may arise when one partner asserts a claim to relational resources based on need, while the other believes they are entitled to such resources based on merit. Based on relational ethics and the development of trust, this paper focuses on the therapist's role in facilitating the conflict-resolution process to assist couples in reestablishing individual responsibility and accountability within the systemic framework of couple therapy. It elucidates several clinical strategies, including (a) cultivating trust through fairness and focusing on the importance of reciprocity and equitable give-and-take, (b) detecting destructive entitlement, and (c) marital relationships and ethics of care. Several clinical examples are discussed, as well as common couple relational issues associated with horizontal and vertical relationships, partnership, and fusion, and the impact of gender and power dynamics and trustworthiness based on the feminist lens.

Ethical Dilemmas in Home Palliative Care

Abstract Background In the past two decades, there has been a noticeable shift towards home-based care, reflecting the broader trend among OECD countries to prioritize a comprehensive approach to health and well-being. This approach emphasizes preventive and proactive measures, often relying on home-based care delivered by multidisciplinary teams providing both curative and palliative care. However, the unique nature of providing care in a home environment raises ethical questions among healthcare providers, necessitating high levels of attentiveness and sensitivity from the caregiving team to address them effectively. Research Objectives This study aims to identify ethical challenges encountered by a multidisciplinary team, as perceived by managers of an organization offering home palliative services in Israel. Methods A qualitative study was conducted, involving interviews with nine key managers to explore prevalent ethical issues in delivering home-based care. Findings Thematic analysis unveiled common ethical dilemmas in providing Home Palliative Care. These dilemmas include balancing patient preferences with professional obligations, addressing the needs of both patients and their families, navigating caregiver-patient relationships, understanding patients’ cultural backgrounds, and advocating for home care as the preferred option while considering alternative treatment approaches. Conclusions Home palliative care poses ethical dilemmas for caregiving teams. It’s imperative for organizations in the home care sector to devise strategies aimed at assisting teams in navigating these challenges while upholding the autonomy and dignity of patients within their home environment. Key messages • Home-based care faces ethical challenges, requiring strategies to balance patient preferences and professional duties. • Ethical home hospice care needs strategies that respect patient autonomy and dignity.

Sharenting Ethics in Indonesian Family Communication Through Cultural Values of Digital Parenting

This research examines the phenomenon of sharenting (sharing-parenting) in the Indonesian cultural context, focusing on how traditional values influence digital parenting practices. This research uses a comprehensive literature study methodology to analyse the intersection between local wisdom and digital communication ethics in care. This study reveals that Indonesian parents practice sharenting through three main cultural pillars: harmony, unggah ungguh, and tepo seliro. These values significantly shape how information about children is shared on social media, creating patterns that differ from Western individualistic approaches. The findings show that parenting practices in Indonesia's digital era are firmly rooted in collective cultural values, where sharing information about children is not simply seen as personal documentation but as part of communal responsibility. This research identifies unique challenges in balancing traditional values with digital privacy concerns, especially in how Indonesian parents interpret and implement privacy boundaries within their collective cultural framework. This study contributes to developing a culturally sensitive ethical framework for digital parenting in Indonesia, emphasizing a balance between traditional values and modern digital practices. Findings suggest practical sharing guidelines in Indonesia must integrate collective cultural values while addressing contemporary digital privacy concerns. Furthermore, this research proposes practical recommendations for implementing culturally appropriate digital literacy programs and developing policies that protect children's interests while respecting traditional family values.