Ethical Expertise Research Articles

Towards an Ethical Analysis of Research in One Health (EAROH).

The COVID-19 and Monkeypox pandemics and the ongoing Marburg outbreak in Rwanda provide a stark reminder of the importance of espousing a One Health (OH) approach to zoonoses as well as other public health and global health issues. Recent years have in fact seen an exponential rise in biomedical and public health journals and publications explicitly adopting the name of OH. Not all research that pertains to be OH however is indeed OH research, insofar as it does not comply with the proclaimed OH goals of benefiting humans, animals, and the environment. Thus, to ensure such compliance a checklist or toolkit for an ethical analysis of research in OH (EAROH) should be required prior to publication in scientific journals or grant applications. Such a toolkit should be developed by a working group of scholars with expertise in OH ethics, animal ethics, and environmental ethics.

The Ethics of Clinical Ethics.

The concept ethics defines health care ethics as a professional practice. Yet the meaning of "ethics" is often unclear in the theory and practice of clinical ethics. Clarity on this matter is crucial for understanding the nature of clinical ethics and for debates about the professional identity and proper role of ethicists, the sort of training and skills they should possess, and whether they have ethics expertise. This article examines two different ways the ethics of clinical ethics can be understood: Real Ethics, which consists of objective moral norms grounded in moral truth; and Conventional Ethics, which consists of conventional norms grounded in bioethical consensus. Drawing on the bioethics literature and features of professional practice, it shows that Conventional Ethics is the dominant paradigm. Then it presents a critique of Conventional Ethics, arguing that it cannot avoid the challenge of moral pluralism, it fails to address vitally important moral questions, and it is incapable of providing an essential service to the people ethicists aim to help. It ends with suggestions about how the practice of clinical ethics might overcome these problems.

Трансформация профессиональной этики в цифровой культуре

Digitalization generates cultural, social, economic, axiological and ethical transformations. Due to the transfer of professional activity to the digital space, the field of professional ethics is also undergoing changes, which becomes part of the so-called digital ethics, forming a new digital culture. The article proves that the digitalization of professional ethics creates a situation of uncertainty, forming ethical risks. The purpose of the study is to identify the risks of digitalization of professional ethics in modern digital culture. The article identifies the current content of digital ethics and professional ethics, examines their relationship and the level of mutual influence. The scientific novelty of the research lies in analyzing the transformation of professional ethics in the digital space. Thus, the article concludes that professional ethics during the transition to the digital space becomes a part of digital ethics. This changes the understanding of the value of the good and affects the ideas about the content of professional ethics. As a result, the ethical risks of professional ethics in digital culture are identified, which include the dehumanization of the ethical principles of the profession and the algorithmization of ethical expertise.

Playing with Virtue: Exploring Musical Expertise Through Julia Annas’s Lens

ABSTRACT In contemporary virtue ethics, virtues are often assimilated to skills. This assimilation suggests that the moral knowledge of virtuous individuals parallels the practical knowledge of experts in a particular skill. According to Julia Annas (2011a, 2011b), virtues function as skills requiring the ability to articulate reasons for one’s actions. These skills are developed through habitual practice over time. For example, a pianist who internalizes piano techniques possesses practical expertise akin to someone who understands their actions, even when performed automatically. Annas argues that to cultivate ethical virtue, we should emulate musical action, viewing it as a habit rather than mere repetition. This analogy aids in understanding virtue acquisition as practical skill-building. Expanding on Annas’s insights, this article contends that musical practice offers profound ethical implications for musicians as potential moral agents. Supported by important neurological and psychological studies on musical expertise, as well as the dynamics of classical music interpretation and professional career development, this argument sheds light on the ethical dimensions of musical agency. These insights into musical expertise could enhance our understanding of ethical expertise overall.

«The Trouble with Bias» in Neural Networks: Conflict and Ethical Challenges

This article is devoted to the analysis of ethical and conflict challenges related to the trouble with bias in neural networks. The necessity of a correct, scientifically based explication of the phenomenon of bias is postulated in order to build models correcting this problem as a necessary element of the software development process based on artificial intelligence algorithms. The history of the development of neural networks is considered from the origin of the idea of a mechanical organism to the construction of modern models of an artificial neuron. The most significant characteristics of modern neural networks are highlighted: architecture, weights and offsets, activation functions, inferences, and learning methods.A detailed description of natural language as a neural network learning resource is given, and programming in natural language is analyzed. The specificity of the natural language of the neural network as a set of linguistic practices reflecting the entire digitized experience of mankind, including stereotypes, inequalities, hate speech and other phenomena, ultimately producing the trouble with bias, is emphasized.Considerable attention is paid to the analysis of the phenomena of “politics classification”, “power discourse”, “cultural violence” in the context of the search for methodological foundations of natural language filtering and censorship strategies in the process of constructing a neural network.Separately, it is emphasized how the errors in neural networks are reflected in the existing ethical and conflict studies debates around the problem of artificial intelligence. It is concluded that the current assessment of the moral aspects of the problem does not imply granting neural networks the status of a moral agent and places the ethical expertise of the product on its developers. It is particularly noted that the conflict aspect of the trouble with bias lies in its recognition exclusively in relation to groups that have now acquired the “sensitive” status of discriminated against as a result of social conflicts.In conclusion, the paper substantiates the urgent need to optimize artificial intelligence in order to reduce the destructive potential of the trouble with bias, which necessarily implies the modification of social relations in the broader context of the struggle of excluded groups for the right to be recognized as discriminated against.

The Role of Ethics Committees in Charity Care Allocation.

Hospital ethics committees (HECs) traditionally focus on clinical ethics but are increasingly recognized for their potential role in addressing organizational ethics, particularly in the allocation of charity care resources. This commentary explores the expanded role of HECs in charity care allocation, emphasizing the core ethical principles of justice, transparency, and accountability. We discuss the need for HECs to develop expertise in organizational ethics, differentiate between emergency and chronic resource allocation, and apply value-based insurance design principles to set service boundaries. By adopting an egalitarian approach to justice, HECs can help reduce health disparities and ensure equitable access to charity care. Enhanced transparency and accountability through clear criteria, regular audits, and public reporting are also vital. This paper underscores the importance of integrating these ethical principles into healthcare resource allocation to promote health equity and maintain the financial sustainability of healthcare institutions.

Adapting the Future VET Curriculum in Response to Emerging Challenges: A Model for Evaluating the Impact of AI Integration in VET for Armed Conflicts and Warfare

This article examines the profound implications and the transformative impact of artificial intelligence (AI) on vocational education and training (VET) within military contexts, underscoring the imperative for curriculum reform to address the evolving demands of contemporary warfare. As AI technologies progress, they present both significant opportunities and challenges, reshaping defense strategies and operational frameworks, fundamentally altering defense strategies and operational paradigms. The integration of AI into military applications necessitates a workforce proficient in specialized competencies, including technical expertise in AI ethics, system design, and human-centered methodologies. This paper delineates the essential competencies required for future VET professionals, emphasizing the necessity for ongoing upskilling and reskilling to effectively navigate the ethical and legal complexities associated with AI in military operations. By incorporating and embedding AI education into VET curricula, stakeholders can cultivate a new generation of defense professionals equipped to utilize AI technologies in a responsible and effective manner, ensuring adherence to and compliance with international humanitarian standards while enhancing operational efficacy. The findings highlight the critical role of VET in developing a skilled workforce prepared to confront the dynamic landscape of military technologies driven by AI.

Challenges to ethical public engagement in research funding: a perspective from practice.

European research funding organizations (RFOs) are increasingly experimenting with public engagement in their funding activities. This case study draws attention to the challenges they face in preparing, implementing, and evaluating ethical public engagement in the context of setting funding priorities, formulating calls for proposals, and evaluating project proposals. We discuss challenges related to seven themes: (1) recruiting participants; (2) commitments and expectations; (3) meaningful dialogue and equal engagement; (4) accommodating vulnerability; (5) funding call formulations; (6) lack of expertise in engagement ethics; and (7) uncertainty, resource constraints, and external factors. To address these challenges, we propose the following seven interventions: (1) developing comprehensive recruitment strategies with experienced recruiters and community organizations; (2) establishing clear communication of roles, expectations, and outcomes through codes of conduct; (3) training mediators to address power imbalances; (4) designing flexible engagement methods and providing tailored support; (5) implementing collaborative feedback loops for inclusive funding call formulation; (6) enhancing ethical standards through internal expertise and external advisory inputs; and (7) developing adaptive strategies for flexible and ethical public engagement. These recommendations emphasize the need for context-adaptive insights to support funding organizations to implement ethical public engagement activities, even when faced with organizational constraints and a lack of ethical expertise.

Ethical Issues Faced by Data Monitoring Committees: Results from an Exploratory Qualitative Study.

To protect research participants and ensure scientific integrity in clinical trials, independent data monitoring committees (DMCs, also known as data and safety monitoring boards) increasingly oversee randomized clinical trials and recommend modifying or stopping research. Little is known about the ethical issues DMCs face. We conducted semistructured interviews of DMC members using a qualitative description approach with low-inference interpretation. We recruited respondents through consultation with experts, an online registry of DMC members, and snowball sampling. We interviewed 22 DMC members who were statisticians, clinicians, and/or ethicists that had overseen a wide variety of trials globally. We identified three themes: finding common ground on responsibilities with variation; the need for judgment but not necessarily ethics expertise; and the resulting emotional distress from navigating ethical challenges. In the first case, DMC members identified 19 distinct duties, with some ethical responsibilities rarely mentioned. In the second case, not all DMC members saw the need for ethicists on DMCs or ethics training. In the third case, ethical challenges sometimes led to strong negative emotions. Developing tailored ethics training and decision-making procedures may help DMCs respond more effectively to ethical challenges.

ANALYSIS OF DATA JOURNALISM IMPLEMENTATION: CHALLENGES AND OPPORTUNITIES IN MODERN MEDIA

Data journalism has transformed the way media reports news, shifting from reliance on sources' opinions to a data-driven approach. In today's information era, this method is essential for enlightening the public. Technological advancements have made it easier for journalists to implement data journalism, but they also present challenges, such as limited access to data and a lack of analytical skills among journalists. This research analyzes the application of data journalism in various media organizations, identifying challenges and uncovering opportunities. The methods used include interviews with journalists, academics, and ethics experts. The findings indicate significant challenges, but also opportunities to enhance news quality, public trust, and reader engagement. The research recommends the need for intensive training in data analysis and the application of strict ethical standards. Thus, data journalism can be an effective tool in addressing challenges in the digital era and contributing positively to media development.

Partnering with the woman who declines recommended maternity care: Development of a statewide guideline in Queensland, Australia.

Choice, a fundamental pillar of woman-centred maternity care, depends in part on the right to decline recommended care. While professional guidance for midwives and obstetricians emphasises informed consent and respect for women's autonomy, there is little guidance available to clinicians or women about how to navigate maternity care in the context of refusal. To describe the process and outcomes of co-designing resources to support partnership between the woman who declines recommended maternity care and the clinicians and health services who provide her care. Following a participatory co-design process involving consumer representatives, obstetricians, midwives, maternal fetal medicine specialists, neonatologists, health service executives, and legal and ethics experts, implementation of the resources was trialled in seven Queensland Health services using Improvement Science's Plan-Do-Study-Act cycles. Resources for Partnering with the woman who declines recommended maternity care have now been implemented statewide, in Queensland, including a guideline, two consumer information brochures (available in 11 languages), clinical form, flowcharts, consumer video, clinician education, and culturally capable First Nations resources. Central to these resources is an innovative shared clinical form, that is accessible online, may be initiated and carried by the woman, and where she can document her perspective as part of the clinical notes. Queensland is the first Australian jurisdiction, and perhaps internationally, to formally establish this kind of guidance in clinical practice. Such guidance is identified as an enabler of choice in the national Australian strategy Woman-centred care: Strategic directions for Australian maternity services.

Moral courage of nursing: Bibliometric analysis.

Moral courage is a recognized virtue. Researchers have focused on various aspects of nursing moral courage, such as its conceptualization and influencing factors. Within these studies, various literature reviews have been conducted, but to our knowledge, bibliometric mapping has not been utilized. This article aims to analyze the production of literature within nursing moral courage research. To investigate publication patterns, we employed VOSviewer and CiteSpace software, focusing on publication dynamics, prolific research entities, and most cited articles. Additionally, we forecasted future research trends. In our study, ethical review was not required. A total of 105 information sources were identified in the WoS database. Overall, there has been a significant increase in research volume after 2020. The most prolific countries are the United States, Finland, and China, while the most prolific source title is "Nursing Ethics." Keywords are also related to moral dilemmas and ethics. However, there are further improvements needed in international cooperation. The results proposed in this paper can serve as a starting point for comprehensive or systematic literature reviews and seek more detailed data, information, and knowledge in the field of nursing moral courage. It can enable outsiders to quickly understand research on nursing moral courage, whether for in-depth exploration or simply to facilitate more effective collaboration with nursing ethics experts.

Brain Death Knowledge and Attitudes Among Fourth-Year Medical Students at Umm Al-Qura University.

Background Despite clear definitions of brain death, students and medical professionals may have varying understandings. This study investigated the knowledge and attitudes of medical students regarding brain death. Methods A cross-sectional survey was administered to 142 fourth-year medical students at Umm Al-Qura University. The survey used single-choice and Likert scale questions to assess knowledge of brain death definition, diagnosis procedures, and student attitudes. Prior to administration, the questionnaire underwent content validation by experts in medicine, ethics, and public health. Results A significant proportion of students lacked knowledge of the legal definition of brain death in Saudi Arabia (26.1%), brain death diagnostic procedures (43.7%), and prerequisites for declaring brain death (38%). While some students expressed confidence in diagnosing brain death, concerns about misdiagnosis were also present. Conclusion Fourth-year medical students in this study demonstrated significant knowledge gaps regarding brain death. Medical education programs may need to be revised to provide more comprehensive training on brain death and its implications. Additionally, public awareness campaigns could improve understanding and facilitate informed decision-making about organ donation. Further research, including multicenter studies, is warranted to confirm these findings and guide educational interventions.

Update on the ethical, legal and technical challenges of translating xenotransplantation

This manuscript reports on a landmark symposium on the ethical, legal and technical challenges of xenotransplantation in the UK. King’s College London, with endorsement from the British Transplantation Society (BTS),...

Review Mechanisms for Advanced Medical Therapies in Japan and Thailand: A Proposal for the Use of Expert Clinical Benefit Assessments at Designated Institutions

AbstractAdvanced new therapies, such as stem cell and gene therapies and xenotransplantation, represent challenges for regulatory and ethical review. Major drug agencies, such as in the U.S., India, and Europe, have asserted regulatory authority and require ethics review by local ethics review committees, using the same strict requirements as those for standard drug approvals. In spite of this, unapproved and undocumented stem cell clinics flourish in all of these places, suggesting that current approaches do not offer patients sufficient protection. Japan has attempted another approach, requiring approvals at local levels for all regenerative medical procedures, and a faster approval of promising new interventions. The Japanese approach has, however, also been criticized as not striking a proper balance between early access and a proper assessment of safety and effectiveness. For smaller and less-resourced countries, such as Thailand, one major challenge is limited expertise to conduct the evaluation of these advanced new therapies. This article provides an overview of the issues facing regulators and proposes that countries should restrict the early adoption of advanced new therapies to specialized clinics with appropriate scientific and ethical expertise for review. Review in these institutions should focus on expert clinical benefit assessments for individual patients being offered such interventions, independently of whether they are offered as research or therapy.

An ethical framework for human-robot collaboration for the future people-centric manufacturing: A collaborative endeavour with European subject-matter experts in ethics

Envisioning humans and (smart) robots collaboratively working on the manufacturing shop floor, sharing spaces, tasks and objectives, reflects the ambitious goal that the ideal factory of the future aspires to attain. However, ensuring the effective implementation of this novel form of labour organisation remains an ongoing area of research. Key aspects such as the future role of workers, potential psychological risks, and the overall ethical considerations of human-robot (H-R) collaboration warrant further investigation until the underpinning safety challenges have been addressed. This study presents a novel ethical framework for H-R collaboration in manufacturing, which involved 30 subject-matter experts in ethics within the European context in a collaborative design process conducted through a year-long three-round data collection qualitative Delphi study. The ethical framework adopts a human-centric approach, recognising the influences that expand beyond the specific context of H-R dynamics on the shop floor, towards organisational and societal governance for a more responsible integration of (smart) robotics into the professional settings. Ethics, in this regard, aims to foster ethical awareness and accountability in the processes and practices of design and innovation, involving all stakeholders who play a role in shaping the future of Industry 5.0.

Деятельность локального этического комитета по повышению качества биомедицинских исследований молодых сотрудников университета

The article is devoted to the issues of clinical research: their ethical and legal regulation at the present time, the history of ethical expertise in the Russian Federation and at Kazan State Medical University. The role of ethical committees as a structure responsible for quality of scientific research and a guarantor of compliance with the principles of ethics, protection of the rights, safety and well-being of research participants is considered. The article presents the working experience of the local ethics committee of Kazan State Medical University on ethical examination of research projects with human participation and analysis of the most common mistakes in preparation of research documentation made by young scientists of clinical departments. The digital information showing typical errors and inaccuracies in the formation of a package of documents for ethical examination, based on the analysis of 284 initiative papers of PhD candidates from clinical departments: every fifth protocol required revision in accordance with the ethical and legal framework adopted in the Russian Federation, in 1.5% of cases the documentation was submitted for already conducted studies (i.e. ost factum), when no changes to its design are possible anymore. Typical mistakes were the following: inability to form research and control groups, calculate a representative number of participants, write an information sheet for a participant in a clinical trial and a sheet of informed consent, going beyond the specialty, desire to prescribe drugs beyond the scope of registered indications, etc. The ways of increasing both the awareness of young researchers and quality of ethical expertise by specialists of the ethics committee are proposed.

Ethics, design, and implementation criteria of digital assistive technologies for people with dementia from a multiple stakeholder perspective: a qualitative study

BackgroundDementia impairs the ability of people with dementia to be autonomous and independent. They need support from third parties, who should ideally respect their autonomy and independence as much as possible. Supporting people with dementia can be very burdensome for caregivers and numbers of patients increase while numbers of potential caregivers decline. Digital assistive technologies (DATs) that directly support patients or their caregivers may help bridging the increasing gap between need of support and available resources. DATs have the potential to preserve the autonomy and independence of people with dementia and promote their abilities, if they are properly designed in close interaction with future users. In our study, we focused on ethical concerns, technological requirements, and implementation criteria for DAT in general and specifically to support outdoor mobility of people with dementia.MethodsWe applied a qualitative approach and conducted a World Café (2 tables, n = 7) and an online focus group (n = 6) with people with dementia, relatives, healthcare professionals, scientists, ethics experts, and experts for digitally-assisted medical care. We descriptively analyzed the data using a content analysis approach.ResultsThe participants reported technological (e.g., lack of Wi-Fi), financial (e.g., expensive devices or lack of budget for DATs), political (e.g., legal hurdles such as the European Medical Device Law or data protection regulations) as well as user-related hurdles (e.g., lack of digital competence) for the implementation of DAT in dementia care. Among the issues discussed were the importance of autonomy, independence, safety, privacy, and questions of decision making capacity in DAT’s use. Participants identified opportunities and benefits in self-learning, situation-aware DATs and wished for dementia-friendly communities. They emphasized the value of personal interaction that should not be replaced, but rather supported by DAT.ConclusionThe results revealed multiple hurdles and ethical concerns for DAT use and provided recommendations for designing and implementing DATs. Further investigations are needed on the impact of DAT on personal interactions in caregiving and the role of DAT in dementia-friendly communities.

Factors associated with Saudi physicians' utilization of clinical ethics consultation services.

Clinical Ethics Consultation (CEC) aims to resolve ethical dilemmas at the bedside. Through a structured process, CEC allows practitioners and patients to consult ethicists at times of moral conflict or uncertainty. Over the past few decades, CEC has become an invaluable part of healthcare practice. In Saudi Arabia, however, CEC services remain inexplicably underutilized. This study attempts to understand the factors associated with Saudi physicians' utilization of CEC to better meet the needs of practitioners and patients. Results indicate that although physicians routinely experience moral dilemmas, they seldom request a CEC. This is not due to unfamiliarity, lack of accessibility, or suspicion of ethical expertise. Rather, reluctance is likely due to an ingrained medical cultural stronghold that pressures practitioners to act heroically, and to resolve ethical dilemmas independently. Recommendations to improve the utilization of CEC services include wider availability, active collaborations with clinical practitioners, routine quality improvements, and managerial and national support.

재건축사업에서 사업주체자의 역량이 조직효과성에 미치는 영향

This study examined how the empowerment of housing reconstruction project leader affects organizational effectiveness in order to suggest improvement measures to prevent project delays in the process of housing reconstruction projects. To this end, a survey was conducted among members who have experienced housing reconstruction projects in Gwacheon, and descriptive statistics and multiple regression analysis were conducted. The results showed that the ethical leadership, expertise, transparency, and participation of reconstruction project leader was significant in increasing organizational effectiveness. In addition, moral and ethical leadership was analyzed as an important factor in the organizational effectiveness of reconstruction project union, which are a special type of organization. This study is significant in that it examined the role of organizational effectiveness in the reconstruction project in the process of promoting the projects based on the trust of the members from the initial stage. The results of this study are expected to be used as a basis for policy improvement to improve the residential environment in old cities, including the first phase of new towns, and to improve the business satisfaction of landowners.