Ethical Commitment Research Articles

A protocol to study the impact of implementation of National Accreditation Board for Hospitals & Healthcare Providers (NABH) standards among health care workers in a tertiary care hospital in India

Background: The healthcare system is now transforming widely with new technology including the introduction of a variety of medical gadgets, clinical trials, telemedicine, health insurance, health tourism, and outsourcing programs. Recent research focused on the quality of healthcare has proved useful for evaluating satisfaction and improvement of services in an organization. The World Medical Assembly asserts that in order to enhance patient outcomes on an individual level and community health, healthcare providers and organizations have an ethical and professional commitment to continuously improve the quality of services and patient safety. The National Accreditation Board for Hospitals & Healthcare Providers - Quality Council of India - (NABH) formed a constituent board to design and oversee an accreditation scheme for healthcare institutions to ensure the quality of care. Healthcare accreditation organizations and certification programs have progressed international efforts to raise the standard of healthcare since the 1970s. The accreditation process, which is carried out by qualified external peer reviewers, allows a healthcare organization to be officially recognized for achieving performance standards. The objectives of this protocol are to understand the perception and impact of healthcare workers towards implementation of NABH standards and to study the impact of pre and post assessment of NABH with the help of 10 important key performance indicators in hospitals. Methods: A descriptive cross-sectional design will be adopted in the study. It includes collection of data from the medical record department records for pre-assessment and direct questionnaire to the participants for post-assessment of NABH standards. The pre-assessment data of quality indicators will be collected from the previous records of NABH files from the quality assurance department. Expected result: The expected result of the study will identify the different impacts of implementation of NABH standards after pre and post assessment in an organization.

Making the invisible visible: stakeholder capitalism and powerless stakeholders

Purpose Stakeholder capitalism has been proposed as an alternative way of thinking about business purpose and value creation. However, stakeholder capitalism can only work as an alternative model of business if all stakeholders and their interests are visible to and taken seriously by managers. The purpose of this paper is to untangle the challenges that invisible, marginalized and powerless stakeholders pose for theorizing about stakeholder capitalism. Design/methodology/approach This paper is conceptual. The authors first briefly outline the promise of stakeholder capitalism for addressing pressing questions about value creation and stakeholder welfare. The authors then conceptualize stakeholder invisibility as the outcome of a particular stakeholder being both powerless and marginal through the prism of moral intensity theory and one of its elements: proximity. This study discusses the ways in which managers can make invisible stakeholders more visible in their decision-making. Findings For managers truly to manage for stakeholders, as anticipated by stakeholder capitalism, all stakeholders and stakeholder interests must be visible to them. This study analyzes why sometimes they are not, how they can be made more visible and why stakeholder visibility matters for stakeholder capitalism. This study proffers three principles for business practice: ethical commitments to reduce stakeholder invisibility, analyses of business strategies to surface the contributions of marginalized and invisible stakeholders and taking rights seriously. Originality/value This study provides a new perspective on stakeholder capitalism by linking the challenge in operationalizing it to the problems of stakeholder invisibility and marginality.

Development of Quality Management Model in Realizing Quality School Through Leadership and School-Based Evaluation

This study aimed to find a feasible quality management model for realizing quality schools through leadership and school-based evaluation, especially at the junior high school level. The research locations were in six Junior High Schools that implemented the Program Sekolah Penggerak (SMP Penggerak) Batch 1 in Batam City. The study used explanatory sequential mixed methods. The number of samples used was 178 teachers, including six principals. The data analysis technique used the weighted mean scores to measure the average tendency of respondents' answers and Pearson's correlation to measure the level of relationship between variables. Based on the research results, a feasible quality management model is implemented through the PDCA approach in the activities of mission alignment, involvement and empowerment, roles and responsibilities, digitalization in management work, ethical commitment, knowledge management, action for change, or the acronym MERDEKA. This model can improve school quality.

The ethical dimensions of Mong Kinemong in music performance in catholic worship: a phenomenological analysis of first Friday night eucharist musicians at Ganjuran Church

In the context of Catholic worship at Ganjuran Church, music and musicians play vital roles in enhancing the spiritual experience of worshippers. This research employs a qualitative and phenomenological approach to explore the ethical aspects related to musical performances during the First Friday Night Eucharist. Through careful observation, interviews, and documentation, the study analyzes the musicians' practices using Marc Benamou's theory of Rasa and Keontjoroningrat's insights on religious emotion. The findings reveal that musicians at Ganjuran Church embody the ethical principle of 'Mong Kinemong,' demonstrating a profound ethos of mutual care deeply embedded in their musical practice. This ethical commitment is bolstered by the musicians' intense experience of religious emotion, evoking feelings of majesty and serenity among choir members. Additionally, instrumentalists, referred to as 'pengrawit,' express heightened veneration, describing their peak moments as 'semu' (joyful), 'nges' (serene and good), and 'dados' (fulfilling expectations). Importantly, this 'Mong Kinemong' ethos harmoniously integrates with musical elements, enhancing the overall worship experience. This study contributes to a deeper understanding of ethics in musical performance within the Catholic liturgy context, shedding light on the significance of mutual care, emotional resonance, and harmonious musical expression in enriching the spiritual dimension of worship.

Conceptual Profile of Older-Person-Centred Care Within the General Framework of Person Centred Medicine

Background: The elderly represents a growing segment of the population for whom person-centred medicine (PCM) has been pointedly argued as highly relevant. This is due to demographic weight, clinical complexity, and ethical challenges. Therefore, it should be valuable to elucidate the key elements of person-centred care for this important population. Approaches for doing this may include analyses of aging-related studies selected from general populationstudies engaged for the systematic conceptualisation of PCM.
 Objectives: The purpose of this study was to delineate the conceptual profile of person-centred care for older people within the general framework of PCM.
 Methods: The main methodological approach employed in the present study was analyses of older-person studies selected from a large set of general population studies reviewed towards exploring the systematic conceptualization of PCM. That general study yielded eight principles as follows: (1) Ethical Commitment, (2) Cultural Sensitivity, (3) Holistic scope, (4) Relational Focus, (5) Individualised Care, (6) Common Ground for Collaborative Diagnosis andCare, (7) People-centred Systems of Care, and 8) Person-centred Education and Research.
 Results: It was found that the eight principles of PCM elucidated for the general population were present in older-person-centred care papers, although to various degrees across principles. It was evidenced that the principles on Ethical Commitment, Holistic Framework, Relationship Focus, Individualised Care, and Person-centred Education and Research had the greatest presence in the articles on older-person-centred medicine.
 Discussion: The considerable consistency found between the conceptual profile of person-centred care for older persons and the principles of PCM in the general population may reflect that the PCM perspective was historically pioneered within the old-age health field and that the PCM perspective continues to attract enormous interest in the old age field. This is highlighted by the fact that ethical commitment was a key motivator for the pioneering development of PCM in the geriatric field and that this principle has been prominently identified in recent systematic conceptualisation studies of PCM for the general population and appears as well among recent academic developments and proposals from major international institutions.
 Conclusions: The fundamental characteristics of older-person-centred care appear to have considerable consistency with the general principles of PCM, with particular attention to ethical commitment, holistic framework, communicative and relational focus, and attention to the values and needs of the older persons involved.

THE INFLUENCE OF WORK ETHIC AND ORGANIZATIONAL COMMITMENT ON EMPLOYEE PERFORMANCE AT PT. BTN (PERSERO) MEDAN BRANCH OFFICE

This study aims to analyze the influence of work ethic on employee performance, ascertain the impact of organizational commitment on employee performance, and determine the combined influence of work ethic and organizational commitment on employee performance. The research is of a quantitative nature with an associative approach. The study's population consists of employees at PT. Bank Tabungan Negara (Persero) Tbk Medan Branch Office. Simple random sampling was employed to select a sample of 61 respondents. The findings reveal that the work ethic variable (X1) significantly affects employee performance, as does organizational commitment (X2). Work ethic and organizational commitment collectively influence employee performance. The determination test yielded a correlation coefficient (R) value of 0.661, indicating a relatively strong relationship between work ethic, organizational commitment, and employee performance. The adjusted R-square value, or coefficient of determination, suggests that 41.7% of employee performance variance can be explained by work ethic and organizational commitment variables, while the remaining 58.2% is influenced by other unexamined variables.

The dialectic of articulation: a Hegelian response to Adams

ABSTRACT This article responds to Nicholas Adams by exploring the affinities between his account and Hegel, with a particular focus on the dialectic of articulation. They seem to agree on the undermining effect of articulation and reflection on implicit commitments. However, Adams diverges from Hegel by questioning the consequence and supposed inevitability of this dialectical process. Whereas Hegel argues for the desirability of conscious articulation in the progress towards modernity, Adams contends that it is actually a destructive and oppressive process, challenging Hegel’s Enlightenment optimism and Eurocentrism. Still, I suggest that Hegel’s concern for rational dialogue as an indispensable condition for modern life and community should be taken seriously. Scriptural reasoning, as discussed by Adams, provides a model how we can have a form of rational dialogue that escapes from the dilemma posed by the Hegelian dialectic, and that it may be possible to combine strong ethical commitments with an openness to pluralistic dialogue.

Workplace Ethics and Employee Commitment of Public Secondary School Teachers in Rivers State

This study investigated the relationship between workplace ethics and employee commitment of public secondary school teachers in Rivers State. The objective of the study was to examine the influence of workplace ethics on employee commitment of public secondary school teachers. The study adopted survey research design. The population of this study comprised of Twenty (20) selected public secondary schools in Rivers State using simple random sampling. Four hundred and eighty (480) teachers were surveyed. Sample of two hundred and fourteen (214) was determined using Krejcie and Morgan sample size determination table. Two hundred and fourteen (214) copies of questionnaire were administered to the teachers but one hundred and eighty three (183) copies were correctly filled and returned. These copies were analyzed and the hypotheses were tested using the Pearson Product Moment Correlation Coefficient (rs) Statistical tools via SPSS Package version 22.0. The result revealed that there was a significant relationship between workplace fairness and affective commitment. Also, workplace integrity significantly influence affective commitment. Based on the findings, it was concluded that organizational fairness and integrity increases the commitment of workers thereby increasing productivity. The study therefore recommended that School administrators and principals should lead with integrity, openness, and be reliable that would inspire the best in their subordinates and increase the support needed for success.

La vocación médica, más allá del deber de cuidar: Revisión de la literatura desde el aspecto ético y filosófico

This review article explores medical vocation as a phenomenon that extends beyond the mere duty of caring for patients, focusing on the significance of ethical commitment, empathy, and resilience in medical practice. The implications for medical training and clinical practice are discussed.

Moral Distress, Conscientious Practice, and the Endurance of Ethics in Health Care through Times of Crisis and Calm.

When health professionals experience moral distress during routine clinical practice, they are challenged to maintain integrity through conscientious practice guided by ethical principles and virtues that promote the dignity of all human beings who need care. Their integrity also needs preservation during a crisis like the COVID-19 pandemic, especially when faced with triage protocols that allocate scarce resources. Although a crisis may change our ability to provide life-saving treatment to all who need it, a crisis should not change the ethical values that should always be guiding clinical care. Enduring ethical commitments should encourage clinicians to base treatment decisions on the medical needs of individual patients. This approach contrasts with utilitarian attempts to maximize selected aggregate outcomes by using scoring systems that use short-term and possibly long-term prognostic estimates to discriminate between patients and thereby treat them unequally in terms of their eligibility for life-sustaining treatment. During times of crisis and calm, moral communication allows clinicians to exercise moral agency and advocate for their individual patients, thereby demonstrating conscientious practice and resisting influences that may contribute to compartmentalization, moral injury, and burnout.

At home in my enemy's house: Israeli activists negotiating ethical values through ritualized Palestinian hospitality

AbstractEngaged Dharma Israel (EDI) activists resist their state's occupation of West Bank Palestinians by offering them solidarity and support. Whereas most Israelis consider such Palestinians’ houses unsafe, EDI participants “feel at home” when acting as polite guests there, experiencing the hospitality of their politically subordinate counterparts as poignant. Such activists value intimacy—crossing boundaries between self and other on both personal and national levels—which they substantially realize during their visits. However, they also seek to promote Israelis’ and Palestinians’ mutual autonomy, or nonintervention in each other's personal and communal affairs, an often‐competing value that the visits likewise help effectuate. These capacities of hospitality result from its ritualized nature—namely, its tendency to follow conventional scripts that do not require certain inner states (e.g., sincerity). Hospitality can therefore be usefully approached as a ritualized arena that enables people to promote multiple values, or culturally valorized ideals, including ones frequently found in tension. This ability of hospitality to work out and negotiate participants’ plural ethical commitments is embedded in the power dynamics and political inequalities that normally characterize hospitality events.

The Critical Role of Understanding Epistemic Practices in Science Teaching Using Wicked Problems

AbstractWicked problems have been characterised by their high epistemological and axiological complexities. These are the kinds of problems that may invade our classrooms because many of them concern many stakeholders, including our students. Several approaches have been developed to address wicked problems in various contexts. However, little is known about how they may translate into educational research and practice. This paper proposes a conceptual framework in which wicked problems are analysed from their ontological, epistemological, and ethical commitments. Subsequently, they are framed within post-normal science, drawing on critical discourse in science studies and science education. Chief to the arguments is a focus on epistemic practices that are strongly anchored in but also extend from disciplinary science and engineering education. Implications for research and practice in higher science education are presented.

Preparing for partnership: Using dilemmas to help teacher candidates apply anti-bias praxis to problem solving

ABSTRACT Teacher educators are charged with supporting adult learners as they prepare to collaborate with diverse families and colleagues . In this research, we examined how a cohort of teacher candidates (N = 29) developed over a semester in their understanding, dispositions, and knowledge of strategies for partnership through the dilemmas writing assignments using a Grounded Theory approach. The assignment and range of responses from teacher candidates are described, as are implications for teacher educators in helping candidates develop and articulate an anti-bias praxis and build an understanding of their ethical commitment as early childhood professionals to promote equity .

The paradoxical position of nurses regarding euthanasia and its legalisation: A descriptive quantitative study.

To learn about the attitudes of nurses working in the Andalusian Public Health System regarding euthanasia and its legalisation. Euthanasia often finds itself in the crosshairs of ethical and political debate on an international scale. Currently, the Spanish Organic Law 3/2021 of 24 March, 2021, recognises euthanasia as a fundamental right in Spain. It is of particular interest to know about the views, attitudes and stances that Andalusian nurses have of euthanasia as they are key players within the framework of euthanasia and administration of life-ending drugs. They play a central role in guiding patients through the euthanasia application process. Observational descriptive study. A study of Andalusian Public Health System nurses was carried out using non-probability convenience sampling. 518 nurses with an average age of 44.75 years answered in a questionnaire that was distributed on an online platform. Socio-demographic and occupational variables were assessed, together with the Death Anxiety Scale and the Euthanasia Attitude Scale. A bivariate analysis and a multivariate linear regression model were performed. The STROBE checklist was used. The mean score obtained on the Euthanasia Attitude Scale was 75.95 (SD = 16.53). The mean score obtained on the Death Anxiety Scale was 7.56 (SD = 3.05). The variables age and work experience were negatively correlated with the total scores of the Euthanasia Attitude Scale and the categories 'Ethical considerations', 'Practical considerations' and 'Treasuring life'. On the other hand, there was a significant positive correlation between age and work experience and 'Spiritual beliefs' category. The current situation shows a worrying paradox. There is a stark difference between positive professional attitudes towards euthanasia and the desire to participate in its application. It is vital that educational and healthcare institutions make the necessary efforts to ensure that nurses develop sound moral judgement, displaying the moral conscience and ethical commitment required of this established profession. No patient or public contribution.

Cultural Rhetorics Stories and Counterstories: Constellating in Difficult Times

In our introduction to this special issue on cultural rhetorics, we as editors recognize that members of the field maintain many different approaches and frameworks. This diversity suggests that the work of prioritizing emplaced stories over universalizing theories brings cultural rhetoricians together, making research and teaching accountable first to communities, rather than the academy, and continuously examining our ethical commitments to O/others. This work, then, requires that scholars situate themselves within networks of places and spaces, cultures and peoples, power and privilege, so that we may practice relationality and accountability, actively seeking to make meaningful connections within and across research sites, and create space for silenced voices while building a more just world and disciplinary community.

Continental divide: Native Americans and the Atlantic world

ABSTRACT This essay assesses how historians have studied the relationship between Native Americans and the Atlantic world in the early modern period. It traces the development of what the author calls a “continental divide” between scholars of Indigenous and Atlantic histories, as distinct subfields emerged from different questions, methods, archival practices, and ethical commitments. Recent scholarship has begun to bridge this divide, however, suggesting promising new directions.

Deepening our capacity for teaching with Place

AbstractThis paper presents a learning journey about deepening capacity for teaching with Place through relational learning and shares three pedagogical ingredients that are integral in enacting more ethical, decolonial place pedagogies. We are three women, educators working in community and teacher education with interests in environmental education, decoloniality and indigeneity. We write from the position of people whose ancestry is not Indigenous to the places we were born, nor those where we live now. We bring diverse experiences, voices, bodies and memories of Place into productive conversations as we think and write together about how we are learning with Place, and our response-abilities for enacting regenerative place pedagogies. We situate our emergent and relational inquiry within our experiences and encounters with Place in solidarity with the call for the sharing of stories that “explore knowing and being as relational practices” (Bawaka Country et al.). Our paper is premised on the understanding that our ethical commitment to decoloniality involves learning to live and learn with and love the places we are now, and prioritising Indigenous philosophies, scholarship and ways of knowing Place throughout our education practices.

Disaster solidarity and survivor ethics: a case study of Hurricane María in Puerto Rico.

Liminal periods of disaster solidarity in the aftermath of disaster are a common experience of many survivors. These periods have a specifically ethical component in that people spontaneously engage in collective, altruistic action and magnanimously expand their ethical focus beyond normative social distinctions and hierarchies. Inevitably, however, such solidarity seems to wane, and people return to pre-disaster patterns of interaction. Nevertheless, some individuals move beyond opportune acts of assistance to more extensive reorganisations of their lives during the recovery period and reshape their ethical commitments in new and durable directions. These individuals help make visible marginalised 'others' and draw collaborators to share new ethical visions. Based on observational and interview data collected after Hurricane María (2017) in a mountainous Puerto Rican municipality and employing the framework of virtue ethics, this paper examines the differential effects of disaster solidarity on survivors' ethical responses and the different contributions these make to society.

Silence is not an option: pre-service teachers embedding First Nation knowledge and practices in primary/middle mathematics and science

ABSTRACT Teachers, pre-service teachers and teacher educators in Australia are predominately European Australian with a small minority of First Nations people. Those with limited first-hand understanding of First Nations ways of knowing can find it difficult to embed these knowledges across learning areas. This is particularly complex for pre-service teachers. We argue that all teacher educators have a responsibility to engage First Nations ways of knowing across learning areas as an ethical and professional commitment to preparing pre-service teachers for negotiating the complexities of Australian histories and living cultures. This paper reports on interventions implemented with final year primary/middle pre-service teachers with an expertise in science and mathematics. Firstly, we discuss pre-service teachers’ confidence (self) ratings in integrating their understanding of Aboriginal and Torres Strait Islander histories and cultures across the curriculum. Secondly, we present an in-depth exploration of two pre-service teachers’ transdisciplinary units of work which embed Aboriginal and Torres Strait Islander knowledges and practices. This study challenges all science and mathematics teacher educators to consider ways a transdisciplinary, culturally responsive approach prepares students to transition into confident and competent early career teachers.

The two sides of corporate social responsibility and the quality of internal control audit opinions

Although corporate social responsibility (CSR) activities provide a strong signal of management integrity, the involvement of the client in irresponsible CSR should alert the auditor to the risk of material misstatement. Framing management integrity assessments by relying on responsible CSR activities can lead to auditors' unintended alignment with their clients' preferred outcomes. Motivated by the increasing frequency of clean internal control opinions (ICOPs) regarding clients that subsequently misstate, we explore whether auditors' overreliance on responsible CSR influences the quality of ICOPs. We find that clients' CSR involvement is associated with fewer adverse ICOPs, but this CSR effect is asymmetric because it is only explained by responsible CSR activities and not by irresponsible CSR activities. Importantly, the ‘good side of CSR’ is associated with fewer adverse opinions being issued to misstated clients. Additional analyses show that only irresponsible CSR activities increase the risk of financial misstatements. Our findings provide support for the Public Company Accounting Oversight Board's warning that certain conditions inherent in the audit environment, such as the assessment of management integrity, can lead to auditors unconsciously favouring confirming evidence (represented by responsible CSR activities) instead of relying on disconfirming evidence (represented by irresponsible CSR activities) that could raise issues about management's integrity and ethical commitment.