Major Ethical Challenges Research Articles

Chatbots, Robots, and the Ethics of Automating Psychotherapy

Recent developments in artificial intelligence—AI--have caused considerable discussion among both philosophers of technology and psychotherapists. In particular, the question of whether or not new forms of AI will complement or even replace traditional psychotherapists has emerged as a major contemporary debate. This debate is not entirely new, as it has its origins in the Turing Test of 1950, and an early psychotherapy chatbot named Eliza, developed in 1966 at MIT. However, recent developments in AI technology, coupled with long waiting lists and variable access to psychotherapists have raised the question of machine psychotherapists in an urgent manner. Already, there are psychotherapy apps that one can download onto a standard smartphone and use in lieu of a human psychotherapist. In the near future, this simulacrum of a human therapist may be enhanced by the use of android therapists, programed to duplicate the knowledge and behavior of human therapists instantly, appealing to convenience or self-gratification through technology. This raises a host of ethical questions: can such beings be equally effective, and if so, ought we to reason in a consequentialist manner in their favor so as to increase accessibility and reduce costs through technology? Would there be a psychological difference between automated and potentially anthropomorphic therapy and genuine human therapy, if only a subtle one? Even if a chatbot or robot therapist is transparently such, is there an element of emotional manipulation and potential dishonesty in this interaction? Can the security of clients and their data be thus secured? I will argue that key aspects of chatbot psychotherapy present major ethical and clinical challenges in these areas, although transparent forms of it should not be legally banned. Keywords: chatbots, technological momentum, automation, psychotherapy, trust, anthropomorphism, data

Like Water: Feeling and Negotiating Relational Complexity in School-Based Ethnographic Childhood Research in China Through the Lens of Emotional Reflexivity

Ethnography is often considered as a suitable methodological approach to explore childhoods, nevertheless, there is limited reflection on ethics in the field in the Global South educational settings, such as China. Previous China-based fieldwork studies suggest complex field relationships as a major ethical challenge. Although the issue is especially prominent in research that contests “normative” Chinese childhoods, it hasn’t been sufficiently discussed due to a culture of silence surrounding researchers’ emotions and positionality. This paper uses emotional reflexivity as a lens to revisit two Chinese female researchers’ experiences of fieldwork, respectively, with left-behind children and disabled children in Chinese primary schools. The analysis examines how we identified ourselves and negotiated complex relationships with school members and unpacks experiences of “sameness” and “otherness” and the vulnerability and creditability impacted by our fluid identities. The paper adds insights into ethical considerations of school-based ethnographic research with diverse children in the Global South.

Comparing attitudes towards compulsory interventions in severe and persistent mental illness among psychiatrists in India and Switzerland.

Psychiatrists face a major ethical challenge when deciding whether to make use of coercive measures in the treatment process of patients suffering from severe and persistent mental illness (SPMI). As India and Switzerland show major cultural, political and financial differences, it is hypothesized that attitudes towards coercive measures among Indian and Swiss psychiatrists will vary too. Exploring differences in attitudes between cultures strengthens the critical reflection on one's own stances and in consequence, on our way of action. Especially when it comes to situations involving power imbalances between patients and health practitioners, self-reflection is essential to prevent ethically inappropriate behavior. An online survey on aspects of care for patients with SPMI was sent to 3'056 members of the Indian Psychiatric Society between April and June 2020 and to 1'311 members of the Swiss Society for Psychiatry and Psychotherapy between February and March 2016. The respondents' answers were compared. This article deals with the questionnaire's items on autonomous decision making and the implementation of coercive measures in clinical practice. More precisely, participating psychiatrists were asked to rate the importance of patient's autonomy in general and their willingness to apply coercive measures regarding two specific case vignettes depicting a patient with schizophrenia and one with depression. The statistical analysis, namely descriptive data analysis and calculation of arithmetic means, Shapiro Wilks tests and Mann-Whitney U tests, was carried out using IBM SPSS Statistics version 27. Answers were received from 206 psychiatrists in India and 457 psychiatrists in Switzerland. Indian participants tended to value autonomous decision making as slightly less important than Swiss participants (62.2% vs. 91%, p =.01). Regarding a case of severe and persistent depression, psychiatrists in the Indian group were on average more in favor of acting against the wishes of the patient (55% vs. 34.1%, p <.0001) as well as of accepting a temporary decrease in quality of life due to coercion (40% vs. 23%, p =.008). Answers concerning a case of schizophrenia revealed that Indian participants were more in favor of acting against the patient's wishes than Swiss participants (39% vs. 37%, p =.007), whereas the comparison whether to accept a temporary decrease in quality of life regarding this case showed no significant difference (p =.328). The significant difference in attitudes towards coercive measures among Indian compared to Swiss psychiatrists found in this study might arise from a predominantly more collectivist society in India compared to Switzerland. Moreover, differences in financial resources, the organization of the health care system, and the historical background might have an influence. Continuous and critical reflection on one's own views and behavior is essential, especially if ethical principles and individual rights could be violated through a power imbalance, as in the case of coercive measures.

Ethical Considerations in Using Artificial Intelligence to Improve Teaching and Learning

One way that AI could improve the educational experience is by making it more individualized and efficient. However, there are a number of ethical concerns that have to be addressed as a result of this accomplishment. This study discusses some of the major ethical challenges posed by AI in the classroom, as well as some potential answers to those problems. The use of AI in the classroom raises serious questions about data privacy and security. Massive volumes of student data are collected and analyzed by AI systems, necessitating robust security measures. Clear communication and informed permission regarding data handling are crucial in solving these privacy issues. Another ethical problem with AI is the potential for discrimination and prejudice. As a result of inherent biases in their training data, AI systems may unfairly disadvantage specific demographics of students. Concerns about bias and unfairness in AI-powered learning technologies persist. Decisions made by AI must be explicable and open to scrutiny. Understanding how AI systems create recommendations and assessments is important for students, teachers, and leaders. Both trust and responsibility in the classroom benefit from more openness. The ethical implications of AI for educators and the field as a whole also need to be considered. Technology should complement teachers rather than replace them. The usage of AI and the training of educators are essential to this shift. The goal of this study is to study the impact of ethical issues factors by using AI in T&amp;L &amp; to identify the impact of AI Factors on T&amp;L (Teaching &amp; Learning).. &#x0D;

Ethical challenges as perceived by nurses in pediatric oncology units.

Providing care to children with cancer is one of the most challenging areas of ethical care for nurses. Few studies have addressed nurses' perception of the barriers to giving ethical care in oncology departments. Thus, it is essential that the ethical challenges in caregiving as perceived by oncology nurses be investigated. The present study was conducted to investigate the ethical challenges as perceived by nurses in pediatric oncology units in the south of Iran. The present study is a qualitative work of research with a conventional content analysis design. Data were collected via individual semi-structured interviews. The collected data were analyzed using the qualitative content analysis method. The participants were 21 nurses from pediatric oncology units in state hospitals who were selected by purposeful sampling. Sampling continued until the data were saturated. The study lasted from April to October 2022. Three main themes, promoting psychological safety in the children, respect for the dignity of the children, and expansion of support for families, and nine subthemes were extracted from the data. The study's protocol was approved by the Research Ethics Committee of the University of Medical Sciences and ethical principles were followed throughout the study. From the nurses' perspective, the major ethical challenges in providing ethical care in pediatric oncology units were reducing tension toward promoting the patients' psychological safety, showing respect for the identity and dignity of the children with cancer, and expanding support of the patients' families. By creating the right cultural and professional context and establishing proper protocols, healthcare policymakers and administrators can take effective steps toward eliminating the barriers to providing ethical care.

Risky research? Exploring the potentially detrimental effects of employing stigma scales

Research on stigma is confronted with major ethical challenges. One potential risk of investigating stigma utilizing self-reports includes the unintentional reinforcement of stigma. Commonly used self-report scales to assess stigma usually include items that directly confront people with the negative stereotypes underlying the stigma. Even though findings in the domain of priming research suggest that such a way of assessing stigma might potentially activate and reinforce existing stigma-relevant beliefs, research to date has neglected the issue of potential detrimental effects. A preregistered online experiment was conducted with a sample of 762 participants (51.1% female, Mage = 49.7 years, SDage = 16.4, 69.9% with some form of tertiary education). The objective of the study was to explore the potential impact of exposure to stigma scales which incorporate negative stereotypes on the development of stigmatizing attitudes toward two specific groups: individuals who use pre-exposure prophylaxis for HIV prevention and patients who undergo weight loss surgery. The findings underline the relevance of the issue by showing that responding to negative stereotypical items on a stigma scale bears the risk of facilitating scale-related stereotype accessibility, negative judgment, and promoting social demarcation from the groups under investigation.

Ethics of antibiotic allergy

Antibiotic allergies are commonly reported among patients, but most do not experience reactions on rechallenge with the same agents. These reported allergies complicate management of infections in patients labelled as...

Digitally Mediated Misogyny and Critical Discourse Studies: Methodological and Ethical Implications

The loose network of anti-feminist men’s websites and social media communities known as the “manosphere” is receiving increasing attention in academia and the mainstream media. However, research into this phenomenon brings notable challenges. For example, because some manosphere communities are known for hostility or even harassment towards women, common guidance for social media research such as gaining informed consent and sharing results with the community may not be viable. In this article, I reflect on some of the major methodological and ethical challenges I have faced during the course of my PhD research into the manosphere and the ways in which my positionality as a female, feminist linguist has impacted my work. I discuss the discourse-historical approach to critical discourse studies and argue that it is a valuable, useful framework for a study of online misogyny due to its principles of triangulation and interdisciplinarity, and its empowerment of the researcher to take a critical, even feminist, stance on controversial issues.

Bitcoin Price Prediction and NFT Generator Based on Sentiment Analysis

Twitter sentiment has been found to be useful in predicting whether the price of Bitcoin will rise or fall will climb or decline. Modelling market activity and hence emotion in the Bitcoin ecosystem gives insight into Bitcoin price forecasts. We take into account not just the emotion retrieved not just from tweets, but also from the quantity of tweets. With the goal of optimising time window within which expressed emotion becomes a credible predictor of price change, we provide data from research that examined the link among both sentiment and future price at various temporal granularities. We demonstrate in this study that not only can price direction be anticipated, but also the magnitude of price movement with same accuracy, and this is the study's major scientific contribution. Non-Fungible Token (NFT) has gained international interest in recent years as a blockchain-based application. The most prevalent kind of NFT that can be stored on many blockchains is digital art. We did studies on CryptoPunks, the most popular collection on the NFT market, in examine and depict each and every major ethical challenges. We investigated ethical concerns from three perspectives: design, trade transactions, and relevant Twitter topics. Using Python libraries, a Twitter crawler, and sentiment analysis tools, we scraped data from Twitter and performed the analysis and prediction on bitcoin and NFTs.

Awareness of Ethical Issue in Online Teaching for Medical Education, West Bengal, lndia

Currently, the world is responding to a pandemic of contagious respiratory disease caused by a novel corona virus and its emerging new variants of concern, COVID-19 that has impacted all aspects of our lives, including education. Hence, online classes have become a key component in the continuity of medical education, it allows the students to interact with their teacher face-to-face through the internet using online tools and so on, which can be combination of blended learning (attending classes along with virtual class). In online learning, academic dishonesty in institutions is one of the major ethical challenges which is affecting negatively on the character and personality of student. The present study is conducted to assess the perceptions and awareness of ethical issues in online learning by study participants. A self-administered online questionnaire using Google Forms® having combination of closed- and open-ended questions was given to participants. The data collected was analyzed in excel sheets using simple statistical tool. 62 (36%), out of 171 students disagreed that online teaching sessions were more effective and helped them to study better, they considered it is not effective in delivering or promoting effective teaching learning in medical education considering various barriers to it. However, 19 (76%) out of 25 faculty agreed that Online learning in medical education enables students to continue their education similar to the traditional approach. Participants awareness on ethical issues was good when using online learning systems in medical education and the students should be made fully knowledgeable about ethical issues to avoid unethical behavior during their academic period.

A Preliminary Study to Explore the Informed Consent Approach and the Ethical Challenges in the Malaysian Biobanking for Research

Since 2005, Malaysia has established several biobanks to keep in line with the advancement of biomedical research and development of biobanks in other countries such as the UK and the USA. Despite the establishment of several biobanks in Malaysia, little is known about the informed consent approach in biobanking research and its ethical challenges. This study aims to identify the approach in obtaining informed consent in the Malaysian biobanking for research and explore its ethical challenges. Using non-probability purposive sampling, an in-depth interview with the key informants was conducted in Klang Valley. Based on the interviews, broad consent is the main approach used in obtaining informed consent in biobanking for research in Malaysia and five major ethical challenges were identified. These challenges include the informants’ opinion on the current informed consent approach, understanding participants’ rights, the role of the research ethics committee, biobanking governance in Malaysia, and informants’ knowledge and awareness. In summary, there is a lack of understanding among those involved in biobanking on the ethical, legal, and social aspects of biobanking for research in Malaysia.

The ethical and deontological values of the lawyer profession

n a modern society, characterized by technological, informational, social and cultural changes, a society often plagued by major ethical and moral challenges, it is essential that the pursuit of any profession, and even more so of a legal profession, be grounded. on the observance of ethical and deontological values.Lawyers are considered to be role models in society since ancient times. Consequently, maintaining and increasing the prestige of the profession cannot be achieved without respecting the rules of professional ethics and without there being a permanent concern of the members of this profession to achieve the highest professional and deontological standards.The role of the lawyer is not limited to representing his client, but he acts in the interests of justice and the rule of law, and values such as humanism, professionalism, integrity, dignity, good faith, empathic obedience and mutual respect must govern his work.Based on these considerations, this article aims to reaffirm the importance of respecting the rules of ethics and deontology in the exercise of the legal profession and to analyze the key principles that apply to the profession, as outlined in domestic law by Law no. 51/1995 for the organization and exercise of the legal profession, the Statute of the legal profession and the Deontological Code of the Romanian lawyer.

Anticipating need for intensive care in the healthcare trajectory of patients with chronic disease: A qualitative study among specialists.

IntroductionWe investigated the reflections and perceptions of non-ICU physicians about anticipating the need for ICU admission in case of acute decompensation in patients with chronic disease.MethodsWe performed a qualitative multicentre study using semi-structured interviews among non-ICU specialist physicians. The interview guide, developed in advance, focused on 3 questions: (1) What is your perception of ICU care? (2) How do you think advance directives can be integrated into the patient’s healthcare goals? and (3) How can the possibility of a need for ICU admission be integrated into the patient’s healthcare goals? Interviews were recorded, transcribed and analysed by thematic analysis. Interviews were performed until theoretical saturation was reached.ResultsIn total, 16 physicians (8 women, 8 men) were interviewed. The main themes related to intensive care being viewed as a distinct specialty, dispensing very technical care, and with major human and ethical challenges, especially regarding end-of-life issues. The participants also mentioned the difficulty in anticipating an acute decompensation, and the choices that might have to be made in such situations. The timing of discussions about potential decompensation of the patient, the medical culture and the presence of advance directives are issues that arise when attempting to anticipate the question of ICU admission in the patient’s healthcare goals or wishes.ConclusionThis study describes the perceptions that physicians treating patients with chronic disease have of intensive care, notably that it is a distinct and technical specialty that presents challenging medical and ethical situations. Our study also opens perspectives for actions that could promote a pluridisciplinary approach to anticipating acute decompensation and ICU requirements in patients with chronic disease.

Artificial intelligence based decision-making in accounting and auditing: ethical challenges and normative thinking

PurposeThis paper aims to identify ethical challenges of using artificial intelligence (AI)-based accounting systems for decision-making and discusses its findings based on Rest's four-component model of antecedents for ethical decision-making. This study derives implications for accounting and auditing scholars and practitioners.Design/methodology/approachThis research is rooted in the hermeneutics tradition of interpretative accounting research, in which the reader and the texts engage in a form of dialogue. To substantiate this dialogue, the authors conduct a theoretically informed, narrative (semi-systematic) literature review spanning the years 2015–2020. This review's narrative is driven by the depicted contexts and the accounting/auditing practices found in selected articles are used as sample instead of the research or methods.FindingsIn the thematic coding of the selected papers the authors identify five major ethical challenges of AI-based decision-making in accounting: objectivity, privacy, transparency, accountability and trustworthiness. Using Rest's component model of antecedents for ethical decision-making as a stable framework for our structure, the authors critically discuss the challenges and their relevance for a future human–machine collaboration within varying agency between humans and AI.Originality/valueThis paper contributes to the literature on accounting as a subjectivising as well as mediating practice in a socio-material context. It does so by providing a solid base of arguments that AI alone, despite its enabling and mediating role in accounting, cannot make ethical accounting decisions because it lacks the necessary preconditions in terms of Rest's model of antecedents. What is more, as AI is bound to pre-set goals and subjected to human made conditions despite its autonomous learning and adaptive practices, it lacks true agency. As a consequence, accountability needs to be shared between humans and AI. The authors suggest that related governance as well as internal and external auditing processes need to be adapted in terms of skills and awareness to ensure an ethical AI-based decision-making.

190 Enhancing Research Ethics, Equity and Protections for Uninsured Study Participants

OBJECTIVES/GOALS: To increase diversity in clinical and translational research (CTR), to strengthen protections for uninsured and under-insured study participants from vulnerable groups by addressing their medical, ancillary care and psycho-social needs and to develop a systematic ethically sound approach to addressing such needs in the study protocol and budget. METHODS/STUDY POPULATION: We conducted) ethical analyses of: (1) the regulatory and ethics scholarship concerning protections and duty of care to research participants from vulnerable groups, and 2) arguments concerning the nature and scope of ancillary care obligations of researchers, as well as 3) a review of the applicable local, federal, and international regulations and practices concerning the duty of care to CTR participants and potential participants who are uninsured, under-insured and/or undocumented members of vulnerable groups. RESULTS/ANTICIPATED RESULTS: Uninsured and underinsured study participants pose major ethical challenges for CTR as medical needs arising during a study are usually covered by the participants own insurance. Lack of health insurance increases vulnerability and creates (1) a barrier to research participation for members of socially disenfranchised groups, (2) risk of discriminatory exclusion of such participants from clinical studies, and (3) inter-institutional inconsistencies in meeting their medical needs; thus limiting diversity in CTR. To address the challenges, we propose an inclusive, systematic, ethically sound approach, which deliberately plans for and provides resources within a study protocol to address the medical and psycho-social needs of uninsured participants during and beyond the study. DISCUSSION/SIGNIFICANCE: Including diverse participants in CTR ensures data quality and social justice. PIs and IRBs should adopt an inclusive approach to the medical needs of vulnerable uninsured participants, plan for their medical and ancillary care needs in the protocol and budget, list community resources, provide follow-up support and note assistance in their files.

Concrete Experiences and Support Needs Regarding the Euthanasia Practice in Adults With Psychiatric Conditions: A Qualitative Interview Study Among Healthcare Professionals and Volunteers in Belgium.

ObjectiveAlthough euthanasia in the context of adult psychiatry is legalized in Belgium, it poses major ethical and clinical challenges for the health care professionals and volunteers involved. This study aimed to address these members' concrete experiences and support needs.MethodsA qualitative semi-structured interview study was conducted with 16 physicians and 14 other health care professionals and volunteers, with at least one concrete experience with euthanasia requests and procedures concerning adults with psychiatric conditions.FindingsConcrete experiences concerned the following 8 domains: (1) the impact of euthanasia on the clinical trajectory and (2) on the therapeutic relationship, (3) internal and (4) external collaborative partnerships, (5) patients' social inner circle (non-)involvement, (6) the use of recently published guidelines and, (7) the first criminal trials on this topic, and (8) the act of euthanasia. The following 8 main support needs emerged; (1) protocols addressing specific sub-populations and pathologies, (2) protocols specifically drawn up for non-medics, (3) guidance on how to adequately implement the two-track approach, (4) (after)care for patients, (5) (after)care for the health care team, (6) guidance on the patient's social inner circle involvement, (7) enhanced education measures, and (8) enhanced financial measures, including incentives for holistic, palliative care approaches.ConclusionThe health care professionals and volunteers reported many positive and negative experiences in dealing with euthanasia requests in adult psychiatry. They reported several support needs across the extensive euthanasia trajectory, pertaining to concrete management of thorny issues that guidelines do not (yet) touch on. Important implications of our study relate to tackling these existing issues, and to paying sufficient attention to the impact of a euthanasia trajectory on all actors, including the patients and their social inner circle, involved.

Five ethical challenges facing data-driven policing

This paper synthesizes scholarship from several academic disciplines to identify and analyze five major ethical challenges facing data-driven policing. Because the term “data-driven policing” encompasses a broad swath of technologies, we first outline several data-driven policing initiatives currently in use in the United States. We then lay out the five ethical challenges. Certain of these challenges have received considerable attention already, while others have been largely overlooked. In many cases, the challenges have been articulated in the context of related discussions, but their distinctively ethical dimensions have not been explored in much detail. Our goal here is to articulate and clarify these ethical challenges, while also highlighting areas where these issues intersect and overlap. Ultimately, responsible data-driven policing requires collaboration between communities, academics, technology developers, police departments, and policy makers to confront and address these challenges. And as we will see, it may also require critically reexamining the role and value of police in society.

Proposing an Emergency Medicine Ethical Guideline; a Qualitative Study.

Introduction:Emergency medicine physicians face major ethical challenges in their practices. Furthermore, they need to be aware of the principles of ethical analysis and clinical decision-making in order to provide quality care. This study aimed to propose professional ethics codes in the emergency medicine department. Method:This is a qualitative study, which was performed using narrative review and expert panel, and was conducted in three steps, including: literature review and preparation of the initial draft of the ethical concepts, obtaining expert opinions on this initial draft and its validation, and finalizing main ethical components in emergency medicine. In this study, we received the opinions of an expert panel including 10 medical ethicists and 12 emergency medicine specialists using a survey form. Results:The ethical guide to emergency medicine can be formulated in 34 key ethical concepts, 6 sub-components, and 5 main components including emergency physician-patient relationship, and emergency physicians’ relationships with other professionals, students, researchers, and community. Conclusion:Emergency care providers need to be familiar with ethical guidelines in order to improve quality of care in emergency departments. The findings of this study suggest that a guideline on patient-physician relationship as well as the emergency physicians’ ethical obligations for other professionals, students, researchers, and community should be developed in line with ethical norms.

The Attitude of Iranian Critical Care Nurses Toward Euthanasia

Today, one of the major ethical challenges facing the world's health care system, and in particular nurses in the intensive care unit, is euthanasia or death out of pity. The aim of this study was to investigate the attitude of Iranian nurses in the intensive care unit toward euthanasia. This was an analytical cross-sectional study using census sampling. The data collection tool was the Euthanasia Attitude Scale. A total of 206 nurses working in the intensive care unit in 4 hospitals in the Mazandaran province of Iran were included in this study. The mean of total Euthanasia Attitude Scale score in intensive care unit nurses was 2.96. The mean euthanasia dimensions were ethical consideration, practical considerations, treasuring life, and naturalistic beliefs, 3.03, 2.92, 2.98, and 2.99, respectively. There was significant but low negative correlation between age and total Euthanasia Attitude Scale score, ethical considerations, and practical considerations. Male nurses exhibited significantly higher Euthanasia Attitude Scale scores, specifically in regard to ethical and practical considerations compared with female nurses. The most Iranian nurses in the intensive care unit had a negative attitude toward euthanasia for patients in the later stages of the disease. However, this opposition was less than similar studies in Iran in the past.

Administrative and Ethical Issues in Ghana’s Public Administration

This study examines some of the major administrative and ethical challenges facing Ghana’s public administration, with regard to the issues associated with the country’s governance processes and public sector service delivery. The methodology used is based on the qualitative approach with combined sources from primary and secondary data and the case study method. The findings in the study show that whereas Ghana’s democracy has made significant inroads over the years since the 1992 democratic transition, a number of administrative and ethical issues hinder the country’s public administration processes and procedures, which require immediate government attention to address them more appropriately. The study recommends that the government (executive branch) and the bureaucracy (Ministries, Departments and Agencies) should make frantic efforts towards promoting effective and efficient service delivery system and government accountability for accelerated national development. The study’s implication for theory is that it will inform its readers about the different perspectives on the topic discussed. Given the service delivery and corruption challenges in Ghana’s public sector, the recommendations will go a long way to help address some of the problems facing Ghana’s MDAs and the government in general. The significance of the study is that it provides key insights into important issues in Ghana’s public administration, which can serve as useful lessons for the government, public institutions and the bureaucracy. The outlined challenges and recommendations will inform the government, MDAs and other government agencies of the need to improve governance and administration in order to accelerate the country’s political and socio-economic development. This study further contributes towards academic discussions on the administrative and ethical issues hampering the effective delivery of services and public and administration in Ghana and Africa in general.