Ethical Factors Research Articles

Clinical decision making within occupational therapy: a critical reflection of providing palliative care for a patient in the community

Clinical decision-making within occupational therapy is a complex and dynamic process shaped by numerous scientific, narrative, professional, ethical, legal and personal factors. By reflecting on these factors and by developing metacognition of one's own reasoning pathways, biases, and heuristics, patient-centred and balanced clinical decisions can be made. This reflective case study examines the factors underpinning an occupational therapist's clinical decision making for a man with terminal cancer. A critical reflective model is used in this article to provide structure and to ensure critical consideration of the case. Implications for practice aim to serve as inspiration for others to reflect on their own journey, and personal action points are detailed to develop the author's own clinical decision-making.

Prospective cohort study of genomic newborn screening: BabyScreen+ pilot study protocol

IntroductionNewborn bloodspot screening (NBS) is a highly successful public health programme that uses biochemical and other assays to screen for severe but treatable childhood-onset conditions. Introducing genomic sequencing into NBS...

Organ Donation: Willingness, Attitude, and Knowledge among General Population of Western India – A Cross-sectional Study

Background: The issue of organ donation is complex and multifactorial involving ethical, legal, medical, organizational, and societal factors. There is a wide gap between the required number of donations and actual donations in India. There is a need to identify the reasons for this wide gap from the community perspective. Methods: A cross-sectional study was done among relatives of patients attending the outpatient department at a tertiary care center. Data were collected using a pre-designed semi-structured questionnaire. For the assessment of knowledge, relevant questions were asked. Attitude toward organ donation was assessed using 22 items on a 5-point Likert scale. Data were entered into Excel sheet and analyzed using SPSS software. Average knowledge, attitude, and practice scores were calculated and compared with religion, gender, and other sociodemographic variables. A Chi-square test of association was applied between sociodemographic variables and their willingness to sign the donor card. P <0.05 was considered statistically significant. Their suggestions for improving organ donation practices were also documented. Results: The average knowledge score among participants was 8.06. Good, average, and poor attitude toward organ donation were found among 3 (0.77%), 339 (87.37%), and 46 (11.86%) participants, respectively. Good, average, and poor practice toward organ donation were observed among 1 (0.26%), 65 (16.75%), and 322 (82.98%) participants, respectively. Discussion: When deciding whom to donate their organs, 156 (40.21%) said that the health status of the recipient and his/her chances of survival will be the most important factor. Age and poor health status were the major barriers toward organ donation among participants. Still, many participant’s motivation toward organ donation was that they want to help others and 190 (49.0%) participants were willing to be part of awareness group and promote organ donation activity in the society. Solving their barriers/reasons for refusing organ donation may help to improve organ donation in the society. Conclusion: Knowledge has an impact on changing person’s attitude and practice; even our study has shown significant results of association between knowledge and attitude, knowledge and practice as well as attitude to their practice toward organ donation. Age and poor health status were the major barriers toward organ donation among participants.

The Ethical Dimensions of Mindfulness in Public Health

AbstractThis commentary on “Mindfulness for global public health: Critical analysis and agenda” seeks to add to the discussion by considering, what are the moral or ethical implications of introducing mindfulness-based interventions (MBIs) into public health? An open question should be asked: Do MBIs promote “moral health,” a type of mental well-being based on moral integrity? Currently, there is a lack of comprehensive understanding regarding the moral influences of MBIs on individuals, but more concerning is the complete absence of population or collective-based data. Moreover, the data on the moral influences of MBIs originate from neurotypical, socially advantaged, and homogeneous demographics, so caution is warranted regarding the potential impact on general public’s moral functioning before proceeding. This commentary briefly reviews the existing literature on the relationship between moral functioning and MBIs, then addresses why the unknown effects of moral functioning from mindfulness on a social level are a concern for public health. Following many of Oman’s proposed axes, it then raises questions about what MBIs could do to the moral functioning of certain populations with mental health issues, diverse and disadvantaged populations, and various multi-sector levels throughout society. In some cases, MBIs might need to include ethical adaptations, which add components that explicitly encourage moral development. These adaptations could support protective measures or mitigate moral risk factors. The commentary concludes by suggesting that ethical motivation could be an added axis to Oman’s scheme, as there is an alignment between mindfulness and public health. Nonetheless, it cautions that more research is needed at the population level on the moral influences from MBIs before their widespread implementation in public health.

An overview of labelling and environmental claims on fish and seafood products in New Zealand supermarkets

Fish and other seafood are a major component of New Zealanders’ diet; the 2018/2019 and 2019/2020 New Zealand Health Survey found that nearly three quarters of New Zealanders eat seafood at least once a week(1). Environmental and ethical factors influence New Zealand consumers’ purchase of seafood and consumers prefer to get their information about seafood at the point of purchase(2). However, environmental claims are not regulated under the Australia New Zealand Food Standards Code, unlike health and nutrition claims. Some seafood products are certified by programmes (e.g. Best Aquaculture Practice (BAP)), ensuring the seafood was sourced according to specific criteria related to environmental management, but other products carry self-declared environmental claims that have not been independently verified. This study aimed to describe labelling practices, including environmental claims, on fish and seafood packaged products sold in major New Zealand supermarkets and available in the 2022 Nutritrack database. Nutritrack is an annual survey conducted by trained fieldworkers who take photographs of all packaged food and beverage products displaying a nutrition information panel (NIP) from 4 major supermarkets in New Zealand. Information from the photographs, including the NIP and the ingredients list is entered into the Nutritrack database. For this study, data (including fish species, harvest location, processing country, fishing method, environmental certifications and self-declared environmental claims) were extracted from the archived photographs of all sides of the packaged fish and seafood products in the 2022 Nutritrack database. Self-declared environmental claims were assessed against the ISO 14021 standard for “Environmental labels and declarations — Self-declared environmental claims (Type II environmental labelling)” on specific criteria that were relevant for seafood products, including if the self-declared claim mentioned the word “sustainable” (as this term is difficult to substantiate and should be avoided); was vague and non-specific; or overstated the benefits (to imply multiple benefits from a single environmental change). There were 369 fish and seafood products included in this study. Eighty-eight products (23.8%) displayed a certification; the Marine Stewardship Council’s certification (MSC) for wild fish was the most common and was featured by 72 products (19.5%). One hundred and fifty-two products (41.2%) displayed at least one self-declared claim. Thirty-three distinct self-declared environmental claims were identified, 16 (48.5%) of which breached the ISO 14021 standard for environmental declarations because they used the term “sustainable” and 26 (78.8%) of which breached the ISO 14021 standard because they were vague. This analysis suggests that stricter regulation is needed for self-declared environmental claims on fish and other seafood products available for purchase in New Zealand, to prevent greenwashing and to provide consumers transparent, accurate and substantiated information.

FREEDOM OF EXPRESSION AND CENSORSHIP IN PERFORMING ARTS: A LEGAL AND ETHICAL PERSPECTIVE

With an emphasis on the ethical and legal factors that impact creative freedom, this study investigates the intricate relationship between free speech and censorship in the performing arts. In light of the importance of the performing arts as a platform for social criticism and cultural reflection, this research investigates the legal safeguards that artists have, especially in democracies like India. Censorship systems, which aim to maintain public order, moral principles, and cultural sensitivity, often moderate these liberties. Courts' interpretations of the limits of speech in the performing arts are examined in this article via an examination of seminal judgments from India and other countries. It also takes into account the social effects of censorship on innovation, creativity, and public debate as well as the ethical considerations of limiting art. This paper proposes legislative changes to better balance creative freedom with community norms by comparing censorship regulations across countries. In the end, the piece argues for a balanced approach that safeguards creative expression while upholding ethical limits, with the goal of creating a democratic setting where the performing arts may flourish as catalysts for social transformation.

Conscientious enrolment in clinical trials during the COVID-19 pandemic: right patient, right trial

This article describes our efforts to screen and enrol clinical trial participants conscientiously in the COVID-19 pandemic setting. We present the standard screening and enrolment process prior to, and our process of adapting to, the pandemic. Our goal was to develop a way to screen and enrol people for clinical trials that was both equitable and effective. In addition, we outline the steps our research department took to ensure that ethical, clinical and logistical factors were considered when matching a patient to a clinical trial.

Peculiarities of compensation for damage caused by the death of a minor

This article is emphasised of compensating for damages resulting from the death of a minor. The loss of a minor is an emotionally devastating event for any family, compounded by the complex legal considerations surrounding compensation for the damages incurred. This abstract delves into the peculiarities of compensation for damages arising from the death of a minor, examining the multifaceted dimensions that legal systems must navigate.
 The author explores the peculiarities surrounding compensation in such cases, shedding light on the legal frameworks, precedents, and challenges that shape the compensation process. In many jurisdictions, the calculation of compensation for the death of a minor involves intricate assessments of both tangible and intangible losses. While quantifiable expenses such as medical bills and funeral costs are relatively straightforward, the valuation of non-economic damages, such as loss of companionship, guidance, and future earnings potential, poses significant challenges. The inherent difficulty in assigning monetary value to these intangible losses underscores the need for nuanced legal frameworks sensitive to the unique circumstances of each case.
 The analysis of scientific literature is covered various aspects, including legal responsibilities, the determination of damages, and the establishment of liability. The determination of liability in cases involving the death of a minor often raises complex questions of causation and responsibility. Legal systems must carefully consider factors such as negligence, wrongful acts, and contributory negligence, weighing the actions of all parties involved to ascertain accountability. In cases where the death results from medical malpractice or accidents, the burden of proof may be particularly onerous, requiring thorough investigation and expert testimony.
 The article is examined potential reforms and policy considerations that may enhance the adequacy and fairness of compensation for the death of a minor. It navigates through the complexities of assigning a monetary value to intangible losses, such as the emotional and psychological suffering endured by the bereaved family. In conclusion, the compensation for damages caused by the death of a minor is a multifaceted issue that demands careful consideration of legal, ethical, and societal factors.

Sustainable marketing dilemmas: moral, ethical, and practical in business communication perspectives

Abstract In recent years, corporations' sustainable marketing practices have gone beyond just selling mere products or services and present significant challenges. This study examines the moral, ethical, and practical challenges encountered by sustainable marketing, specifically from the standpoint of business communication. This research explains the notion of sustainable marketing and discerns its ethical dilemmas by examining the current body of scholarly literature. The discussion focuses on stakeholder theory, ethical consumerism, and communication theories. The study employs a qualitative research methodology, gathering data through comprehensive interviews and case analysis. The participants comprise marketing professionals, consumers, and companies that place sustainability as a top priority. The findings illustrate that organisations face many moral and ethical challenges while creating and executing sustainable marketing strategies. For example, challenges arise when trying to balance the desire for genuineness and openness and the success of marketing communications, as well as conflicts between moral evaluations and business goals. These challenges substantially impact the company's communication strategy, as they are directly connected to consumer trust and brand image. This study offers valuable insights for companies creating and implementing sustainable marketing strategies. It highlights the crucial role of managing moral and ethical factors to achieve long-term success. Moreover, the discoveries can aid policymakers and regulatory agencies formulate criteria and recommendations to foster sustainable corporate practices.

Organisational ethics context factors in a public energy utility company: A millennial view

Orientation: Millennials have become the largest age cohort in the modern world of work. Understanding the phenomenological experiences of millennials may be the key to facilitating more ethical organisational cultures.Research purpose: The aim of this article is to explore the lived, working experiences of millennials’ organisational ethics contexts factors as predisposed by ethical leadership in an organisation in the energy sector.Motivation for the study: An extensive body of research exists concerning the statistical relationship between ethical leadership, ethical culture, and workplace ethics climates. However, less explored is qualitative studies regarding millennials’ work experiences of organisational ethics context factors.Research design, approach and method: A qualitative research design was selected. Purposive and convenience sampling were utilised. The sample included eight millennials, and face-to-face interviews were used for data collection. Data were analysed by means of content analysis.Main findings: The findings suggest an ambivalent and paradoxical split in how millennials experience the ethical context factors in the participating organisation.Practical and managerial implications: The study has implications for the type of leadership styles that should be considered when engaging with millennials. Top human resource management could use the results to create a working environment that actively fosters psychological attachment, satisfaction, and boosts employee commitment.Contribution or value added: Expanding and enhancing the comprehension of how ethical leadership contributes to the theory of ethical leadership in the work context.

Examining the Mechanism of the Attitude-Behavior Gap in Ethical Consumption and the Concept of Creating Value from Ethical Factors

Examining the Mechanism of the Attitude-Behavior Gap in Ethical Consumption and the Concept of Creating Value from Ethical Factors

Parental refusal of prenatal screening for aneuploidies.

To analyze the reasons for refusal of aneuploidy screening in a multicultural Middle Eastern population. The study included patients delivering in a university hospital, who had refused aneuploidy screening during their pregnancy. We evaluated through a questionnaire submitted during the postpartum period the sociodemographic characteristics, beliefs, attitudes, and the main reason underpinning their choice. Religious, ethical, and financial factors, personal beliefs, medical information, perceived media information, and familial input were assessed through a Likert scale. Our pilot study included 70 patients. The main reason (33 %) was the refusal to terminate pregnancy if the screening tests ultimately led to a diagnosis of aneuploidy. Lack of adequate information on the availability and benefits of this screening method (28 %), religious beliefs (17 %), in addition to other minor reasons such as financial considerations, familial recommendations, late pregnancy follow-ups, and media influence were also identified as contributing factors. Aneuploidy screening is routinely offered to couples, with varying uptake rates observed worldwide. Sufficient information on prenatal screening and diagnosis should be provided to all pregnant women, presenting all available options, thus enabling them to make a free and informed choice during their pregnancy.

Digital Horizon: Assessing Current Status of Digitalization in Maritime Industry

This study addresses the critical role of maritime transport, which accounts for a significant part of world trade, but faces environmental challenges due to its dependence on the combustion of conventional fuels. The study focuses on the fast-growing area of digitalization in the maritime industry as a solution and uses a bibliometric analysis to assess trends, country participation, patents, and influential journals. China leads in both publications and patents, with Ocean Engineering emerging as one of the most important journals. The study identifies modern technologies such as IoT, Blockchain, AI and Neural Networks as crucial to overcoming the challenges facing the industry. However, it also points to obstacles, including the need for advanced text analytics tools and interdisciplinary research. The integration of previous research efforts highlights gaps and the dynamic nature of the field. Implications for future research emphasize international collaboration, understanding the patent landscape and consideration of ethical and regulatory factors. The discussion highlights the transformative potential of AI, IoT, Big Data Analytics, and Blockchain in maritime digitalization and emphasizes the importance of balancing technological advances with safety and sustainability. In summary, the study provides valuable insights into the progress of maritime digitalization. It provides a basis for future research and highlights the potential for efficiency, safety and sustainability improvements that require a cautious and balanced approach.

NAVIGATING GOVERNANCE FOR EQUITABLE HEALTH SYSTEMS: ETHICAL DIMENSIONS, IDEOLOGICAL IMPACTS, AND EVIDENCE-BASED IMPROVEMENTS

The essay's purpose is to comprehensively address the gaps in the literature by analyzing the ethical dimensions of selective partnerships, the influence of political ideologies, the importance of comprehensive analytical work, and the synthesis of insights from diverse regions. These elements collectively contribute to evidence-based governance improvements that foster equitable resource allocation and enhanced health outcomes. Drawing from an extensive review of existing literature, the essay synthesizes insights from empirical case studies in both European and Asian contexts. The theoretical framework used—the "Political Economy of Health Governance"—provides a comprehensive lens to examine the intricate interplay between political, economic, and ethical factors that shape governance practices within health systems. The analysis reveals several novel perspectives that offer fresh insights into evidence-based governance improvements. The ethical dimensions of selective partnerships are explored, shedding light on potential equity implications. The impact of political ideologies on governance practices is uncovered, emphasizing the need for alignment with equitable health outcomes. The essay advocates for comprehensive analytical work as a precursor to policy, ensuring transparent decision-making and stakeholder inclusivity. By synthesizing insights from diverse regions, the essay enriches the understanding of governance qualities that drive successful health system reforms. In conclusion, this essay contributes to the field by addressing existing gaps in the literature and offering a holistic view of governance's impact on health systems performance. The synthesis of diverse perspectives and the application of the "Political Economy of Health Governance" theory provide a nuanced understanding of evidence-based governance improvements. These insights hold the potential to reshape policy paradigms, promoting equitable resource allocation and enhanced health outcomes within health systems.

Ethical triage in public health emergency facilities: distributive justice – a decision model

PurposeA new triage method, MBCE (Medical Bio Social Ethics), is presented with social justice, bio, and medical ethics for critical resource distribution during a pandemic. Ethical triage is a complex and challenging process that requires careful consideration of medical, social, cultural, and ethical factors to guide the decision-making process and ensure fair and transparent allocation of resources. When assigning priorities to patients, a clinician would evaluate each patient’s medical condition, age, comorbidities, and prognosis, as well as their cultural and social background and ethical factors.Design/methodology/approachA statistical analysis shows no interactions among the ethical triage factors. It implies the ethical components have no moderation effect; hence, each is independent. The result also points out that medical and bioethics may have an affinity for interactions. In such cases, there seem to be some ethical factors related to bio and medical ethics that are correlated. Therefore, the triage team should be careful in evaluating patient cases. The algorithm is explained with case histories of the selected patient. A group of triage nurses and general medical practitioners assists with the triage.FindingsThe MBCE triage algorithm aims to allocate scarce resources fairly and equitably. Another ethical principle in this triage algorithm is the principle of utility. In a pandemic, the principle of utility may require prioritizing patients with a higher likelihood of survival or requiring less medical care. The research presents a sensitivity analysis of a patient’s triage score to show the algorithm’s robustness. A weighted score of ethical factors combined with an assessment of triage factors combines multiple objectives to assign a fair triage score. These distinctive features of the algorithm are reasonably easy to implement and a new direction for the unbiased triage principle.Originality/valueThe idea is to make decisions about distributing and using scarce medical resources. Triage algorithms raise ethical issues, such as discrimination and justice, guiding medical ethics in treating patients with terminal diseases or comorbidity. One of the main ethical principles in triage algorithms is the principle of distributive justice.

Der Beitrag ethischer Faktoren zur Erklärung der rückläufigen Innovationsdynamik

Abstract When analysing the declining innovation and growth dynamics of modern economies, cultural and ethical influencing factors can be identified alongside economic causes. In his theory on the innovative capacity of the market economy, Edmund Phelps emphasised the importance of non-monetary motives for entrepreneurial activity, which can also be substantiated by looking back at the history of the industrial revolution(s). From a current perspective, the introduction of shareholder value-oriented approaches to corporate management and the transition to financial market-based benchmarks at the end of the 20th century led to a radical change in the culture of motivation in the financial and real economy. As a result, the ability to innovate was impaired by reduced investment in research and development, which was exacerbated by the misallocation of capital in the financial sector.

Development of a Content Framework of Artificial Intelligence Integrated Education Considering Ethical Factors

The rapid advancement of Artificial Intelligence (AI) technology has brought about significant positive changes across society. However, it has also introduced challenges like privacy breaches, data bias, and spreading fake news. In response, several countries, including South Korea, have provided ethical guidelines and policies for AI. Yet, these measures often fall short of keeping pace with the speed and diversity of AI development. To address these issues, this study developed a comprehensive approach by integrating ethical considerations into AI education, covering the entire AI technology development and application process. It involved analyzing previous research on AI and AI ethics education and creating a draft of an integrated AI education program focused on problem-solving based on computational thinking and ethical practicality. The draft was refined and supplemented through two rounds of expert Delphi surveys, ultimately leading to an “Integrated AI Education Program.” This proposed program emphasizes that the knowledge content of AI technology and ethical considerations should not be treated separately but addressed together. It aims to enhance moral and social capacities alongside the experience of thinking like a computer scientist when solving real-life problems. Through this, the program supports the ultimate goal of AI education: to foster computational thinking while providing an educational experience that considers both technology and ethics. This study is expected to advance the discussion on integrating AI ethics into AI education curricula and contribute to developing socially responsible AI developers and users.

The Impact of Macroeconomic Indicators on Medical Tourism: A Global Perspective

Medical tourism is an expanding global phenomenon stimulating economic development driven by a combination of multiple macro and socioeconomic factors. The study aims to investigate whether the development of medical tourism globally is associated with specific macroeconomic indicators. The association of Medical Tourism Index (MTI) is explored with Gross Domestic Product (GDP), healthcare spending and international tourism receipts. A countries’ grouping method and an ordinary least squares (OLS) regression model were used. MTI was used as the outcome variable, while macroeconomic indicators as potential predictors. The grouping of countries showed that European and Asian countries as well as Canada excel high ranking in all indicators. However, the Gulf Cooperation Council countries (GCC) that exhibit high performance in GDP, rank below the MTI average. Caribbean and Latin American countries are ranking high in the MTI but fall below the average in all the indicators. The OLS analysis showed a positive correlation between the score of the MTI and health expenditure and no correlation among MTI, GDP and international tourism receipts, a finding also supported by the grouping analysis. Taking into consideration the similarities and disparities found among countries regarding the macroeconomic indicators mostly impacting medical tourism, it seems that there is a consensus on their relationship but not clearly identified rather due to a variety of social, cultural and ethical factors that dominate in each country. Further research is needed in order to obtain more robust and comparative evidence.

The future of artificial intelligence in thoracic surgery for non-small cell lung cancer treatment a narrative review.

To present a comprehensive review of the current state of artificial intelligence (AI) applications in lung cancer management, spanning the preoperative, intraoperative, and postoperative phases. A review of the literature was conducted using PubMed, EMBASE and Cochrane, including relevant studies between 2002 and 2023 to identify the latest research on artificial intelligence and lung cancer. While AI holds promise in managing lung cancer, challenges exist. In the preoperative phase, AI can improve diagnostics and predict biomarkers, particularly in cases with limited biopsy materials. During surgery, AI provides real-time guidance. Postoperatively, AI assists in pathology assessment and predictive modeling. Challenges include interpretability issues, training limitations affecting model use and AI's ineffectiveness beyond classification. Overfitting and global generalization, along with high computational costs and ethical frameworks, pose hurdles. Addressing these challenges requires a careful approach, considering ethical, technical, and regulatory factors. Rigorous analysis, external validation, and a robust regulatory framework are crucial for responsible AI implementation in lung surgery, reflecting the evolving synergy between human expertise and technology.

Nurses' moral courage and related factors: A systematic review

BackgroundNurses face various ethical conflicts when taking care of patients, and such conflicts require moral courage. This systematic review was conducted with the aim of investigating moral courage and its related factors among nurses. MethodsTo find related studies, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The PubMed, Web of Science, Google Scholar, Scopus, Embase and Science Direct databases were searched using keywords such as Courage, Moral Courage, and Nurses, and no lower time limit was imposed when conducting the searches. The identified studies were published between January 2000 and March 2023. Quality of articles was assessed using the STROBE checklist. ResultsThe pooled sample size for the 19 included studies was 7863. All studies were observational and cross-sectional. The results showed that three categories of factors most related to moral courage are individual, moral, and factors related to the organization. Underlying factors of each category are also provided within this paper. ConclusionMoral courage is an integral part of nursing, which as a profession, is becoming even more challenging with the advancement of science and technology. Therefore, there is a need for nurses and especially nursing managers to be considerate of factors affecting moral courage of nurses, with a view to strengthening the positive factors and reducing the negative impacts.