Ethical Lens Research Articles

Constructing Data Ethically

AbstractEthical issues are structurally present in the design and choice of data; the interaction between problem, model, and intervention; and the scientism that supports data analytics’ claims to authority. In this chapter, I argue against three social assumptions behind common implementations of learning analytics: data realism, technological neutrality, and scientism. Recognizing the need to create a mindset of conscious ethical awareness for learning analytics, I challenge institutional researchers to consider learning analytics through three critical lenses: a professional ethics lens, a responsibility lens, and an equity lens.

Ethical Considerations in Immediate Postpartum Long-Acting Reversible Contraceptive Care [2F

INTRODUCTION: Hospitals across the country are implementing immediate postpartum long-acting reversible contraceptive (LARC) programs. Our objective was to qualitatively evaluate representative services through the lens of clinical ethics. METHODS: We conducted a multiple case study using a literature review to identify academic hospitals providing immediate postpartum LARC. We conducted in-person, semi-structured interviews with 66 key informants across 11 facilities. Two authors independently analyzed data using a framework analysis based on the Armstrong Clinical Ethics Coding System. Authors obtained IRB exemption. RESULTS: Analysis revealed three significant ethical considerations. First, we found that most sites do not offer immediate postpartum LARC to all patients, instead offering it only to patients with insurance coverage for this care-generally Medicaid recipients. Service delivery thus leads to disparities in LARC access and the potential targeting of LARC to marginalized populations. Second, we identified challenges with informed consent processes: providers struggled to promote both LARC access and patient autonomy (e.g., providers grappled with the appropriateness of newly offering LARC to a laboring woman versus the paternalism of not offering LARC at all). Third, while patient needs and preferences were a major motivating factor in establishing immediate postpartum LARC programs, no site had corresponding provisions to enhance access to subsequent LARC removal. CONCLUSION: Hospitals offering immediate postpartum LARC contend with important ethical issues, including providing equitable access to contraceptive care, creating robust informed consent processes, and ensuring access to LARC removal. Engaging with patients and a reproductive justice framework when designing these programs may help hospitals adopt safeguards to promote patient-centered care.

“There are carers, and then there are carers who actually care”; Conceptualizations of care among looked after children and care leavers, social workers and carers

Looked after children and care leavers (LACCL) are some of the most vulnerable and marginalized young people in our communities. Existing research demonstrates that this group often interprets care in terms of genuineness and tends to feel uncared for. Less work exists from the perspective of social workers and formal carers. This study aims to explore how care is perceived and practiced among LACCL and those with a duty of care for them. We use a theoretical lens of care ethics to compare and contrast understandings in order to explore how they affect the delivery and receipt of care. There were 44 participants from four local authorities in north-east England including nineteen LACCL aged 12-20, eight social workers, and nineteen formal carers. Twenty-eight semi-structured 1:1 interviews, four dyad interviews and three focus group interviews. LACCL desired care that felt familial, went beyond minimum standards and involved understanding. Social workers had to manage LACCL expectations and build relationships by both rationing care according to role constraints whilst sometimes going 'above and beyond' statutory care. Carers conceptualized care in terms of dedication and discipline but felt limited in their ability to achieve care in this way. Bridging different conceptualizations of care is necessary to achieve integrated support for these vulnerable young people whilst also helping them to develop key skills for later adult life. A deeper understanding of frameworks of care has implications for social worker and formal carer training and practice.

Ethical and moral considerations of (patient) centredness in nursing and healthcare: Navigating uncharted waters.

This discussion paper aims to explore potential ethical and moral implications of (patient) centredness in nursing and healthcare. Healthcare is experiencing a philosophical shift from a perspective where the health professional is positioned as the expert to one that re-centres care and service provision central to the needs and desires of the persons served. This centred approach to healthcare delivery has gained a moral authority as the right thing to do. However, little attention has been given to its moral and ethical theoretical grounding and potential implications for nurses, persons served and the healthcare system. Based upon a review of academic and grey literature, centredness is proposed as a value-laden concept in nursing inquiry. Potential moral and ethical implications of centredness on nurses/healthcare providers, persons served and the healthcare system are discussed. These challenges are then considered within the context of normative and relational ethical theories. These perspectives may offer guidance relative to how one should act in those circumstances as well as an understanding as to how interdependency and engagement with the other person(s) can help navigate the challenges of a centred care approach. Viewing centredness through an ethical theoretical lens provides a valuable discourse to nursing in efforts to expand the knowledge base and integrate centred approaches into practice and policy.

Testifying Bodies: Testimonial Injustice as Derivatization

ABSTRACTHuman beings as objects, and we are objects inter alia, offer information, even knowledge. And yet, in a society marked by pervasive identity prejudice, even objects do not offer neutral facts. Here, I argue that the harms imposed on those who suffer testimonial injustices cannot be sufficiently understood through the ethical lens of objectification. Such persons are not simply objectified, not simply treated as mere sources of information rather than as informants. Even as objects (not mere objects), they are often unable to testify on their own behalf or testify to true facts of the matter. Rather than follow Miranda Fricker’s argument that testimonial injustices are acts of objectification, I argue that they are better understood as acts of what Ann Cahill calls derivatization. A re-examination of Fricker’s account of the wrong of testimonial injustice as derivatizing rather than objectifying clarifies the wrong of epistemic injustice, reinforces the mutuality of testimonial exchanges where both the speaker and listener are actively engaged and obligated to participate well to succeed, and opens up a discussion of how even when being treated as a source of information, informants can be mistreated.

Licensure Portability Through an Ethical Lens: Considering Multiple Stakeholders

Counselors have been licensed to practice in all 50 U.S. states and the District of Columbia since 2009, but licensure portability (the ability to transfer a license from one state to another) remains elusive, due in large part to variations in educational and training requirements between states. In this article, we extend the American Counseling Association and American Mental Health Counselors Association counseling codes of ethics beyond the counseling relationship to consider license portability along ethical dimensions at the macro level. We apply an ethical decision-making model to demonstrate how lack of portability may have ethical implications related to both counselors and clients. We submit several considerations for how the profession can conceptualize and address these issues through an ethical lens.

‘Learning the rules of the game’: emotional labor and the gendered academic subject in the United States

In this article, we investigate how entrenched sexism in higher education can take root in graduate school, where many of us learn the ‘rules of the academic game’ through our roles as teaching assistants (TAs). Feminist and anti-racist scholars have documented how these ‘rules of the game’ are scripted on different academic bodies. We focus this article on the stubborn persistence of sexism in university life through the everyday, mundane forms of emotional labor and care that TAs feel obligated to perform. As the current #MeToo movement reminds us, sexism, sexist exploitation, and oppression are as evident today as they were decades ago when feminist scholars and activists challenged the masculinism of geographical discourse through examinations of power, knowledge, and subjectivity. Our research returns to these themes by examining TAs’ experiences of sexism in the classroom through the lens of critical care ethics. A focus on TAs brings attention to the constitution of the gendered academic subject and identifies the emotional labor required to manage this subject. We believe that the durability of sexism warrants an investigation of the sites where women learn their ‘place’ in the academy.

Empty Templates: The Ethical Habits of Empty State Pages

ABSTRACTThis article examines how empty state pages (ESPs) constrain user-generated communication through the ethical lens of Bourdieu’s habitus. The authors define ESPs as interactive instructional templates that prompt users to input information to participate in an online network. Through a case study analyzing ~450,000 online comments from The New York Times, the authors find a direct connection between ESP elements, such as the character limit for comments, and online writers’ cultivated habitus.

Indian healthcare through the global health ethics lens: despite some gains, have we truly progressed?

ABSTRACTThe role (if any) that principles of global health ethics play in the formulation of global and national level policies remains poorly understood. In this article we examine the status and trajectory of India, as a prototype low-middle income country that is on track to meet some important health targets set by the Sustainable Development Goals, with a view to assessing how relevant the global goals are to achieving equitable health care and health outcomes in India. We define the principles of global health ethics relevant to our discussion and then examine some critical aspects of Indian healthcare policy through this lens. We demonstrate various areas where principles of global health ethics have been overlooked in planning and resulted in serious flaws in the healthcare system. It is our position that explicit attention should be given to the principles of global health ethics while framing policy at the national as well as the global level to ensure just health care outcomes in the future.

Consumer Ethics and Family Relations: The Economic Side of Fathering

Among contexts in which consumer ethics unfold, the family is a very relevant one because it holds a sizeable share of consumption decisions, and is intimately connected to the search and sustaining of a common life project. Based on interviews with 20 fathers cohabiting with their partners and children, we examine the role of the father in family consumption, including the progressive weakening of the breadwinner model in favor of more involved ways of male presence in the family. We explore whether fathers show any kind of ethical concern in their family consumption decisions and, if that is the case, whether those concerns are better understood through the lens of an ethics of care –as usually done in the case of mothers– or through the lens of virtue ethics –which is connected to consumers’ projects and their search for the good life.

Beyond a Northern Paradigm

Notwithstanding the commitment to the inclusion of historically underrepresented communities, Christian ethics continues to be dominated by the voices, concerns, norms and methodologies of scholars from the northern hemisphere. This paper analyses the state of the field through the lens of the Catholic Theological Ethics in a World Church network whose mission is to promote international exchange. It assesses the lacunae arising from the northern-centric nature of Christian ethics as practiced in the northern hemisphere, highlights the inflection points, and considers the likely re-prioritization of concerns that will flow from the systemic inclusion of the multiple, diverse voices of majority world scholars.

The politics of error: Rethinking the power of the symptom in the case of ADHD diagnosis in Chilean society

This article seeks, mainly, to develop a critical approach to the problem of Attention Deficit Hyperactivity Disorder (ADHD) and, through this, to rethink the problem of activism and militancy in relation to the power of a symptom linked to a corporality that seems to overflow a determined moral political framework. For this reason, we seek to think of a militancy that intensifies error, as a political power, beyond the search for a specific and universal diagnostic associated with what is understood as evidence. We begin with the description of the emergence of what we have called the ADHD Situation. First, using field notes from a collective ethnographic investigation performed during 2017, we describe the ADHD Situation as an ongoing process. Then we connect it to a broader context by examining the role of the school in contemporary Chilean neoliberal society from a genealogical-affective approximation, trying to avoid substantializing readings. In the second section, we develop this connection, describing the production of the ADHD Situation through the lenses of epistemology, ethics, economics, and politics. We also use here a critical analysis of three key documents that help us chart the institutional development of the disorder: The National Mental Health Plan (2017), the National Children’s Health Program (2015) and the Clinical Guide to Attention Deficit (2009). We demonstrate the existence of an epistemological connivance between macrosocial transformations and the community approach utilized in these documents. This provokes us to think about a militancy capable of trespassing the borders of academia, health definitions, and social interventions through the intensification of the power of error as an opening to radical transformations.

Some ethical considerations for South Africa's climate change mitigation approach in light of the Paris Agreement

South Africa ratified the Paris Agreement in 2016 and thereby committed to reducing Greenhouse Gas (GHG) concentration levels as part of its self-determined goals in its Nationally Determined Contribution (NDC). This articleviewed the targets in the NDC through an ethical lens. It was demonstrated that the commitment below the ‘business-asusual’ (BAU) level allowed for large increases in South Africa’s emissions without explaining how these were consistent with a specific understanding of what equity required. Also, the NDCtargets were found to be highly insufficient. Consequently, South Africa’s climate change mitigation commitments were deemed inconsistent with the ethical ‘no-harm’ principle.

Getting to the Heart of the Matter: Navigating Narrative Intersections in Ethics Consultation

Ethics consultants can apply a narrative ethics approach to address ethical challenges that arise in critical situations. This approach recognizes how those involved in the narrative make sense of, keep faith with, and try on new identities and new understanding of their stories. This case study explores the ways in which the stories of patient, provider, and clinical ethics consultant intersect, and considers how the organic nature of the narrative ethics approach allows ethics consultants to navigate the stories of multiple stakeholders as they grapple with complex health care decisions. This essay also suggests that clinical ethics consultants applying the lens of narrative ethics have an obligation to approach consultations with courage, professional humility, intellectual curiosity, and an appreciation for the narratives of as many of the stakeholders as possible (including one's own).

Reinstating the artist’s voice: Artists’ perspectives on participatory projects

Claire Bishop argued that the ethical lens applied to socially engaged arts practice encourages ‘authorial renunciation’ in favour of collaboration and limits the opportunity to expose such practice to critical reception. This article responds to Bishop’s implicit call to envision an artist-centred framework for participatory arts by identifying the motivations and beneficial discoveries that artists make when they seek out the creative involvement of others. Based on interviews with Australian performing artists who have established socially engaged practices, the article aims to bring about a form of ‘authorial reinstatement’ into the value system around participatory arts practice. It identifies a range of motivations for artists who establish socially engaged or participatory practice, from self-developmental to altruistic; and from arts-focused to community- and society-focused. The article argues that using these motivations to inform indicators of achievement for participatory practice provides new opportunities for critical interrogation of those practices.

Is circular economy the key to transitioning towards sustainable development? Challenges from the perspective of care ethics

The Sustainable Development Goals represent a global consensus on the urgency to preserve the conditions that make life possible on this planet and ensure a future of wellbeing for humanity. Transforming consumption and production processes is a fundamental priority of this development agenda. Circular Economy has emerged as an alternative model, given its potential for value creation, while generating social and environmental positive impacts. An exploratory study carried out in Navarra (Spain) shows its potentiality for socio-economic and environmental benefits as well as technological, organizational, financial, institutional and social challenges. However, through the lenses of care ethics and gender, we argue that Circular Economy entails a wider range of opportunities and defies for entrepreneurs, organizations, institutions, economics and society as a whole. The transformational changes at societal level that it implies and the complexity of socio-ecological systems make necessary a holistic approach and foresight to design strategies, policies and programs to turn economic activities into loops of care for people and the environment. Circular Economy frameworks, methodologies and tools need to strengthen its social dimension. Appropriate institutional arrangements and strategic leadership are necessary to make this paradigm shift contribute towards sustainable development.

Sustainability in wildlife tourism: challenging the assumptions and imagining alternatives

PurposeThis study raises and discusses questions concerning the assumptions of sustainability to uncover aspects that might lead to new critical ways of understanding it. More specifically, the aim of this study is to discuss the adoption of the sustainability approach in wildlife tourism and challenge its underlying anthropocentric assumptions.Design/methodology/approachThe approach adopted is one of animal ethics, more precisely Ecofeminism.FindingsThe discussion ends by highlighting the possibility for new thinking. In particular, the concept of entangled empathy is presented as a potentially central element for re-thinking wildlife tourism.Research limitations/implicationsThis study raises critical questions and starts the conceptualization of a non-anthropocentric approach in wildlife tourism. This can be viewed as a mental exercise that should be developed further and translated into practical suggestions.Originality/valueThis study views innovation as a process of re-thinking sustainability through the adoption of the animal ethics lens.

A prioritized global research agenda following systematic review of evidence addressing fertility care and infertility interventions

Involuntary childlessness impacts up to fourteen percent of heterosexual couples globally, thus the burden and impact has been defined as significant. In addition, often a high psychosocial burden is placed on these couples as well as on members of their extended families and communities, especially within societal frameworks for which parenthood is critical to recognition and acceptance. Evidence-based fertility care and infertility interventions that are able to assist those with fertility problems can help to safeguard maternal, paternal and child health outcomes when delivering and providing access to care. Furthermore, ensuring appropriate implementation of recommended interventions can often prove to be (cost-)effective and can indicate a high quality of care. However, a systematic analysis of literature during the development of a set of basic, but comprehensive global draft recommendations for the World Health Organization to consider for infertility and fertility care has exposed a large number of gaps in the evidence. A strong evidence base is required to ensure interventions will support quality and a high level of safety in access to care. A mechanism was needed to identify a shortlist of and then a prioritization process for all of the identified evidence gaps in order to generate a prioritized global research agenda. A Delphi survey was initiated among groups of multi-disciplinary experts and patients, and members representing reproductive medicine societies, infertility patient organizations, UN agencies and non-governmental agencies. Delphi Round I identified key evidence gaps (n=127) in six prioritized clinical areas. The identified evidence gaps themselves were prioritized in Round II, and these prioritized evidence gaps were then rated for importance in Rounds III and IV, resulting in a ranking within and across the six clinical areas. The highest-ranking gaps (n=66) revealed five overarching thematic parameters: child outcome, maternal morbidity and mortality, effectiveness, education and training and universal access to care within health systems through an ethics, gender and human rights lens. Many gaps overlapped clinical topic areas, and thus the ability to present these gaps through a gender and human rights lens should help to ensure that in future the calculated burden of involuntary childlessness will include populations beyond heterosexual couples in long term stable relationships. This prioritized research agenda which will be presented should be able to assist decision-makers, researchers and funding agencies in the development of their respective research portfolios aiming to increase global access to care and strengthen the evidence supporting fertility care and infertility interventions.

Dante Fedele, Naissance de la diplomatie moderne (XIIIe-XVIIe siècles). L’ambassadeur au croisement du droit, de l’éthique et de la politique

This volume is the final form of the Doctoral thesis of Dante Fedele (Research Fellow, KULeuven), written in French under the supervision of Michel Senellart and defended at the Ecole Normale Supérieure in Lyon in 2014. Fedele has accomplished an impressive synthesis of literature on diplomacy, stretching from the Middle Ages to Louis XIV. Contextual approaches are currently on the rise.1 However, the present work is both a relativisation and a defense of doctrine as the dominant language of diplomacy.2 The juxtaposition of ethical, political and legal lenses offers novel insights. The introduction clearly states that doctrine is not studied as an autonomous system of thought, but within a dialectical approach. Firstly, the diplomatic process is seen as a ‘reflexive practice’ (p. 28), a constantly evolving dialogue with concepts borrowed from previously elaborated types of knowledge. Secondly, de lege ferenda diplomatic theory is not ‘fictitious’, but an ‘operating’ fiction, a term borrowed from Pierre Bourdieu (p. 30).

‘Adding another spinning plate to an already busy life’. Benefits and risks in patient partner–researcher relationships: a qualitative study of patient partners’ experiences in a Canadian health research setting

ObjectiveTo better understand, based on patient partners’ experiences, benefits and risks in patient partner–researcher relationships in a health research setting.DesignQualitative interviews with thematic analysis informed by a relational ethics lens.SettingA...