Institutional Duties Research Articles

Does the Duty of Rescue support a moral obligation to vaccinate? Seasonal influenza and the Institutional Duty of Rescue

Seasonal influenza poses a significant public health risk in many countries worldwide. Lower immunity and less influenza virus circulating during the pandemic has resulted in a significant increase in cases...

A Review of Effectiveness of Anti-Corruption Strategies and Institutions in Kenya

It is often stated that the fight against corruption in Kenya does not need strong men; rather, the onslaught against pilferage and plundering of public resources requires strong institutions. Unfortunately, present efforts to combat corruption in Kenya have yielded a mixed bag of results, both negative and positive. Ostensibly, extant discourses indicate that anti-corruption institutions in Kenya and the Ethics and Anti-Corruption Commission in particular have been unable to achieve a single high-profile conviction. Towards this, the debate on the effectiveness of anti-corruption strategies and the institution in the country is interminable. It is, therefore, the view of this study that institutions in Kenya face systemic and endemic snugs that are perhaps preventing them from achieving their institutional duty of custodianship of good practice. Results from this conceptual review indicate that although Kenya has one of the most progressive legislative and institutional frameworks on anti-corruption, the Corruption Perception Index has it that Kenya still experiences high corruption, with a score of 3 out of 10, or a ranking of position 126 out of 180 countries. Although the study noted political interference, particularly from the executive, it underscores that anti-corruption institutions do not have adequate human and financial resources, which are thought to hinder their capacity to investigate and prosecute corrupt individuals. It is recommended that Kenya should strengthen legal safeguards, empower whistleblowers, implement various anti-corruption strategies, and entrench a culture of integrity. The study recommends that the anti-corruption institutions should be allocated sufficient resources, both human and financial, so that they carry out their duties independently. The study further recommends that the future of anti-corruption actions depends on incorporating civil society organizations, the media, and international partners into the campaign against the misappropriation of public funds, as these entities play peripheral, yet pivotal roles in oversight, advocating for reforms, and enhancing public awareness. Top of Form Over and above, the study notes the criticality of freeing independent institutions from the control of the executive so that they can work autonomously.

Towards an Epistemology of ‘Speciesist Ignorance’

AbstractThe literature on the epistemology of ignorance already discusses how certain forms of discrimination, such as racism and sexism, are perpetuated by the ignorance of individuals and groups. However, little attention has been given to how speciesism—a form of discrimination on the basis of species membership—is sustained through ignorance. Of the few animal ethicists who explicitly discuss ignorance, none have related this concept to speciesism as a form of discrimination. However, it is crucial to explore this connection, I argue, as ignorance is both an integral part of the injustice done to animals as well as an obstacle to improving their treatment. In order to adequately criticize sustained structural speciesism and injustices towards animals, I develop an epistemological account of ‘speciesist ignorance’. I begin by defining and distinguishing between individual and group-based accounts of speciesist ignorance. I argue that humans, taken as a group, enjoy a position of privilege, which allows them to comfortably remain ignorant of their participation in collective wrongdoings towards animals. Additionally, I point out that speciesist ignorance is structurally encouraged and thereby maintains the dominant view that the human-animal-relationship, as it stands, is just. In sum, this article lays the groundwork for a social epistemology of speciesist ignorance. In particular, it informs further debate about individual and institutional epistemic duties to inquire into speciesism and to inform the public, about the moral culpability of ignorant actions, and about effective animal advocacy and policy which actively rejects speciesist ignorance.

"Everything's so Role-Specific": VA Employee Perspectives' on Electronic Health Record (EHR) Transition Implications for Roles and Responsibilities.

Electronic health record (EHR) transitions are increasingly widespread and often highly disruptive. It is imperative we learn from past experiences to anticipate and mitigate such disruptions. Veterans Affairs (VA) is undergoing a large-scale transition from its homegrown EHR (CPRS/Vista) to a commercial EHR (Cerner), creating a unique opportunity of shedding light on large-scale EHR-to-EHR transition challenges. To explore one facet of the organizational impact of VA's EHR transition: its implications for employees' roles and responsibilities at the first VA site to implement Cerner Millennium EHR. As part of a formative evaluation of frontline staff experiences with VA's EHR transition, we conducted brief (~ 15min) and full-length interviews (~ 60min) with clinicians and staff at Mann-Grandstaff VA Medical Center in Spokane, WA, before, during, and after transition (July 2020-November 2021). We conducted 111 interviews with 26 Spokane clinicians and staff, recruited via snowball sampling. We conducted audio interviews using a semi-structured guide with grounded prompts. We coded interview transcripts using a priori and emergent codes, followed by qualitative content analysis. Unlike VA's previous EHR, Cerner imposes additional restrictions on access to its EHR functionality based upon "roles" assigned to users. Participants described a mismatch between established institutional duties and their EHR permissions, unanticipated changes in scope of duties brought upon by the transition, as well as impediments to communication and collaboration due to different role-based views. Health systems should anticipate substantive impacts on professional workflows when EHR role settings do not reflect prior workflows. Such changes may increase user error, dissatisfaction, and patient care disruptions. To mitigate employee dissatisfaction and safety risks, health systems should proactively plan for and communicate about expected modifications and monitor for unintended role-related consequences of EHR transitions, while vendors should ensure accurate role configuration and assignment.

How should institutions help clinicians to practise greener anaesthesia: first-order and second-order responsibilities to practice sustainably

There is a need for all industries, including healthcare, to reduce their greenhouse gas emissions. In anaesthetic practice, this not only requires a reduction in resource use and waste, but...

How to respond when patients invoke a diagnosis for themselves: Evidence from a nurse’s response practices in personality disorder interviews

ABSTRACT What is going on when a psychiatric patient claims a psychiatric diagnosis for themselves which is different from the one a practitioner is investigating? We analyze cases from 10 interviews between psychiatric patients and a nurse using a formal interview schedule to assess whether the patient has a personality disorder. When the patient invokes (temporary) depression to explain some of their experiences or life circumstances, the nurse then has to handle that, while dispassionately pursuing an interview schedule that is, on the contrary, predicated on the diagnosis being a long-term personality disorder. We show how the nurse balances respect for the patient’s account while also performing her institutional duties. The data are in Finnish.

An Institutional Duty to Vote: Applying Role Morality in Representative Democracy

Is voting a duty of democratic citizenship? This article advances a new argument for the existence of a duty to vote. It argues that every normative account of electoral representation requires universal turnout to function in line with its own internal normative logic. This generates a special obligation for citizens to vote in electoral representative contexts as a function of the role morality of democratic citizenship. Because voting uniquely authorizes office holding in representative democracies, and because universal turnout contributes powerfully to representation being fair, to be a good citizen of such democracies requires one to vote. Whereas previous arguments for a duty to vote have invoked basic moral principles like fairness or a Samaritan duty of rescue, this account is based on citizens occupying a vital functional role within electoral representative institutions. This institutional duty solves the “specificity problem” of justifying a duty to vote better than competing accounts and also immunizes the duty to objections that there is no duty to vote when there are only bad choices and that there is a no duty to vote but rather duty to vote well. By emphasizing the tight connection between institutions and individual conduct, the role morality approach used here supplies a less abstract and more realistic framework than much previous research on the ethics of democratic citizenship and brings the debate closer to constitutive features of democratic politics.

Privacy and epidemiology: let's find a shared solution.

During the pandemic period, Italian epidemiologists managed to monitor the situation despite fragmented and often low-quality data flows, comparing themselves to other countries (such as England and Israel) that were able to provide valuable indications in very short times thanks to the availability of a large amount of interconnected data at the national level. In the same months, the Italian Data Protection Authority launched several investigations that triggered an immediate stiffening of the mechanisms for accessing data by epidemiological structures at both regional and company levels, leading to a significant limitation in the conduct of epidemiological investigations, and in some cases the complete suspension of important projects. The interpretation of the General data protection regulation (Gdpr) was found to be subjective and heterogeneous among different institutions. The path to legitimizing data processing appears obscure and subject to the sensitivity of the different actors involved in the process within companies and regions. Apparently, only economic reporting is unanimously considered the primary and legitimate use of data. The work of Italian epidemiologists has been called into question to the point of making it practically impossible to carry out their institutional duties, even though they are an integral part of the National health service's (Nhs) function to promote and ensure health and well-being for the population. Today, it is necessary to immediately initiate a path to identify shared solutions among the various actors at both the central and local levels, which allow epidemiological structures and professionals to carry out their tasks with serenity, while ensuring data protection. The obstacles to conducting epidemiological studies are not a problem of individual operators or individual epidemiology structures, but a block to the production of knowledge and, ultimately, to the processes of improving the Nhs.

UMA DÉCADA DE ATUAÇÃO NA REDE MUNICIPAL DE EDUCAÇÃO: RELATO DE EXPERIÊNCIA

ABSTRACT This experience report aims to present the professional practices of psychologists who were members of the first multidisciplinary team of a municipal education system located in the North of the State of Rio de Janeiro throughout its first decade of operation (2011-2021). In order of events, the experiences and challenges of this pioneering service are presented in the events order. Likewise, the construction of an institutional mapping and the inauguration of an Institutional Duty service are reported, through which it was possible to determine school inclusion and student retention as scopes of psychological interventions. As a result, it was realized that psychologists must be aware of the mistaken expectations about their professional duties and the discourses that blame teachers and students, so that they can act to promote quality public education for all in partnership with other actors in the educational process field.

Moral distress and spiritual/religious orientation: Moral agency, norms and resilience.

Nurses tasked with providing care which they perceive as increasing suffering often experience moral distress. Response to moral distress in nurse wellbeing has been widely studied. Less research exists that probes practicing nurses' foundations of moral beliefs. The purpose of this phenomenological study was to gain understanding of nurse meaning-making of morally distressing situations, with particular attention to ethical norms, moral agency and resiliency, and nurse religious/spiritual orientation. This exploratory study employed semi-structured interviews using open-ended questions. Qualitative data analysis was assisted by MAXQDA software. Nine pulmonary care nurses during COVID-19 in a tertiary care teaching hospital in the northeastern United States. The study was approved by the IRB. Participants were consented before the study and confidentiality was preserved. The study revealed three main themes of meaning-making, rooted in the identity of the "good nurse": Being true to one's own values, pursuing ideal patient care ("doing good"), and conforming to/challenging values of the system and culture. Tensions were found between (a) nurse's own values (b) duty to institutional norms and duty to nurse's personal code of ethics, and (c) perceptions of institutional support in response to nurse moral distress. Religion was described as a remote source of nurse moral values, among other sources. Spiritual practices were not experienced as sufficient in coping with moral distress at the bedside. The study suggests nurses need more opportunities to engage in reflection on their practice and values. The findings also indicate need for accessible institutional supports for nurses experiencing moral distress and strategic use of chaplains in helping with moral distress. Further research is needed on the interplay of nurse spirituality, moral agency, and reflective practice in the face of morally challenging situations.

The integration of subgroups at the supranational level: The relation between social identity, national threat, and perceived legitimacy of the EU

Previous research suggests that social identity influences public attitudes about the European Union, but little is known about the role of social identity for perceived legitimacy of the EU. This article explores the relation between different forms of identification (national, EU, dual) and EU legitimacy perceptions, and the moderation of this relationship by experienced threat to national power and sociocultural identity. A survey was conducted in six countries (N = 1136). A factor analysis of legitimacy items resulted in two subscales (institutional trust and duty to obey). Separate regression analyses were therefore run on these subscales. All forms of identification were positively related to perceived EU legitimacy, while threat was a strong and universal negative predictor. However, the results suggest that national identification only positively predicted legitimacy when participants experienced no threat to their nation by the EU, while dual identification positively predicted legitimacy even when participants experienced threat. Overall, respect for national identities and their values may offer opportunities to safeguard and improve the perceived legitimacy of the EU. Findings are discussed in terms of the literature on the ingroup projection model and the common ingroup model.

COVID-19: The effects of perceived organizational justice, job engagement, and perceived job alternatives on turnover intention among frontline nurses.

Nurses’ turnover intention has become a concern for medical institutions because nurses are more needed than ever under the prevalence of COVID-19. This research sought to investigate the effects of the four dimensions of organizational justice on COVID-19 frontline nurses’ turnover intention through the mediating role of job engagement. We also tested the extent to which perceived job alternatives could moderate the relationship between job engagement and turnover intention. This descriptive cross-sectional study used an online survey to collect data from 650 frontline nurses working in appointed hospitals in Jiangsu province, China. Hierarchical regression was used to analyze the hypothesized relationships. Findings revealed that all organizational justice components significantly influenced job engagement and turnover intention. Job engagement also significantly affected nurses’ turnover intention and mediated the relationships between organizational justice components and turnover intention. Besides, perceived job alternatives moderated the relationships between job engagement and turnover intention. The implications of this study include demonstrating that healthcare authorities should respect human rights through effective organizational justice as this approach could encourage nurses to appreciate their job and be more devoted to staying and achieving their institutional duties, especially under challenging circumstances.

Implementation Of Kiai's Leadership Style In Improving Teacher Creativity At The Jawahirul Hikmah Islamic Boarding School Tulungagung

The research in this dissertation is motivated by the kiai as the leader of the pesantren which is an interesting leadership phenomenon. Kiai and teachers innovate with various forms of activities. Kiai improves the quality of Human Resources (HR) for teachers/asatidz and administrators, by instilling faith in the hearts of every student, administrator and board of Asatidz with a sincere attitude of lillahi ta'ala, riyadhoh, uswatun hasanah (exemplary) and patient; changing the mindset of asatidz, developing teacher skills and introducing and strengthening all institutional rules, duties, rights and obligations of asatidz, both as citizens of Islamic boarding schools, communities and citizens. The research approach uses qualitative methods. Data collection techniques are participant observation, in-depth interviews and documentation. The data analysis techniques used are l) data condensation 2) data presentation, 3) conclusion drawing/verification. From the results of this study, it can be concluded that: 1) Ithe implementation of the kiai leadership style in increasing teacher creativity at the Jawahirul Hikmah Islamic Boarding School Tulungagung is carried out by: a) Visionary leadership style is carried out with the kiai being the direction setter, agent of change,good mentor and role modelthe spirit of jihad and the spirit of fighting for and advancing the Jawaahirul Hikmah Islamic boarding school by forming a team in the management of educational institutions and collaborating with external parties in learning activities. b) The entrepreneurial leadership style is carried out by the kiai forming an entrepreneurial organization for Marble mining, carp and catfish farming, freshwater lobster cultivation, AQUAQY Factory to increase teacher creativity. c) Style,Innovative leadership by: (1) Kiai forming Marble mining entrepreneurship organizations, carp and catfish farming, freshwater Lobster cultivation, AQUAQY Factory to increase teacher creativity, (2) Kiai providing guidance by forming small groups with a quarantine model, (3 ) Outdoor class by making small groups in learning. d) Charismatic leadership style consists of: (1) belief in the kiai in providing policies, there are directions and instructions for program implementation to teachers/asatidz and administrators. (2) the kiai in his leadership involves members/followers and gives confidence to his members through all activities. (3) Leaders focus on the performance of their subordinates by providing motivation by providing complex, challenging, initiative, risk so that members become more responsible and diligent. e) The democratic leadership style provides the freedom to accept suggestions, thoughts, ideas from teachers to improve the existing programs at the Jawaahirul Hikmah Islamic Boarding School.

Surgery should be routinely videoed

Video recording is widely available in modern operating rooms. Here, I argue that, if patient consent and suitable technology are in place, video recording of surgery is an ethical duty....

Vaccine apartheid: global cooperation and equity

Vaccine apartheid: global cooperation and equity

Recordkeeping Cultures

Recordkeeping Cultures

‘Trying to make it matter’: The challenges of assimilating a resettlement culture into a ‘local’ prison

As part of the Transforming Rehabilitation reforms, 70 ‘local’ prisons in England and Wales were re-designated as resettlement prisons, in order to provide additional through-the-gate support to individuals serving short sentences. Drawing on staff and prisoner interviews in one case study resettlement prison, this article considers what challenges were involved with implementing a resettlement culture in a local prison. Findings first outline factors inhibiting the resettlement status of the prison; these include a tension between attempts to implement a more expansive resettlement remit into the prison, while also fulfilling more long-standing core institutional duties; the size and churn of the prison population; wide-scale apathy caused by change fatigue; and government austerity policies which caused significant difficulties in the day-to-day staffing of the prison. This article then turns to practitioner responses to the re-designation, finding that practitioners interpreted resettlement in two limited ways: top-down managerial attempts to instil a wider resettlement culture into the prison, and resistance from prison officers who felt unwilling or unable to expand their roles beyond custodial and security concerns. This article concludes by outlining how this set of inter-related barriers frustrated staff and prisoners alike, eroding a sense of hope and purpose and impeding true cultural change.

Essay mills and other contract cheating services: to buy or not to buy and the consequences of students changing their minds

Very few parts of the world have legislation that prohibits the operation or the promotion of contract cheating services. This means that commercial companies providing such services can formally register and operate in most countries. If a student enters into an agreement with a contract cheating provider, what rights do they have to change their mind and what are the risks if they choose to do so? This paper examines the question through legal, institutional and societal lenses, showing that although a student has the consumer rights to withdraw from a contract with an essay mill, they may also be putting their future at risk by doing so. Contract cheating providers are now embedded within many institutions, using sharp practices to connect with vulnerable customers, but are also perfectly placed to blackmail students or threaten to report them to their institution if they ask to cancel their order. The paper argues that, while not condoning the practice of contract cheating, supportive processes need to be in place to help students at risk as part of standard institutional duty of care. This must be backed up by institutional policy that considers academic integrity as a core value for all.

Immersion, drowning, dispersion and resurfacing: Coping with the emotions of ethnographic management learning

While organisational researchers have had a long-standing commitment to ensuring the well-being of others, relatively little attention has been paid to the care of fieldworkers themselves, particularly in emotional terms. Drawing on personal experiences of ethnographic research with UK charity Samaritans, this paper considers the ways in which embedding oneself in the culture of another organisation can expose researchers to pain which, if not recognised or ameliorated, can be become toxic. The paper questions whether such pain is an inevitable consequence of certain forms of qualitative research and, if so, how we might learn to cope with its effects. In answer, the paper describes a journey through immersion, drowning and eventually resurfacing, where the latter is facilitated by a process defined as emotional dispersion. The paper contributes to our understanding of (i) the necessarily painful nature of certain immersive modes of ethnographic and qualitative research, (ii) the conceptualisation of emotional dispersion and its practical implications for coping with emotional pain, burnout and toxicity as a relational practice and (iii) the relative balance of institutional and individual duties when it comes to a care of the self in emotional terms.

Virtual learning solutions in COVID-19 era: University Italian Ophthalmology department perspective.

Introduction:Few months after the COVID-19 pandemic burst, many aspects of the human life, including education, dramatically changed. Because of the lockdown measures taken to limit the virus spread in Italy, in-person teaching and learning have been interrupted in all health care disciplines and readapted in virtual formulae.Methods:As academic ophthalmology departments, we had to maintain the educational needs of medical and orthoptic students, internships, surgical training of residents, as well as to cover the scientific update of health care personnel (HCPs), and the continuation of research and academic activities. To assure these needs we ideated an educational strategy and a team, which was then translated on a multichannel virtual platform created with Microsoft Teams.Results:In this platform there were 21 channels organized in a public view mode, open to all Team members, or in private view mode to separate non-permanent HCPs, internships, residents, and students’ tasks, from permanent HCPs tasks. Virtual channels were dedicated to provide theoretical lessons, clinical cases, surgical video, internal meetings and webinar, to offer news from scientific societies, requests of appointments from biomedical companies, links with ophthalmological websites, to move forward research projects, to participate at institutional academic duties, and to obtain feedbacks from users. Residents continued their training on surgery using a surgical simulator, after consulting an agenda uploaded into the dedicated virtual channel.Conclusion:These positive initial results should represent a boost to rapidly proceed with the development of even more versatile virtual learning solutions, given that the forecasts for the duration of the COVID-19 pandemic are not encouraging.