Potential Ethical Implications Research Articles

Biomarkers of PTSD: military applications and considerations.

BackgroundAlthough there are no established biomarkers for posttraumatic stress disorder (PTSD) as yet, biological investigations of PTSD have made progress identifying the pathophysiology of PTSD. Given the biological and clinical complexity of PTSD, it is increasingly unlikely that a single biomarker of disease will be identified. Rather, investigations will more likely identify different biomarkers that indicate the presence of clinically significant PTSD symptoms, associate with risk for PTSD following trauma exposure, and predict or identify recovery. While there has been much interest in PTSD biomarkers, there has been less discussion of their potential clinical applications, and of the social, legal, and ethical implications of such biomarkers.ObjectiveThis article will discuss possible applications of PTSD biomarkers, including the social, legal, and ethical implications of such biomarkers, with an emphasis on military applications.MethodLiterature on applications of PTSD biomarkers and on potential ethical and legal implications will be reviewed.ResultsBiologically informed research findings hold promise for prevention, assessment, treatment planning, and the development of prophylactic and treatment interventions. As with any biological indicator of disorder, there are potentially positive and negative clinical, social, legal, and ethical consequences of using such biomarkers.ConclusionsPotential clinical applications of PTSD biomarkers hold promise for clinicians, patients, and employers. The search for biomarkers of PTSD should occur in tandem with an interdisciplinary discussion regarding the potential implications of applying biological findings in clinical and employment settings.

Ethical Decision-Making While Using Social Networking Sites: Potential Ethical and Clinical Implications for Marriage and Family Therapists

The increasing popularity of social networking sites is changing the way therapists interact with others personally and professionally. Interface over the Internet present unique challenges to the therapeutic relationship concerning privacy and ethical boundaries. However, lack of guidelines concerning the use of SNSs often force therapists to navigate the American Association for Marriage and Family Therapy Code of Ethics and federal laws. This article provides a beginning discussion for therapists to consider new ethical decisions in the context of engaging in online interactions with clients. The authors provide guided questions and vignettes to elicit reflection among therapists on their decision-making.

When Not Knowing is a Virtue: A Business Ethics Perspective

How leaders and managers respond to not knowing is highly relevant given the complex, ambiguous, and chaotic business environment of the twenty-first century. Drawing on the literature from a variety of disciplines, the paper explores the dominant, unfavorable conceptualization of not knowing. The authors present some potential ethical implications of a negative view of not knowing and suggest how organizations would benefit from identifying any unhelpful aspects of the culture that may encourage unethical, undesirable, and/or hasty actions in situations of not knowing. The paper specifically illustrates how patience, courage, honesty, integrity, and humility are integral to negative capability in the contexts of not knowing. Finally, the paper calls for deeper inquiry into the role of virtue ethics in preparing managers and leaders for not knowing and urges organizations to embrace negative capability in not knowing rather than engaging in damaging delusion.

Ethical implications of resource-limited evaluations: Lessons from an INGO in the eastern Democratic Republic of Congo

The emphasis on demonstrable program results in international development work has produced countless evaluation guidelines and numerous scholars have championed specific, ethical-based evaluation approaches to guide international nongovernmental organizations (INGOs). Yet few studies have examined the ethical implications of current evaluation practices among INGOs or the resulting effects on INGO-funded programs. This article focuses on one among a growing population of young, U.S.-based INGOs whose evaluation practices reflect limitations of time, methodological expertise and funding. Drawing on existing principles of ethical evaluations, the author explores the circumstances and potential implications of one evaluation performed by an INGO in the eastern Democratic Republic of Congo and concludes that an ethically defensible evaluation exceeds the capacity of this young INGO. Four propositions are forwarded to highlight the tensions between currently accepted evaluation guidelines and INGO realities. Finally, to help under-resourced INGOs minimize the potential ethical implications for their programs, the article recommends that they prioritize their limited resources to: (1) build local capacity and decentralize evaluation tasks and responsibilities; (2) share program agendas and solicit feedback on implementation from evaluands; (3) share field impressions with local and expert stakeholders; and, (4) translate communications into local dialects to facilitate discussion about structuring future programs and their evaluation.

Legal and Ethical Implications of Using Religious Beliefs as the Basis for Refusing to Counsel Certain Clients

This article addresses potential legal and ethical implications of lawsuits that have been brought when counselors and counseling students have used their religious beliefs as the basis for refusing to counsel lesbian, gay, bisexual, and transexual clients. Four lawsuits are reviewed, issues relevant to the cases are identified, and implications for counselor educators and counseling students are discussed.

»Jesus« und »Politik«?

AbstractThe paper deals with potential ethical implications of contemporary Christological studies. In a first section the argument is made that doctrine and ethics belong together. In the central section, this claim is then illustrated with reference to recent approaches to Christology. Under the theme »Christology and Ethics« six popular approaches are discussed with a view to their respective ethical implications. In each case, representative examples are provided. The six approaches are those that underline living in communion with Christ, that emphasize remembering Jesus, that call for discipleship, that employ the threefold office, that depart from the worship of Christ and that emphasize Christ’s promised future. In a brief final section three conclusions are developed regarding Christology and public theology, or Jesus and politics.

‘JESUS’ EN ‘POLITIEK’? CHRISTOLOGIESE LITERATUUR EN PUBLIEKE TEOLOGIE VANUIT ’N SUID-AFRIKAANSE PERSPEKTIEF

The article deals with potential ethical implications of contemporary Christological studies. In a first section the argument is made that doctrine and ethics belong together. In the central section, this claim is illustrated with reference to recent approaches to Christology. Under the theme ‘Christology and Ethics’ six popular approaches are discussed with a view to their respective ethical implications. In each instance, representative examples are provided. The six approaches are those that underline living in communion with Christ, that emphasize remembering Jesus, that call for discipleship, that employ the threefold office, that are based on the worship of Christ and that emphasize Christ’s promised future. In a brief, final section three conclusions are developed regarding Christology and public theology, or Jesus and politics.

Views on the acceptability of financial incentives for breastfeeding: a qualitative study

BackgroundBreastfeeding is good for both baby and mother, and the associated health benefits persist. However, in many communities breastfeeding is not the norm. Financial incentives are a potentially powerful method to achieve health-related behaviour change, and these incentives have been used with varying success in a range of settings. The use of financial incentives to promote breastfeeding is controversial, and there has been little research in this area. A street intercept survey with women from areas of low breastfeeding rates showed that financial incentives were acceptable to 80% (95% CI 67–88; n=54) of those sampled. In this study, we aimed to investigate in depth the acceptability of financial incentives for breastfeeding both in principle and in practice among a range of key stakeholders. Our research is part of a wider study to develop and trial a financial incentive scheme for breastfeeding in areas with 6–8-week rates below 40%. MethodsWe undertook semistructured individual interviews (n=54) and focus groups (n=8) with two stakeholder groups based in south Yorkshire and north Derbyshire: mothers who had breastfed or formula fed, or both (n=38) and health-care staff with infant feeding roles (n=53). A sampling frame was developed to purposively sample for maximum variation in the range of infant feeding preferences and experiences in different age groups. Stakeholders were recruited from children's centres, breastfeeding support groups, parent and toddler groups, and community or hospital maternity services. Health-care staff were midwives, health visitors, breastfeeding peer support workers, children's centre managers, charity or voluntary sector workers, public health leads, and commissioners. Interviews were analysed by thematic analysis, drawing on the principles of framework analysis. NVivo was used to support the analytical process. Interviewer bias was minimised by use of inter-rater reliability, peer debriefing, and reflexivity. Ethics approval for the study was obtained from ScHARR Research Ethics Committee, NHS R&D, and Sheffield Local Authority Research Governance. FindingsAlthough a wide range of views about financial incentives were expressed, both mothers and health-care staff had similar views about the potential benefits, emotional effect, and ethical implications of a financial incentive scheme. The common key emergent themes were the scheme's potential to encourage, reward, and support breastfeeding; ethical concerns about financial incentives for breastfeeding; potential negative effects; and concerns about the practical implementation of a scheme. Many interviewees felt that financial incentives might encourage more women to attempt breastfeeding. Health-care staff, particularly, felt that a financial incentive might help to normalise breastfeeding in communities with low breastfeeding rates. Some viewed the incentive as being a reward for breastfeeding and that breastfeeding would be perceived as valuable and good. Both groups were concerned about moral implications, perception of incentives as bribery, penalising those unable to breastfeed, and how such interventions would be policed. Many considered the moral implications of how a financial incentive would be spent and whether the incentive should be cash or vouchers. Further, financial incentives could affect women negatively—in particular, if it reduced the intrinsic motivation to breastfeed. Additionally, an incentive could add pressure on the woman to breastfeed and might not help if she ran into difficulties. Both groups made suggestions for the practical implementation of the scheme that would make it more acceptable. There was low acceptability for verification methods that required the mother to perform in order to prove that she was breastfeeding. InterpretationThere was difficulty in recruiting primiparous women to the study, which limits the generalisability of these results. Although a wide range of views were expressed within and between stakeholder groups, financial incentives for key stakeholders were broadly acceptable, in principle. Issues were identified that need consideration when implementing a financial incentive scheme in practice. FundingMedical Research Council—National Prevention Research Initiative (MR/J000434/1).

The Ethical and Clinical Implications of Utilizing Cybercommunication in Face-to-Face Therapy

Information and communication technology has created a new way for individuals to communicate and has entered a number of professional practices, including clinical social work. This article explores the potential ethical and clinical implications when cybercommunication is used in conjunction with traditional face-to-face clinical social work practice. Specific challenges addressed include confidentiality, professional boundaries, effective and competent practice, and unanticipated contact. The authors discuss how information and communication technology is emerging as an inevitable component of the therapeutic exchange, influencing in-person social work practice and the ways that practitioners interact with their clients.

Ethical Issues Surrounding Interprofessional Collaboration

Global healthcare and health disciplines' education policy and position statements contain mandates for education that incorporates interprofessional collaboration. One of the popular educational technologies involves virtual simulation as tools for educating future generations of healthcare professionals. This article discusses potential ethical implications for interprofessional collaboration from a humanbecoming lens of understanding.

Internet Research and Ethics: Transformative Issues in Nursing Education Research

As practice in the educational and clinical settings seeks to be evidence based, faculty are increasingly required to conduct research and publish the results to advance the science of our profession. The purpose of this article is to discuss transformative research ethics because Internet use is an increasing component of current research studies. How nurse educators can engage in research-utilizing methodologies inclusive of technology while adhering to ethical standards developed before the advance of the Internet is reviewed. Recommendations are cited to address the new questions that arise at institutional review board meetings resulting from potential ethical implications of using students or research participants in cyber space.

DECODING CONSCIOUSNESS

Geraint Rees is a Professor of Cognitive Neurology at University College London, where he directs the Institute of Cognitive Neuroscience. His research interests focus on understanding the neural basis of...

A Statistical Correction to 20 years of Banding

Statistically based banding is often considered a viable method for minimizing adverse impact in test‐based employment decisions. By utilizing the standard error of the difference (SED), scores are equated based on the assumption that there is substantial unreliability in any single observed score. However, based on the derivations of Dudek, the formula commonly used to calculate the standard error of measurement (SEM) – a component that is typically used to calculate the SED – is incorrect. Specifically, utilizing the SEM when calculating the SED produces a band of observed scores around a true score, not a band of true scores around an observed score as would be appropriate for banding. This study compares the differences between banding‐based selection decisions when the appropriate SED formula – which utilizes the standard error of estimate – is and is not applied. Overall, results suggest that utilizing the appropriate formula for calculating the SED produces substantial variations in employment decisions. The potential legal and ethical implications of these discrepancies are discussed.

Participant Withdrawal: Challenges and Practical Solutions for Recruitment and Retention in Clinical Trials

A major challenge in the conduct of clinical trials is recruiting and retaining adequate numbers of study participants. Pressure for steady recruitment and retention is great. A wide range of strategies are used to retain participants; however, some approaches raise ethical questions. This article examines issues of participant retention, literature addressing the volunteer nature of informed consent, the moral distress surrounding participant withdrawal, and potential ethical implications. Strategies are proposed to resolve issues and reduce participant and investigator distress. Case studies of two patients with complex chronic illnesses illustrate practical solutions and lessons learned.

“Trust is not something you can reclaim easily”: patenting in the field of direct-to-consumer genetic testing

Recently, 23andMe announced that it had obtained its first patent, related to "polymorphisms associated with Parkinson's disease" (US-B-8187811). This announcement immediately sparked controversy in the community of 23andMe users and research participants, especially with regard to issues of transparency and trust. The purpose of this article was to analyze the patent portfolio of this prominent direct-to-consumer genetic testing company and discuss the potential ethical implications of patenting in this field for public participation in Web-based genetic research. We searched the publicly accessible patent database Espacenet as well as the commercially available database Micropatent for published patents and patent applications of 23andMe. Six patent families were identified for 23andMe. These included patent applications related to: genetic comparisons between grandparents and grandchildren, family inheritance, genome sharing, processing data from genotyping chips, gamete donor selection based on genetic calculations, finding relatives in a database, and polymorphisms associated with Parkinson disease. An important lesson to be drawn from this ongoing controversy seems to be that any (private or public) organization involved in research that relies on human participation, whether by providing information, body material, or both, needs to be transparent, not only about its research goals but also about its strategies and policies regarding commercialization.

Ethical Implications and Interprofessional Education

Policy and position statements from global regulatory agencies in all health disciplines are emphasizing and implementing requirements that interprofessional team education become a mandatory educational component for each of the health disciplines. What is interprofessional and/or interdisciplinary team-based healthcare? What are potential ethical implications specifically for the practice of nursing? In this column the author offers an exploration of potential definitions and meanings for future nursing education, research, and practice from a nursing theoretical perspective.

Creating “companions” for children: the ethics of designing esthetic features for robots

Taking the term “companion” in a broad sense to include robot caregivers, playmates, assistive devices, and toys, we examine ethical issues that emerge from designing companion robots for children. We focus on the relative importance and potential ethical implications of creating robots with certain types of esthetic features. We include an examination of whether robots ought to be made to appear or act humanlike, and whether robots should be gendered. In our estimation, this line of ethical inquiry may even provide insight into the nature and appropriateness of existing institutions and widely accepted interactions among human beings.

CT coronary angiography vs. invasive coronary angiography in CHD.

Scientific background Various diagnostic tests including conventional invasive coronary angiography and non-invasive computed tomography (CT) coronary angiography are used in the diagnosis of coronary heart disease (CHD).

Teaching-Learning in Community

Metaphors are creative learning devices that may illustrate novel and different meanings in teaching-learning situations. In this column, the author discusses possible meanings of the metaphor of nurse as guest in nurse-community relationships from a humanbecoming theoretical lens. Humanbecoming teaching-learning essences, paradoxes, and processes are used to illustrate potential ethical meanings and implications for nurse practice.

Does physicians’ right to strike outweigh students’ right to an education? The on-going ethical dilemma in Peru

Although often viewed as an action of last resort, going on strike remains a legal and often effective option for physicians seeking labor improvements and better working conditions. Indeed, in some countries, there have been reports of strikes by physicians (1, 2), followed by ensuing discussions of potential ethical implications (35). However, little has been said about the consequences of such a mass labor stoppage on undergraduate medical education and those students who aspire to the profession. (Published: 19 December 2012) Citation: Med Educ Online 2012, 17 : 19870 - http://dx.doi.org/10.3402/meo.v17i0.19870