Ethical Preparedness Research Articles

Ethical empowerment: Examining the impact of business education in Indian universities through the lens of international standards and CIPP model

This study assessed the effectiveness of Indian postgraduate business education in addressing ethical challenges, integrating International Education Standards (IES) and the Context, Input, Process, and Product (CIPP) model. Using a positivist approach, a cross-sectional survey was conducted, focusing on 233 postgraduate business students through various sampling methods. Data analysis employed descriptive (frequency, percentage, mean, and standard deviation) and inferential (multiple linear regression) statistics. Findings revealed a significant 75% alignment with IES 4 in surveyed universities' business programs. Participative teaching methods were found to be used often in ethics instruction, particularly in accounting courses. Students perceived the program as highly effective in meeting ethical requirements, influenced by age, religiosity, and to a lesser extent, gender. Future research should explore components affecting ethical preparedness, considering content, teaching methods, case studies, long-term impacts, and cultural variations. The study, which was constrained by self-reported data and student perspectives, highlights the need for diverse viewpoints and methods in future cross-cultural research.

Ethical preparedness of data monitoring committees (DMCs) to oversee international clinical trials: a qualitative descriptive study

IntroductionA data monitoring committee (DMC) is an independent group of experts who assess the ongoing scientific and ethical integrity of a study through periodic analyses of study data. The objective...

Nurses' perspectives on privacy and ethical concerns regarding artificial intelligence adoption in healthcare

BackgroundWith the increasing integration of artificial intelligence (AI) technologies into healthcare systems, there is a growing emphasis on privacy and ethical considerations. Nurses, as frontline healthcare professionals, are pivotal in-patient care and offer valuable insights into the ethical implications of AI adoption. ObjectivesThis study aimed to explore nurses' perspectives on privacy and ethical concerns associated with the implementation of AI in healthcare settings. MethodsWe employed Van Manen's hermeneutic phenomenology as the qualitative research approach. Data were collected through purposive sampling from the December 7, 2023 to the January 15, 2024, with interviews conducted in Bengali. Thematic analysis was utilized following member checking and an audit trail. ResultsSix themes emerged from the research findings: Ethical dimensions of AI integration, highlighting complexities in incorporating AI ethically; Privacy challenges in healthcare AI, revealing concerns about data security and confidentiality; Balancing innovation and ethical practice, indicating a need to reconcile technological advancements with ethical considerations; Human touch vs. technological progress, underscoring tensions between automation and personalized care; Patient-centered care in the AI era, emphasizing the importance of maintaining focus on patients amidst technological advancements; and Ethical preparedness and education, suggesting a need for enhanced training and education on ethical AI use in healthcare. ConclusionsThe findings underscore the importance of addressing privacy and ethical concerns in AI healthcare development. Nurses advocate for patient-centered approaches and collaborate with policymakers and tech developers to ensure responsible AI adoption. Further research is imperative for mitigating ethical challenges and promoting ethical AI in healthcare practice.

Ethical preparedness in genomic medicine: how NHS clinical scientists navigate ethical issues

Much has been published about the ethical issues encountered by clinicians in genetics/genomics, but those experienced by clinical laboratory scientists are less well described. Clinical laboratory scientists now frequently face...

Too Close to Home: Photoelicitation with African Diasporic Communities, Ethical (Un)preparedness and the Importance of Critical Reflexivity in International Development Research

Photoelicitation is a creative and multidimensional visual methodology used to stimulate participant subjectivities and situated knowledges. International development research documenting this method often amounts to methodological ‘how-to’ discussions around procedural ethical considerations (e.g. of consent, confidentiality, anonymity and dissemination). Notwithstanding their instructions and recommendations, scholarship is almost exclusively concerned with ethics with respect to participant produced photographs. Less considered are elaborations around unanticipated ‘ethically important moments’ that occur unexpectedly in the here and now dynamic of researcher-supplied photoelicitation. Appropriately, this article presents a methodological reflection of the author’s unpreparedness for participant confessional stories and emotional responses about identity and racism evoked by INGO fundraising photographs of Black African poverty in a qualitative study with British African diasporic communities. It concludes with a two-pronged recommendation of critical reflexivity as an ethical safeguard whereby researchers 1) interrogate their positionalities, and 2) assess the ethical appropriateness of using photos with audience groups who share racialised identities and relationships with those featured in the fundraising imagery. Here, critical reflexivity is defined as the process through which researchers examine who they are and their role within the research context. While ethical safeguard refers to a certain ethical discernment and responsiveness that guards against some of the potentially harmful implications of ethical unpreparedness.

Ethical Preparedness for Health Policymaking and Implementation During Public Health Emergencies: The Role of Rapid Ethical Assessment.

Scholars have called for ethical preparedness for public health practice and research to address the challenges of special ethical considerations under time and resource pressure during emergencies like the COVID-19 pandemic. We propose the idea of a rapid ethical assessment (REA) that aims to provide ethical justifications and policy recommendations for a specific public health policy, which is necessary for the ethical legitimacy of health policymaking and implementation. We suggest that an REA task force be established and incorporated into the administrative procedure to perform an REA in the early, middle, and terminal stages of a policy proposed by the health authority and to determine to what extent the tradeoffs between values and priorities required by the policy are ethically acceptable. The REA task force's role is consultative, with the final decisionmaking power and political responsibilities falling on the health authority. The REA task force should adopt 4 substantial ethical principles: utilitarianism, equity, human rights, and solidarity. The REA task force would consist of a multidisciplinary team of experts and a group of representatives from those who would be affected by the proposed policy. The REA task force would operate with a 5-step procedure of (1) convening, (2) investigation, (3) determination, (4) reporting and communication, and (5) decision and reassessment. We use 2 real incidents in Taiwan to demonstrate how the REA task force could work to enhance the ethical acceptance of a policy.

Ethical preparedness and developments in genomic healthcare

Considerations of the notion of preparedness have come to the fore in the recent pandemic, highlighting a need to be better prepared to deal with sudden, unexpected and unwanted events....

Ethical preparedness in health research and care: the role of behavioural approaches

BackgroundPublic health scholars have long called for preparedness to help better negotiate ethical issues that emerge during public health emergencies. In this paper we argue that the concept of ethical preparedness has much to offer other areas of health beyond pandemic emergencies, particularly in areas where rapid technological developments have the potential to transform aspects of health research and care, as well as the relationship between them. We do this by viewing the ethical decision-making process as a behaviour, and conceptualising ethical preparedness as providing a health research/care setting that can facilitate the promotion of this behaviour. We draw on an implementation science and behaviour change model, COM-B, to demonstrate that to be ethically prepared requires having the capability (ability), opportunity, and motivation (willingness) to work in an ethically prepared way.MethodsWe use two case examples from our empirical research—one pandemic and one non-pandemic related—to illustrate how our conceptualisation of ethical preparedness can be applied in practice. The first case study was of the UK NHSX COVID-19 contact tracing application case study involved eight in-depth interviews with people involved with the development/governance of this application. The second case involved a complex case regarding familial communication discussed at the UK Genethics Forum. We used deductive qualitative analysis based on the COM-B model categories to analyse the transcripbed data from each case study.ResultsOur analysis highlighted that being ethically prepared needs to go beyond merely equipping health professionals with skills and knowledge, or providing research governance actors with ethical principles and/or frameworks. To allow or support these different actors to utilise their skills and knowledge (or principles and frameworks), a focus on the physical and social opportunity is important, as is a better understanding the role of motivation.ConclusionsTo understand ethical preparedness, we need to view the process of ethical decision-making as a behaviour. We have provided insight into the specific factors that are needed to promote this behaviour—using examples from both in the pandemic context as well as in areas of health research and medicine where there have been rapid technological developments. This offers a useful starting point for further conceptual work around the notion of being ethically prepared.

Beyond regulatory approaches to ethics: making space for ethical preparedness in healthcare research

Centralised, compliance-focused approaches to research ethics have been normalised in practice. In this paper, we argue that the dominance of such systems has been driven by neoliberal approaches to governance,...

Ethical Preparedness, Self-Efficacy and Challenges in Engineering Education – A Quantitative Study

Academicians and practitioners in engineering focus on promoting ethical behaviour in their field. Engineering ethics are essential for maintaining public faith in the field and its professionals, especially as engineers rapidly face global and socially complicated issues that involve technical and ethical challenges. Unethical engineering exposes companies to legal action, financial constraints, and decreased effectiveness. To enhance ethical awareness about one’s own ethical self- efficacy, ethical preparedness and the associated ethical challenges, ethical instructions are to be developed among students successfully. With this as the motivation, an attempt is made in this study to develop a survey instrument to capture the freshmen engineering students’ understanding related to ethical preparedness, ethical challenges, and ethical self-efficacy. Considering these three aspects, a survey instrument was created and distributed at an affiliated (autonomous) college in south India (Hyderabad Institute of Technology and Management) during spring 2021 to the freshman engineering students. Exploratory factor analysis was conducted to determine the factor structure of the survey instrument and it results in three factors as hypothesized. The factors had a minimum and maximum loading of 0.56 and 0.90 and Cronbach’s α ranged from 0.83 to 0.88. This instrument could be used by institutions willing to assess students’ current levels of awareness regarding engineering ethics and decide nextsteps accordingly. Keywords: ethical challenges, ethical self-efficacy, engineering ethics, freshman engineering students

Narrative trajectories of disaster response: ethical preparedness from Katrina to COVID-19

While COVID-19 brings unprecedented challenges to the US healthcare system, understanding narratives of historical disasters illuminates ethical complexities shared with COVID-19. In 2005, Hurricane Katrina revealed a lack of disaster...

Evolving an ethical framework for Covid-19 management in India.

The Covid-19 pandemic has caused millions of cases and deaths worldwide and has caused a massive global economic contraction. Governments, policymakers, and medical professionals have been confronted with several complex bioethical dilemmas during these exceptional circumstances. In developing countries like India, having a large population base, inadequate preexisting public health infrastructure, and a multi-level government system with complex administrative mechanisms imposes enormous barriers and challenges in the effective and ethical management of the pandemic. Furthermore, endemic corruption, limited bureaucratic and organisational accountability, and weak oversight, especially among stakeholders in the vast private and non-government health and allied services sector, complicate the assessment of their adherence to ethical public health practices.

COVID-19 and ethical preparedness?

SummaryMankind has to prepare for a pandemic with respect to medical and practical aspects, but also with respect to ethical issues. There are various ethical guidelines for managing infectious disease outbreaks, but they do not apply to the specific aspects of the COVID-19 pandemic, since they were formulated after the different kinds of outbreaks of avian influenza and Ebola. Today we are confronted with completely new issues endangering our fundamental human rights. As COVID-19 is spreading all over the world, we are in a desperate situation to find treatment solutions; however, despite the urgency, scientific rules have to be applied as bad science is unethical since it might be harmful for patients. Fake news and alternative facts might not be easily recognized and are also threatening scientific values. Pandemics might be leading to a meltdown of the health system if no measures are being taken constraining fundamental human rights. Tracking of persons is violating human rights as well if not accepted on a voluntary basis. A failure to have safeguards for times of crisis leads to a scarcity of medicinal products and goods resulting in a nationalistic approach and ignorance of international solidarity. And last but not least selective measures and triage in intensive care have to be taught to young physicians and nursing staff in medical schools in order to be prepared in times of an infectious disease outbreak and scarcity of resources.

Ethical Reasoning Debriefing in Disaster Simulations.

With disasters occurring often, nurses must understand and ethically implement disaster management and patient care coordination. Yet these topics are often not discussed in nursing education curricula. Simulations are a potential solution to this ethical educational deficit, allowing students to act as professional nurses in a realistic scenario with minimal threat of harm to themselves or others. This study investigates the effect of a high fidelity, multiple-casualty disaster simulation followed by a structured faculty-led debriefing session on perceived ethical reasoning confidence on senior Bachelor of Science in Nursing (BSN) students. Additionally, the effect of the intervention on students' perceived importance of ethical reasoning and perceptions of such skills was explored. Students were provided with preparatory materials on the START (Simple Triage and Rapid Treatment) System and The Madison Collaborative's Ethical Reasoning in Action Eight Key Questions (8KQ) frameworks one week before the simulation exercise. In total, 90 students worked in pairs during the 15-minute disaster simulation. Participants' ethical reasoning attitudes were measured before and after the exercise, employing the Survey of Ethical Reasoning (SER) to indicate the importance of each of the 8KQ in students' ethical reasoning process using a five-point Likert scale. The SER was administered electronically using Qualtrics and statistical analysis was completed using SPSS. The 8KQ was also used in the debriefing led by faculty. Comparative assessment of pre and post-results demonstrate significant growth in students' ethical reasoning confidence scores (t(89) = -6.609, p < 0.001). Simulations are shown to be effective educational approaches in developing ethical reasoning confidence and promoting the development of students' ethical preparedness.

Effectiveness of a Case-Based Computer Program on Students' Ethical Decision Making.

The aim of this study was to test the effectiveness of a case-based computer program, using an integrative ethical decision-making model, on the ethical decision-making competency of nursing students in South Korea. This study used a pre- and posttest comparison design. Students in the intervention group used a computer program for case analysis assignments, whereas students in the standard group used a traditional paper assignment for case analysis. The findings showed that using the case-based computer program as a complementary tool for the ethics courses offered at the university enhanced students' ethical preparedness and satisfaction with the course. On the basis of the findings, it is recommended that nurse educators use a case-based computer program as a complementary self-study tool in ethics courses to supplement student learning without an increase in course hours, particularly in terms of analyzing ethics cases with dilemma scenarios and exercising ethical decision making.

Ethics for pandemics beyond influenza: Ebola, drug-resistant tuberculosis, and anticipating future ethical challenges in pandemic preparedness and response.

The unprecedented outbreak of Ebola virus disease (EVD) in West Africa has raised several novel ethical issues for global outbreak preparedness. It has also illustrated that familiar ethical issues in infectious disease management endure despite considerable efforts to understand and mitigate such issues in the wake of past outbreaks. To improve future global outbreak preparedness and response, we must examine these shortcomings and reflect upon the current state of ethical preparedness. To this end, we focus our efforts in this article on the examination of one substantial area: ethical guidance in pandemic plans. We argue that, due in part to their focus on considerations arising specifically in relation to pandemics of influenza origin, pandemic plans and their existing ethical guidance are ill-equipped to anticipate and facilitate the navigation of unique ethical challenges that may arise in other infectious disease pandemics. We proceed by outlining three reasons why this is so, and situate our analysis in the context of the EVD outbreak and the threat posed by drug-resistant tuberculosis: (1) different infectious diseases have distinct characteristics that challenge anticipated or existing modes of pandemic prevention, preparedness, response, and recovery, (2) clear, transparent, context-specific ethical reasoning and justification within current influenza pandemic plans are lacking, and (3) current plans neglect the context of how other significant pandemics may manifest. We conclude the article with several options for reflecting upon and ultimately addressing ethical issues that may emerge with different infectious disease pandemics.

Nurses' experiences of ethical preparedness for public health emergencies and healthcare disasters: A systematic review of qualitative evidence

Little is known about nurses' direct experiences of ethical preparedness for dealing with catastrophic public health emergencies and healthcare disasters or the ethical quandaries that may arise during such events. A systematic literature review was undertaken to explore and synthesize qualitative research literature reporting nurses' direct experiences of being prepared for and managing the ethical challenges posed by catastrophic public health emergencies and healthcare disasters. Twenty-six research studies were retrieved for detailed examination and assessed by two independent reviewers for methodological validity prior to inclusion in the review. Of these, 12 studies published between 1973 and 2011 were deemed to meet the inclusion criteria and were critically appraised. The review confirmed there is a significant gap in the literature on nurses' experiences of ethical preparedness for managing public health emergencies and healthcare disasters, and the ethical quandaries they encounter during such events. This finding highlights the need for ethical considerations in emergency planning, preparedness, and response by nurses to be given more focused attention in the interests of better informing the ethical basis of emergency disaster management.

Nurses' experiences of ethical preparedness for catastrophic public health emergencies and health care disasters; a systematic review of qualitative evidence.

Review Question: This review aims to answer the following specific question: What are nurses’ experiences of preparing for and managing the ethical challenges posed by catastrophic public health emergencies and health care disasters? Review Purpose/Objectives: The purpose of this systematic review is to systematically review and synthesise research literature reporting nurses’ experiences of ethical preparedness for dealing with catastrophic public health emergencies and health care disasters and the ethical quandaries that may arise during such events. INCLUSION CRITERIA: Types of Participants: The review will consider publications that include nurses registered or authorised under a given country’s state of emergency provisions to practice in jurisdictions in which a public health emergency (e.g. pandemic influenza) or sudden‐onset mass casualty health care disaster (e.g. flood, hurricane, earthquake, tsunami, volcanic eruption, terrorist attack) have occurred, or may occur. Phenomena of interest: This review will examine the phenomenon of nurses’ experiences of preparing for and/or managing ethical issues arising during a public health emergency or health care disaster. Consideration will be given to, but not be limited to nurse preparation for and management of ethical issues associated with: development of local public health emergency (including pandemic influenza) and sudden‐onset health care disaster plans provision of first health care contact for the general public personal protection and correct use of safety equipment providing front line clinical care providing community and primary health care assistance with containment measures triaging in a range of settings, including general practices, community health centres, and local hospitals maintaining infection control vaccinations informing the public work attendance.

Nursesʼ experiences of ethical preparedness for catastrophic public health emergencies and health care disasters; a systematic review of qualitative evidence

Review Question: This review aims to answer the following specific question: What are nurses’ experiences of preparing for and managing the ethical challenges posed by catastrophic public health emergencies and health care disasters? Review Purpose/Objectives: The purpose of this systematic review is to systematically review and synthesise research literature reporting nurses’ experiences of ethical preparedness for dealing with catastrophic public health emergencies and health care disasters and the ethical quandaries that may arise during such events. INCLUSION CRITERIA: Types of Participants: The review will consider publications that include nurses registered or authorised under a given country’s state of emergency provisions to practice in jurisdictions in which a public health emergency (e.g. pandemic influenza) or sudden‐onset mass casualty health care disaster (e.g. flood, hurricane, earthquake, tsunami, volcanic eruption, terrorist attack) have occurred, or may occur. Phenomena of interest: This review will examine the phenomenon of nurses’ experiences of preparing for and/or managing ethical issues arising during a public health emergency or health care disaster. Consideration will be given to, but not be limited to nurse preparation for and management of ethical issues associated with: development of local public health emergency (including pandemic influenza) and sudden‐onset health care disaster plans provision of first health care contact for the general public personal protection and correct use of safety equipment providing front line clinical care providing community and primary health care assistance with containment measures triaging in a range of settings, including general practices, community health centres, and local hospitals maintaining infection control vaccinations informing the public work attendance.

Assessing the Legal and Ethical Preparedness of Master of Public Health Graduates

We explored the relationship between the preparedness of master of public health (MPH) graduates in public health law and ethics and their completion of courses in these areas. We reviewed accredited public health schools and programs to assess the supply of required and elective courses in law and ethics. In addition, we conducted an Internet-based scenario survey of MPH graduates. Survey results were analyzed, and relationships between scenario responses and completion of law and ethics courses were assessed. Of the 93 programs and schools reviewed, 14% required a course in ethics and 16% required a course in law. The majority (range = 55%-76%) of the survey respondents indicated being "prepared" or "very prepared" for each of the 9 public health scenarios. There were no significant relationships between scenario responses and completion of an ethics course. Responses to 2 scenarios (one involving food code violations and one involving a prison population) were significantly related to participants' completion of a course in law. Few public health schools and programs require graduate courses in ethics and law. Most MPH graduates report being prepared to address public health challenges. Additional research is necessary to improve techniques for measuring preparedness.