Ethical Dilemmas Research Articles

Artificial Intelligence (AI) and Human Rights: A Social - Philosophical Exploration of Ethical Dilemmas in a Technologically Evolving Society

Artificial Intelligence (AI) and Human Rights: A Social - Philosophical Exploration of Ethical Dilemmas in a Technologically Evolving Society

Exploring medical ethics: moral reasoning among new pediatric resident physicians in a tertiary hospital.

Physicians are frequently faced with ethical dilemmas that require answers based in moral reasoning, which develops and evolves during their lives and their medical education. According to Kohlberg, there are three levels of moral reasoning development: pre-conventional (in which decisions are guided by oneself convenience), conventional (focused on obeying society's rules), and post-conventional (decisions are based in universal ethical principles). The aim of this study was to describe the level of moral reasoning among new pediatric resident physicians in a tertiary hospital. This cross-sectional descriptive study was conducted from 2020 to 2023. The Defining Issues Test was used to assess the level of moral reasoning among 195 new pediatric resident physicians in a tertiary hospital. Most resident physicians considered the fourth stage affirmations to be the most important. The median P-index (PI) was 40, and 49% of participants were on the post-conventional level of moral reasoning. The year with the lowest number of new resident physicians on the post-conventional level was 2021. The moral reasoning level among pediatric resident physicians was higher than the average found in general population. This suggests that the education received during the medical formation may influence the individuals' moral development.

Possible Health Benefits and Risks of DeepFake Videos: A Qualitative Study in Nursing Students.

"DeepFakes" are synthetic performances created by AI, using neural networks to exchange faces in images and modify voices. Due to the novelty and limited literature on its risks/benefits, this paper aims to determine how young nursing students perceive DeepFake technology, its ethical implications, and its potential benefits in nursing. This qualitative study used thematic content analysis (the Braun and Clarke method) with videos recorded by 50 third-year nursing students, who answered three questions about DeepFake technology. The data were analyzed using ATLAS.ti (version 22), and the project was approved by the Ethics Committee (code UCV/2021-2022/116). Data analysis identified 21 descriptive codes, classified into four main themes: advantages, disadvantages, health applications, and ethical dilemmas. Benefits noted by students include use in diagnosis, patient accompaniment, training, and learning. Perceived risks include cyberbullying, loss of identity, and negative psychological impacts from unreal memories. Nursing students see both pros and cons in DeepFake technology and are aware of the ethical dilemmas it poses. They also identified promising healthcare applications that could enhance nurses' leadership in digital health, stressing the importance of regulation and education to fully leverage its potential.

When young muslims meets online lending: Examining legal awareness and assessment of lending platforms

This study aims to fill the gap in the literature by investigating the perspectives of young Muslims on online lending platforms. The article explores young Muslims' understanding of online lending based on Sharia principles and their perceptions of the ethical and legal dilemmas associated with online lending, which are closely linked to their religious and social knowledge. This study starts from the assumption that online lending involves various issues intricately connected to recent legal and financial advancements. Online lending encompasses not only economic and financial matters but also ethical, moral, and legal issues. The research findings indicate that the understanding of Muslim youth regarding the legal aspects of online lending in the study area is quite high. Data shows that 62% of the Muslim youth (student) respondents are knowledgeable about both Sharia compliance and national legal issues concerning online lending. However, the data also reveals that only approximately 60% of the respondents know how to handle legal issues involving online lending platforms. This implies that respondents need further education and information on these matters. Following data collection, we provided socialization and information on legal awareness and the evaluation of online lending platforms, which improved their understanding. The findings of this study highlight several potential directions for future research, such as assessing the effectiveness of legal awareness programs for digital financial services and P2P lending, and creating more effective methods for legal education. Additionally, future studies should expand to include different cities and regions and a broader range of respondents to achieve a deeper understanding of online lending and legal awareness.

Cultural translation of the ethical dimension: a study on the reliability and validity of the Chinese nurses’ professional ethical dilemma scale

BackgroundQuantifying the professional ethical challenges that nurses encounter is crucial for both theoretical insights and practical outcomes. The objective of this research is to assess the psychometric properties of the Chinese adaptation of the Moral Distress Scale for Healthcare Professionals (MD-APPS).MethodsIn 2024, a survey approach was utilized to engage with several tertiary-level healthcare institutions throughout China. A cohort of 448 nursing professionals who satisfied the specified selection benchmarks was consequently incorporated into the study. To evaluate the scale's reliability and validity, methods including the Content Validity Index (CVI), Factor Analysis—both Exploratory (EFA) and Confirmatory (CFA)—alongside assessments of internal consistency and test-retest reliability were employed.ResultsExpert evaluations yielded an I-CVI of 0.90, suggesting good content validity for the MD-APPS's Chinese adaptation. Exploratory Factor Analysis (EFA) revealed a bi-dimensional framework with 7 components, explaining 56.34% of the cumulative variance. Confirmatory Factor Analysis (CFA) outcomes displayed a χ-square/df ratio of 1.542. The estimate for Robust RMSEA was 0.054, and the SRMR was ascertained to be 0.041. Indices for both Robust TLI and Robust CFI surpassed the 0.9 threshold, indicating an acceptable fit; this aspect was supported by a P-value (Chi-square) of 0.094. The internal consistency, measured by Cronbach's α, was found to be 0.74, while the test-retest reliability over a two-week period reached 0.964. These findings provide initial evidence for the psychometric properties of the Chinese MD-APPS.ConclusionThe Chinese adaptation of the MD-APPS demonstrates promising initial psychometric properties, suggesting its potential suitability for exploring nurses' professional ethical challenges within the Chinese cultural context. This scale may facilitate the identification of diverse elements influencing nurses' professional ethics and the assessment of the ethical climate in nursing practices. However, further validation studies are needed to fully establish its psychometric robustness across various healthcare settings in China.

TEACHER COMPETENCE IN THE DIGITAL ERA A PHENOMENOLOGICAL STUDY

This study aims to understand teachers' experiences in developing their digital competence in the era of educational digitalization through a phenomenological approach. The research focuses on the factors influencing teachers' digital competence, the challenges they face, and the role of institutional support such as schools, education policies, and professional training. The research method used is qualitative with a phenomenological approach, where data is collected through in-depth interviews with participating teachers and field observations. The data is then analyzed using thematic analysis techniques to identify key themes that emerge from the teachers' subjective experiences. The findings show that teachers' digital competence is influenced by access to technological infrastructure, prior experience with technology, and institutional support. Teachers in urban areas are generally better prepared to face digitalization compared to teachers in remote areas, who experience limitations in technological access. Additionally, relevant professional training and supportive education policies play a crucial role in enhancing teachers' digital competence. However, challenges such as psychological pressure and ethical dilemmas in maintaining social interaction with students also emerge as barriers in this adaptation process. In conclusion, holistic support, both technical and emotional, is essential to help teachers effectively develop their digital competence.

Beyond Morbidity and Mortality Conference: How Do We Learn From Special Cases?

Physicians experience scary cases in the course of usual medical practice. Cases of near misses, legal and ethical dilemmas, or unique clinical challenges are great sources of education. However, there is no format for presentation and dissemination of cases that do not meet criteria for morbidity and mortality (M&M) conferences. The Scary Cases Conference is an innovative educational forum for scrutiny and analysis of these challenging clinical cases. Scary Cases differs from traditional Morbidity and Mortality conferences as it explores outcomes beyond the scope of medical or surgical errors. From 2011 to 2021: 11 regional and 10 national "Otolaryngology Scary Cases" conferences and mini-seminars were held. The cases presented were analyzed for case specialty, area of management deemed troublesome, and compared to M&M conference criteria. 187 cases were presented. 62% percent of cases included traditional medical problems, whereas 21% involved legal issues, and 17% focused on ethical dilemmas. For the cases with medical problems, 31% involved airway obstruction, 17% nerve injuries, and 17% malignancy. 49% of cases would have met criteria for presentation at traditional M&M conferences. Of all the "scary cases," 25% were near misses and 26% represented ethical or legal dilemmas which would not be classified as morbitidy, mortality, or near miss. The Scary Cases provides a forum conducive to learning amongst peers and experts. It allows medical and surgical specialties to share the cases deemed most impactful. The M&M conference would only include half of such cases, but could be expanded beyond the traditional scope in the future.

A new generation of health professionals – ethical dilemmas and challenges

A new generation of health professionals – ethical dilemmas and challenges

Integrating tax amnesty, CSR, and emerging technologies: Exploring ethical challenges and strategic choices

This paper explores the relationship between tax amnesty programs and Corporate Social Responsibility (CSR), focusing on the ethical challenges businesses face as they navigate financial decisions and societal obligations. While tax amnesty offers financial relief, it raises significant concerns about ethical behavior and transparency. The evolution of CSR into a strategic priority necessitates a careful balance between financial goals and broader societal contributions. Emerging technologies, such as artficial intelligence (AI), blockchain, and data analytics, are transforming tax compliance and CSR practices by enhancing transparency and accountability, but they also introduce new ethical dilemmas. This study integrates theoretical frameworks with practical insights, highlighting the need for businesses to align tax amnesty participation with CSR objectives. Key themes include the role of emerging technologies, ethical decision-making, and the alignment of financial incentives with societal values. By examining these dynamics, the research contributes valuable insights into how businesses can effectively manage the intersection of tax amnesty and CSR, promoting ethical practices and societal well-being.

Whistleblowing intentions by public accountants in a non-Western society: The case of Japanese accountants

This study addresses a gap in the literature by exploring whistleblowing intentions in a society where social harmony, respectfulness, and conformity to rules and norms are perceived as important. A survey of Japanese public accountants indicates attitudes, independence commitment, perceived behavioral control, personal cost of reporting, and personal responsibility for reporting significantly influence internal whistleblowing intentions. Contrary to previous studies, we found personal cost of reporting has significant positive relationship with internal whistleblowing intention, which is a reflection of the unique Japanese work culture. Furthermore, perceived organizational support has a significant positive relationship with internal whistleblowing, signifying that Japanese public accountants feel comfortable to blow the whistle internally when there is high support from the organization. However, the interactive results reveal a significant negative relationship between perceived organizational support and internal whistleblowing, suggesting that despite organizational values that support internal whistleblowing, there is less room for accountants to decide and act independently when faced with an ethical dilemma. For external whistleblowing, both personal factors and interactive results are not significant as accountants perceived it as a betrayal or rebellious act, and feared potential lawsuits. Overall, our results imply that the Japanese unique work culture mitigates the consistency between individual intentions and actual behavior.

Reaching the unreachable through action research? Thomas Mathiesen and the Nordic socio-legal tradition

Thomas Mathiesen has been a source of inspiration for research in critical sociology, criminology, and the sociology of law for many decades. Mathiesen’s impact extends far beyond the academic realm, as his action research lives on. This intervention discusses the ongoing influence of Mathiesen’s action research approach, which integrates research, education, and societal impact. This is illustrated through an action research project we conducted in Denmark’s largest marginalised living area, where over 1,000 public housing units are being demolished, affecting approximately 2,500 residents. In the project, we experimented with different outreach legal aid approaches, considering our own positionalities, to gain knowledge about how to establish a legal aid infrastructure that could reach the unreachable. An ethical dilemma we faced was how we could engage with the people without inadvertently naming issues, particularly legal problems, of which they might not be aware. If the residents were unaware of these issues or did not consider them important, could we then inadvertently create and juridify new problems for them? Moreover, this intervention discusses how, in alignment with Mathiesen, we combined legal aid with legal clinical education, that is, training law students to become legal aid workers. We conclude that Mathiesen’s approach remains relevant, and by integrating his action research with decolonial thoughts, new insights may emerge to reach the seemingly unreachable.

Decoding AI ethics from Users' lens in education: A systematic review

In recent years, Artificial Intelligence (AI) has witnessed remarkable expansion, greatly benefiting the education sector. Nonetheless, this advancement brings forth several ethical dilemmas. The existing research on these ethical concerns within the educational framework is notably scarce, particularly when viewed from a user's standpoint. This research systematically reviewed 17 empirical articles from January 2018 to June 2023, sourced from peer-reviewed journals and conferences, to outlined existing ethical framework in Artificial Intelligence in Education (AIED), identify related concerns from user's perspectives, and construct Ethics Guideline for AIED. The finding revealed that certain ethical aspects, including the ethics of learning analytics and the ethics of algorithms in AIED, are often neglected in the existing ethical frameworks, principles, and standards for AIED. Based on the blank between existing ethical frameworks and ethic concerns from user's perspectives, the research proposes more inclusive and thoughtfully Ethics Guideline for AIED. The study also provides actionable recommendations for multiple stakeholders, emphasizing the need for guidelines that address user-centered concerns. In addition, How this Ethics Guideline for AIED could be developed is discussed, along with outlining potential avenues for future research.

Ethical Ramifications of the Dark Side of Business Practices in the International Business Area

ABSTRACTThe dark side of international business practices has attracted significant research attention recently. However, researchers are struggling to delve into the ethical ramifications of these practices because of a limited understanding of ethical and digital transformation issues in international business, which may be caused, inter alia, by sociocultural and market disparities, lack of regulatory frameworks, information asymmetries, data ubiquity, and power imbalance among key stakeholders. This paper addresses this important gap through four key themes—ethical considerations, data processing issues, legal considerations, and managerial contingencies. We discuss how to step forward in research on ethics in international business, assessing potential risks associated with privacy concerns, big data, cybersecurity, content analysis, stakeholder relationships, and discriminatory outcomes. Finally, we propose a research agenda and recommendations to address the ethical challenges and dilemmas international businesses face due to disruptive technologies (e.g., artificial intelligence) and cross‐market challenges (e.g., legal jurisdictions).

Ethicizing Agency in Body Documentification

ABSTRACTWhile considerations of documents and data are longstanding in the tenants and practices of library and information science (LIS), the recent turn toward bodies and embodiment in the social sciences invites a critical interrogation of our assumptions about the interplay of documents, data, and bodies embedded within sociotechnical systems of power and bodily agency. In response, we begin to theorize the intersection of datafication and documentation as documentification, encapsulating how acts of datafication revoking agency results in a one‐directional superficial documentary status, producing assumptions about bodies by power systems which aim to simplify, nullify, and suppress. We initially examine documentification as it relates to practices of surveillance, BMI, and memory institutions. In doing so, we interrogate the ethical dilemmas emerging from assumptions about agency ascribed to documentified bodies. Finally, we challenge the library and information professions to imagine a world designed with putting people first that centers, rather than reduces, their agency.

Choice of financial audit firm and ESG assurance firm: The role of board of director characteristics

Corporations increasingly seek assurance on their published environmental, social, and governance (ESG) reports. Some companies use their audit firm to assure ESG reports, while others seek assurance services from a different firm. This paper investigates the influence of boardroom-based factors – female directors and multiple directorships – on companies' choice of ESG assurance provider. Using a sample of 438 Australian company-year observations from 2010 to 2020 we find that companies with more female directors and busy boards (i.e., boards with directors having at least three concurrent directorships) are more likely to choose a Big-4 audit firm different from their incumbent financial auditor to assure their ESG reports. Based on agency, social capital and resource dependence theories, we explain this ESG assurance procurement strategy as deliberate to address the potential ethical dilemma of engaging the same audit firm for assurance of financial and non-financial information. Our findings suggest that companies with more female directors and busy boards are likelier than their counterparts to apply this ethical stance in choosing their financial auditors and ESG assurers. Implications for policymakers and regulators in designing board diversity guidelines or rules and companies in setting board diversity criteria and policies are discussed.

Managing the Twin Faces of AI: A Commentary on “Is AI Changing the World for Better or Worse?”

This commentary explores the transformative potential and inherent risks associated with artificial intelligence (AI), particularly generative AI. It focuses on the dual nature of AI, where it offers substantial benefits in industries like retailing, and social media, while also presenting challenges related to ethics, privacy, and job displacement. The article introduces a framework to analyze AI's organizational impact, categorizing outcomes based on how AI supports or disrupts the status quo. It discusses AI's contribution to operational efficiency, demand expansion, and business transformation, acknowledging both the promise of enhanced customer experiences and the peril of ethical dilemmas such as algorithmic bias and data privacy concerns. It explores real-world applications of AI, such as personalized customer engagement and healthcare diagnostics. At the same time, the article critically examines negative implications, including job displacement, wage polarization, and the erosion of human connection in customer service. The commentary offers a balanced perspective, urging businesses and policymakers to embrace Responsible AI principles like fairness, reliability, and accountability. The article projects the future of AI, particularly advancements in agentic AI, artificial general intelligence (AGI), and artificial superintelligence (ASI), as holding both enormous potential and severe risks. It concludes by calling for a thoughtful, regulated approach to AI development to ensure it serves the greater good while mitigating its risks.

“I Do Not Believe We Should Disclose Everything to an Older Patient”: Challenges and Ethical Concerns in Clinical Decision-Making in Old-Age Care in Ethiopia

Clinical decision-making in old-age care is a complex and ethically sensitive process. Despite its importance, research addressing the challenges of clinical decision-making in old-age care within this cultural context is limited. This study aimed to explore the challenges and ethical concerns in clinical decision-making in old-age care in Ethiopia. This qualitative study employed an inductive approach with data collected via semi-structured interviews with 20 older patients and 26 health professionals recruited from healthcare facilities in Ethiopia. Data were analysed using reflexive thematic analysis. Our analysis identified three key themes. First, participants highlighted perceptions that older patients’ religious beliefs interfere with the clinical decisions both older patients and health professionals make. Second, older patients often receive limited information from health professionals about their diagnosis and treatment. Third, families of older patients appear to strongly influence clinical decisions made by older patients or health professionals. This research enhances the understanding of clinical decision-making in old-age care within Ethiopia, a context where such research is scarce. As a result, this study contributes towards advancing the deliberation of ethical dilemmas that health professionals who work with older patients in Ethiopia might face. A key implication of the study is that there is a need for more ethics and cultural competence training for health professionals working with older patients in Ethiopia.

A preventive care approach for oral health in nursing homes: a qualitative study of healthcare workers’ experiences

BackgroundOral health problems are common among care-dependent older adults living in nursing homes. Developing strategies to prevent the deterioration of oral health is therefore crucial to avoid pain and tooth loss. A standardized work widely used in nursing homes in Sweden is the quality register Senior Alert (SA), which assesses age-related risks concerning e.g. pressure sores, falls, malnutrition and oral health. The oral health assessment is performed with the Revised Oral Assessment Guide-Jönköping (ROAG-J), which also includes planning and implementation of preventive oral care interventions with the goal of achieving good quality care. However, what facilitates and hinders healthcare workers in working with oral health in SA remains unexplored. The aim of this study was to describe healthcare workers’ experiences of assessing oral health with the ROAG-J, planning and performing preventive oral health care actions in accordance with SA in nursing homes.MethodsHealthcare workers (n = 28) in nursing homes in two Swedish municipalities participated and data was collected through six focus group interviews. Reflexive thematic analysis was used to identify patterns of meaning in the data.ResultsThemes generated in the analysis were:A structured process promotes communication and awareness and stresses the importance of oral health;Oral care for frail older adults is challenging and triggers ethical dilemmas;Unclear responsibilities, roles and routines in the organization put oral health at risk;Differences in experience and competence among healthcare staff call for educational efforts.ConclusionsThe structured way of working increases staff awareness and prioritization of oral health in nursing homes. The main challenges for the healthcare workers were residents’ reluctance to participate in oral care activities and oral care being more complicated since most older adults today are dentate. Organizational challenges lay in creating good routines and clarifying staff roles and responsibilities, which will require continuous staff training and increased management involvement.

Artificial Intelligence in Infectious Disease Clinical Practice: An Overview of Gaps, Opportunities, and Limitations.

The integration of artificial intelligence (AI) in clinical medicine marks a revolutionary shift, enhancing diagnostic accuracy, therapeutic efficacy, and overall healthcare delivery. This review explores the current uses, benefits, limitations, and future applications of AI in infectious diseases, highlighting its specific applications in diagnostics, clinical decision making, and personalized medicine. The transformative potential of AI in infectious diseases is emphasized, addressing gaps in rapid and accurate disease diagnosis, surveillance, outbreak detection and management, and treatment optimization. Despite these advancements, significant limitations and challenges exist, including data privacy concerns, potential biases, and ethical dilemmas. The article underscores the need for stringent regulatory frameworks and inclusive databases to ensure equitable, ethical, and effective AI utilization in the field of clinical and laboratory infectious diseases.

Ethical Considerations in Clinical Trials: Ethical Dilemmas in Patient Consent and Animal Testing

Clinical trials are indispensable to the advancement of medical science, providing a framework for evaluating the safety and efficacy of new treatments, interventions, and technologies. However, they present profound ethical challenges, particularly in relation to patient consent and the use of animals in preclinical testing. Informed consent is central to safeguarding patient autonomy, yet practical difficulties arise from issues such as patient comprehension, vulnerability, and cultural differences. Animal testing, while traditionally viewed as a necessary component of preclinical research, prompts serious ethical concerns regarding animal welfare and the broader moral implications of causing harm to animals for human benefit. This review examines these ethical dilemmas, tracing their historical evolution, analysing current regulatory frameworks, and evaluating potential alternatives to both patient consent challenges and animal testing. Through the examination of case studies like the Tuskegee Syphilis Study and the Henrietta Lacks case, as well as debates surrounding animal rights, this article emphasizes the need for continuous ethical vigilance and adaptive frameworks that can balance scientific progress with moral responsibility.