Guidelines For Ethical Practice Research Articles

Nursing students' movement toward becoming a professional caring nurse.

Previous research mainly focuses on how to support nursing students in caring for the patient and on educators' views of students' development as professional caring nurses. Against this background, it is important to further investigate nursing students' perspectives on what it means to become a professional caring nurse. This qualitative systematic review study aims to identify and synthesize nursing students' perceptions on the meaning of becoming a caring nurse. Systematic data searches were conducted by using the electronic databases MEDLINE (Ovid), CINAHL (EBSCO), Academic Search Premiere (EBSCO), and Philosopher`s Index. In total, 13 studies met the inclusion and quality criteria. The articles were analyzed by a systematic review and a thematic synthesis according to Thomas and Harden. The study followed good ethical practice guidelines outlined in the Northern Nurses' Federation. The analysis resulted in eight descriptive themes and finally in three analytical themes: Becoming is to get in touch with one's inner ethic or ethos, Becoming is a movement between courage, understanding, and being touched, and Becoming is strengthened through caring role models and a learning culture. Becoming a professional caring nurse is seen as an ongoing movement toward a deeper understanding of oneself and one's being and bearing. This movement is enabled when nursing students have a sense of self-awareness, courage to stand in their vulnerability, and reflect on their responsibility, caring attitude, and inner values and ethics. The force of becoming is that the attention is directed beyond self to care for and feel empathy for others in a caring manner. Becoming is released through a caring relationship, external confirmation, and good role models. A lack of external support in the movement can potentially prevent the students from becoming a professional caring nurse.

The COVID 19 Pandemic as a Moral Test for Society

Abstract The COVID-19 pandemic brings up unprecedented challenges. Healthcare practitioners find themselves in an extraordinary, wartime-like situation and are obliged to apply triage on a daily basis. In this context, routine procedures prove insufficient and the redefinition of ethical practice guidelines becomes a necessity – leading not only to a shift in procedures, but also reshaping the very value of human life. This, in turn, triggers an axiological crisis, which exacerbates the tension between paradigms of sanctity and quality of life and the conflicting principles of egalitarianism and utilitarianism. Triage should not be limited to healthcare practice only: the concept can be extended to a macro-level where policymakers decide whether to prioritize human lives over livelihoods and economic health, impacting healthcare system capacity. The complexity of the challenges arising from the pandemic uncovers the urgent need to seek solutions from an integrated approach. In this paper, we offer a transdisciplinary view: we first define technical aspects of triage from the perspective of a healthcare professional. In the second part, we further analyze the problem of medical prioritization in the light of doctrinal findings related to the value of human life, and we show how and to what extent this philosophical debate is reflected in the emerging ethical guidelines in France, Spain, Italy, Belgium, Germany and Austria. Finally, we broaden the concept of triage, adding the “macro-economic” ingredient in our analysis and we present the results for selected European countries with special emphasis on the case of Poland.

A General Framework for Exploring Ethical and Legal Issues in Sports Medicine.

Medicolegal dilemmas faced by Sports Medicine providers differ from those of other primary care physicians in type and frequency. Exotic, high-profile challenges are widely covered in the literature and offer guidance on how to navigate challenging situations. However, there is a gap in the literature on how to approach more mundane, but nevertheless common, medicolegal dilemmas. The purpose of this article is to provide Sports Medicine providers simple tools for determining whether a course of action is legal or ethical and offer Sports Medicine educators a model for teaching these skills. We searched U.S. federal and state law using the LexisNexis® database for laws regulating Sports Medicine practice, and PubMed for articles related to physician approaches to Sports Medicine legal and ethical challenges. Searches started with the term sports medicine, and included winnowing terms of ethics, ethical practice, ethical guidelines, law, and legal guidelines. We used current ethical practice guidelines followed by the American Medical Association and described in detail by Beauchamp and Childress. We offer a framework for how to approach legal challenges in Sports Medicine and apply it to four common scenarios that Sports Medicine physicians often face. We further suggest that the profession formally address this literature gap with a standardized curriculum in Sports Medicine law. A curriculum using this framework and clinical vignettes provides learners and practitioners with familiarity and confidence when legal and ethical challenges arise in Sports Medicine.

Promoting nurses' and midwives' ethical responsibilities towards vulnerable people: An alignment of research and clinical practice.

To stimulate discussion and debate about the inclusion of vulnerable populations in primary research to inform practice change and improve health outcomes. Current research practices to safeguard vulnerable people from potential harms related to power imbalances may in fact limit the generation of evidence-based practice. The authors draw on their experience working and researching with a recognized group of vulnerable people, incarcerated pregnant women, to provide insight into the application of ethics in both research and clinical practice. In a novel approach, the ethical principles are presented in both contexts, articulating the synergies between them. Suggestions are presented for how individuals, managers and organizations may improve research opportunities for clinical practitioners and enhance the engagement of vulnerable people to contribute to meaningful practice and policy change. Ethical practice guidelines may limit the ability to create meaningful change for vulnerable populations, who need authentic system change to achieve good health outcomes. Inclusive research and practice are essential to ensuring a strengths-based approach to healthcare and addressing health needs of the whole population. Health systems and models of care recognizing the diverse lives and health needs of the broader population demand practical, sustainable support from clinical managers. Practical suggestions for clinical managers to support point of care research is provided, embedding vulnerable voices in policy, practice development and care provision.

Picking the 'proper hat?' Emerging ethical dilemmas while juggling nursing and research roles.

The aim of this study is to explore ethical dilemmas inherent in two potentially conflicting roles: practising nurse and researcher. Ethical guidelines for practice and research in nursing have been widely discussed. Yet examining ethical dilemmas that emerge from engaging in the dual role of nurse-researcher is rare. A qualitative approach was employed, using semi-structured interviews with 15 nurse-researchers. Data were analysed using thematic analysis. One theme emerged with three subthemes of nurse-researcher role definitions: primarily nurse, primarily researcher and combined nurse-researcher. Each subtheme had three dimensions: (a) how ethical dilemmas were expressed in encounters with role colleagues, (b) coping strategies and (c) implications for nurse-researchers. Primarily nurses or primarily researchers experienced conflict in encounters with role colleagues, developed less effective coping strategies and reported impaired well-being. Conversely, combined nurse-researchers said each role nourished the other. Nursing policymakers and managers should support the nurse-researcher role by developing a code of ethics that acknowledges the dual role's inherent dilemmas, assimilate organisational routines and roles that support nursing research and encourage forums for discussing staff dilemmas.

Ohio Abortion Regulations and Ethical Dilemmas for Obstetrician-Gynecologists.

To analyze obstetrician-gynecologists' (ob-gyns') experiences with, and perspectives on, how Ohio's abortion-restrictive regulatory landscape affects their health care practices. Between 2019 and 2020, we conducted qualitative interviews and focus groups with ob-gyns (N=35) who had practiced in Ohio for at least 6 months between 2010 and 2020. Discussions were recorded, transcribed, coded, and analyzed thematically using ATLAS.ti software. Participants perceived Ohio abortion regulations affecting their practice in three key ways: abortion regulations framed abortion and physicians who provide abortion as separate and distinct from other medical practices and physicians; many institutional interpretations of abortion regulations undermined physician expertise and professional autonomy; and the constellation of abortion regulations, institutional interpretations, physicians' trepidation, and their perceived inability to exercise clinical judgment worked together to limit abortion access and increase risks to patients' lives and health. The combined factors left participants feeling distraught that they were unable to practice medicine in an ethical and compassionate manner. Ohio abortion regulations limit ob-gyns' ability to provide comprehensive reproductive health care, creating ethical dilemmas for these physicians as they attempt to care for their patients. As Ohio's abortion laws increase in number and restrictiveness, they further undermine obstetric and gynecologic ethical practice guidelines. However, medical institutions play a key role in determining abortion provision in Ohio; through their interpretation of the law, institutions can demonstrate support or further limit ob-gyns' ability to exercise clinical judgment and provide ethical, compassionate care to their patients. Considerable work remains to bring Ohio's abortion regulations, institutional interpretations, and physician practices into alignment with professional clinical practice and ethics guidelines.

What do we know about ancillary care practices in East and Southern Africa? A systematic review and meta-synthesis

Background: Despite growing calls for the provision of ancillary care to study participants during medical research, there remains a noticeable gap in ethical guidelines for medical researchers in resource-constrained settings (RCS). We reviewed recent studies to determine the extent to which ancillary care is provided in East and Southern Africa and to examine the ethical justifications researchers provide to support their views on ancillary care obligations. Methods: A systematic search for qualitative and mixed methods studies on ancillary care was conducted across MEDLINE, Embase, African Wide Information, PubMed, CINAHL Plus, and Scopus. The National Institutes of Health (NIH) Department of Bioethics and H3 Africa websites and Google Scholar were further searched. Studies conducted in East and Southern Africa between 2004 and 2020, as well as those that reported on ancillary care provided to study participants were included. All studies included in this review were evaluated for methodological quality as well as bias risk. NVivo version 12 was used for thematic analysis. Results: Overall, 4,710 articles were identified by the initial search. After the data extraction and quality assessment, 24 articles were included. Key areas presented include ancillary care approaches and the themes of researcher motivation for providing ancillary care and expectations of participants in medical research. The review shows that while some international researchers do provide ancillary care to their study participants, approaches are not standardised without consistent guidelines for ethical practice for ancillary care. We found limited empirical studies in RCS that report on ancillary care, hence findings in this review are based on single studies rather than a collection of multiple studies. Conclusions: This paper emphasizes the value of establishing ethics guidelines for medical researchers in RCS who consider provision of ancillary care to their participants, and the need to account for these ethical guidelines in medical research.

Patient Access to Mental Health Notes: Motivating Evidence-Informed Ethical Guidelines.

In the last decade, many health organizations have embarked on a revolution in clinical communication. Using electronic devices, patients can now gain rapid access to their online clinical records. Legally, patients in many countries already have the right to obtain copies of their health records; however, the practice known as "open notes" is different. Via secure online health portals, patients are now able to access their test results, lists of medications, and the very words that clinicians write about them. Open notes are growing with most patients in the Nordic countries already offered access to their full electronic record. From April 2021, a new federal ruling in the United States mandates-with few exemptions-that providers offer patients access to their online notes (Office of the National Coordinator for Health Information Technology, Department of Health and Human Services, Available at: https://www.govinfo.gov/content/pkg/FR-2019-03-04/pdf/2019-02224.pdf#page=99). Against these policy changes, only limited attention has been paid to the ethical question about whether patients with mental health conditions should access their notes, as mentioned in the articles by Strudwick, Yeung, and Gratzer (Front Psychiatry 10:917, 2019) and Blease, O'Neill, Walker, Hägglund, and Torous (Lancet Psychiatry 7:924-925, 2020). In this article, our goal is to motivate further inquiry into opening mental health notes to patients, particularly among persons with serious mental illness and those accessing psychological treatments. Using biomedical ethical principles to frame our discussion, we identify key empirical questions that must be pursued to inform ethical practice guidelines.

A Scoping Review of Ethical Considerations in Spiritual/Religious Counseling and Psychotherapy

Four overarching themes from this scoping review were identified, namely: (a) clients' right for autonomy and self-determination; (b) cultural sensitivity; (c) practitioner competency issues; and (d) recommended guidelines for ethical practice. These themes were aligned with the moral principles that guide professional ethical practice. A competency-based model was designed based on findings to enhance counselor/clinician competencies by enhancing sensitivity to spiritual and religious sentiments, which allows greater responsiveness to the clients' needs, values and preferences.

Canine Assisted Occupational Therapy: Protocol of a Pilot Randomised Control Trial for Children on the Autism Spectrum

Autism spectrum disorder is a neurodevelopmental condition characterised by difficulties with communication, social interaction, and restricted and repetitive behaviours. For children with this disorder, the ability to engage with people and activities, and to participate in everyday occupations is compromised. Animal assisted therapy has been proposed as an intervention modality to facilitate development of an individual’s social behaviours such as engagement and attention. In spite of the increasing evidence showing the positive impact animal assisted therapy can have for children on the autism spectrum, there remain no universal standards or formalised guidelines for ethical practice with either the clients or the therapy dogs involved. The proposed pilot randomised control trial aims to determine the impact of canine assisted occupational therapy on the on-task behaviours and overall goal attainment of children on the autism spectrum, as well as consider the impact that being involved within therapy sessions has on the therapy dog.

Responding to contemporary challenges and opportunities for anthropological engagement: Revised NAPA Guidelines for Ethical Practice

Responding to contemporary challenges and opportunities for anthropological engagement: Revised NAPA Guidelines for Ethical Practice

Ethical Issues in the Practice of Assisted Reproductive Technologies in Nigeria: Empirical Data from Fertility Practitioners.

The need to formulate practice guidelines and ethical framework to guide the practice of assisted conception in Nigeria has been highlighted severally. The Association for Fertility and Reproductive Health (AFRH) ethics committee is charged with the objective of producing ethical guidelines that would govern the practice of assisted conception in Nigeria. This study was a survey of attendees at the AFRH international conference that held in Abuja in September 2017. The aim of the study was to generate empirical data that would form the drafting of ethical practice guidelines in Nigeria. Ninety-seven (50%) of the respondents were of the view that performing IVF for unmarried couples was ethical while about 70 (36%) were of the contrary opinion. Respondents were equally divided (45.26% versus 44.21%) on the ethical standing of performing IVF for single ladies. About 128 (70.33%) of respondents agree that egg donors should be paid more in compensation besides reimbursement for personal expenditure incurred during the process of egg donation and that they should be an upper age limit for clients requesting ART with donor eggs. Several unethical practices ongoing in Nigeria were highlighted including inadequate provision of information and counselling and exploitation of egg donors. Majority agreed on the need for a regulatory framework to govern the practice of ART in Nigeria. The diverse range of views and ethical issues concerning ART practice in Nigeria obtained from this study demonstrates the need to recognise the local context in Nigeria when applying universal principles of ethics.

Public perceptions on ethics in the practice of assisted reproductive technologies in Nigeria

The rapid expansion of assisted reproductive technologies (ART) services in Nigeria has stimulated public interest in the need to address related ethical issues and the institutionalization of regulatory guidelines to regulate the practice of ART in Nigeria in order to protect patients’ rights and safety. This study aims to document the views of various stakeholders in ART regarding salient ethical issues relating to its practice in Nigeria. The Ethics committee of the Association for Fertility and Reproductive Health in Nigeria (AFRH) organized a focus group discussion with participants drawn from different sociocultural/religious backgrounds and professional disciplines to deliberate on 16 key ethical issues in ART practice. Given the understanding that there are no rights or wrong answers when considering the ethics, the participants reached a consensus that access to ART is a fundamental reproductive right for all members of the society regardless of marital status and that choices made are dependent individual circumstances. There was a noticeable progressive shift in opinions on some issues, compared with a previous study, and a persistent negative view of others within the legal and sociocultural dictates of the Nigerian society especially on issues concerning sex selection and orientation. This study provides updated information on the societal viewpoints and perceptions which could aid the promulgation of ethical practice guidelines for ART practitioners in Nigeria.

Kidney Paired Donation Protocol for Participating Donors 2014.

Kidney Paired Donation Protocol for Participating Donors 2014.

Medical tourism in plastic surgery: ethical guidelines and practice standards for perioperative care.

The goal of this review was to identify the safety and medical care issues that surround the management of patients who had previously undergone medical care through tourism medicine. Medical tourism in plastic surgery occurs via three main referral patterns: macrotourism, in which a patient receives treatments abroad; microtourism, in which a patient undergoes a procedure by a distant plastic surgeon but requires postoperative and/or long-term management by a local plastic surgeon; and specialty tourism, in which a patient receives plastic surgery from a non-plastic surgeon. The ethical practice guidelines of the American Medical Association, International Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and American Board of Plastic Surgeons were reviewed with respect to patient care and the practice of medical tourism. Safe and responsible care should start prior to surgery, with communication and postoperative planning between the treating physician and the accepting physician. Complications can arise at any time; however, it is the duty and ethical responsibility of plastic surgeons to prevent unnecessary complications following tourism medicine by adequately counseling patients, defining perioperative treatment protocols, and reporting complications to regional and specialty-specific governing bodies. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Working towards culturally sensitive ethical practice in a multicultural society

In the last two decades there has been a lot of theorising about multiculturalism and professional practice. Many practitioners are challenged by cultural diversity daily. Practising from a culturally sensitive ethical perspective in a multicultural society is essential for good practice. Postmodern influences and critical questioning are seen to inform culturally sensitive ethical practice in their encouragement of practitioners’ adoption of multiple belief systems and multiple perspectives and the need to pose questions challenging practice regarding awareness of cultural encapsulation and cultural sensitivity. The development of culturally sensitive ethical practice guidelines within the context of a multicultural society is proposed, firstly, by assessing the cultural sensitivity of the ethics codes and secondly, by balancing culture and ethical codes.

Querer No Basta: Deberes Éticos en la Práctica, Formación e Investigación en Psicología Comunitaria

The article presents a summary of the results of the research project FONDECYT No 1080528, which explores the ethical dimension in practice, training, and research in community psychology (CP) in Chile. An intentional opinatic sample of primary (93 participants—users, students, and psychologists—) and secondary information sources (194 documents—programs, courses, theses and codes—) was used. The use of various data collection techniques and qualitative analysis strategies led to the identification of two relevant results: the principle of respect for the other and community participation in identifying and addressing ethical issues. Divergences in the concept of CP and ethical duties in this field were also found. Finally, ethical guidelines for practice, training, and research in CP are suggested.

Guarding the guardians: Bioethics curricula for psychiatrists-in-training in developing countries

A good physician must be both clinically and ethically competent. High ethical standards are especially important in psychiatry in which several unique challenges present due to a vulnerable patient population, intimate physician–patient relationships, diagnoses made on signs and symptoms rather than irrefutable laboratory investigations, and therapeutic options directed at altering thinking and behaviour. It is critical that psychiatric training equip practitioners with the ability to identify ethical dilemmas in clinical practice and research and respond appropriately. Despite a call to action and the development of guidelines for ethical practice by several regulatory bodies, formal ethics teaching in psychiatry training programmes is still in embryonic stages in the developed world and virtually non-existent in the developing world. Here we highlight the current status of bioethics teaching in psychiatry residency programmes in Pakistan, an example of a developing country where such training is vital, as unethical practices abound in resource-poor settings where clinical and research practices are non-transparent and there are no effective regulatory, legal and accountability bodies. It is critical and urgent that needs-responsive bioethics curricula are developed, institutionalized and implemented in medical schools and post-graduate training programs across the developing world.“Take-home” points• Bioethics teaching should be a key, assessed component of all psychiatric training programmes• Bioethics curricula should be culturally contextual, responsive to stakeholder needs and geared towards preparing psychiatrists for ethical clinical practice and research, bioethics teaching and institutional leadershipFuture directions• Comprehensive needs assessment studies should be conducted to document current bioethics-related knowledge and attitudes in psychiatry training programmes in developing countries• Development, institutionalization and dissemination of needs-responsive bioethics curricula for psychiatry programmes in developing countries

Attachment Theory and Religiosity: A Summary of Empirical Research With Implications for Counseling Christian Clients

The authors summarize the growing body of empirical research literature in the area of psychology of religion that has been guided by attachment theory and indicate implications for counseling, including practical suggestions for case conceptualization, possible spiritual interventions, and ethical guidelines for practice. Attachment theory provides a fertile framework whereby counselors may conceptualize the religious experiences of Christian clients whose spirituality involves the belief in and relationship with a personal God.

Code of Ethics for the American Association of Physicists in Medicine: Report of Task Group 109

A comprehensive Code of Ethics for the members of the American Association of Physicists in Medicine (AAPM) is presented as the report of Task Group 109 which consolidates previous AAPM ethics policies into a unified document. The membership of the AAPM is increasingly diverse. Prior existing AAPM ethics polices were applicable specifically to medical physicists, and did not encompass other types of members such as health physicists, regulators, corporate affiliates, physicians, scientists, engineers, those in training, or other health care professionals. Prior AAPM ethics policies did not specifically address research, education, or business ethics. The Ethics Guidelines of this new Code of Ethics have four major sections: professional conduct, research ethics, education ethics, and business ethics. Some elements of each major section may be duplicated in other sections, so that readers interested in a particular aspect of the code do not need to read the entire document for all relevant information. The prior Complaint Procedure has also been incorporated into this Code of Ethics. This Code of Ethics (PP 24-A) replaces the following AAPM policies: Ethical Guidelines for Vacating a Position (PP 4-B); Ethical Guidelines for Reviewing the Work of Another Physicist (PP 5-C); Guidelines for Ethical Practice for Medical Physicists (PP 8-D); and Ethics Complaint Procedure (PP 21-A). The AAPM Board of Directors approved this Code or Ethics on July 31, 2008.