Ethics Program Research Articles

Exploration of the quality egvaluation system for clinical research based on quantitative evaluation

Objective To evaluate the feasibility and significance of establishing quantitative evaluation indicators in the project closure quality control by quantitative evaluation criteria. Methods To establish the evaluation index and corresponding index weight according to literature analysis, brainstorming and Delphy's expert consultation methodologies, research data were analyzed by radar chart. Results A total of five first grade indicators and twenty-three second level indicators were established, and the implementation evaluation system was established from five aspects: ethical requirements, informatization, program implementation, quality control and scientific research output. Conclusions The evaluation system can effectively evaluate the quality of clinical research, identify the weak links of the study quality management. It is a suitable method for the quality management of clinical research problems. Key words: Clinical research; Evaluation system; Quantitative evaluation; Radar map

Improving the Effectiveness of Health Information Technology: The Case for Situational Analytics.

Health information technology has contributed to improvements in quality and safety in clinical settings. However, the implementation of new technologies in health care has also been associated with the introduction of new sociotechnical hazards, produced through a range of complex interactions that vary with social, physical, temporal, and technological context. Other industries have been confronted with this problem and have developed advanced analytics to examine context-specific activities of workers and related outcomes. The skills and data exist in health care to develop similar insights through situational analytics, defined as the application of analytic methods to characterize human activity in situations and identify patterns in activity and outcomes that are influenced by contextual factors. This article describes the approach of situational analytics and potentially useful data sources, including trace data from electronic health record activity, reports from users, qualitative field data, and locational data. Key implementation requirements are discussed, including the need for collaboration among qualitative researchers and data scientists, organizational and federal level infrastructure requirements, and the need to implement a parallel research program in ethics to understand how the data are being used by organizations and policy makers.

문화코호트로서 탈북학생 민주시민교육을 위한 윤리컨설팅 프로그램 모듈 개발 기초 연구

문화코호트로서 탈북학생 민주시민교육을 위한 윤리컨설팅 프로그램 모듈 개발 기초 연구

Ethical Leadership and Employees’ Perceptions About Raising Ethical Concerns to Managers in the Veterans Health Administration

Background: The willingness of employees to proactively give voice to their concerns, including ethical concerns (ethics voice), is critical to improving organizational performance and integrity. In health care, speaking up is vital to ensuring a delivery system centered on patient safety and quality, including ethics quality. In this study, we explored whether ethical leadership practices contribute to employees’ willingness to raise ethical concerns to those in the organization who have the authority to take corrective action.Methods: We conducted a secondary analysis of 2014 IntegratedEthics Staff Survey data administered to a random sample of 50% of VA health system staff. The data we used reflected responses from 42,412 employees who were associated with 141 administratively defined medical centers that encompass more than 1,400 sites of care delivery and VHA administrative program offices. The response rate to the survey was 29.4%.Results: Employees positioned higher in the organizational hierarchy were more comfortable raising ethical concerns than lower ranked employees. Ethical leadership practices, and especially those that created an expectation of trust, follow-through, and fair treatment, made it more likely that employees would raise ethical concerns with managers.Conclusion: Speaking up about ethical concerns is essential to the delivery of high-quality patient care and is enabled by managers who embody ethical leadership practices. Ethics programs can help create favorable conditions for raising ethical concerns by providing managers and supervisors with ethical leadership coaching, recognizing power differentials, and modeling more egalitarian communication practices. More research is needed to understand how employees conceptualize ethics voice and to assess the comparative effectiveness of different methods of encouraging speaking up about ethical concerns in health care organizations.

The German Ethical Culture Scale (GECS): Development and First Construct Testing.

Misconduct in organizations (such as fraud, stealing, deception, and harming others) is not only a matter of some “bad apples” but also related to the organizational context (“bad barrels”), which can facilitate either ethical or unethical behaviors. Given the financial crisis and recurring corporate ethics scandals, policymakers, regulators and organizations are interested in how to change their organizational cultures to enhance ethical behavior and to prevent further disasters. For this purpose, organizations need to better understand what strategies and factors of the organizational environment can affect (un)ethical behavior. However, to assess the corporate ethical culture, solid measures are required. Since there is an urgent need to have a German measure to promote research in German-speaking countries, this research developed and tested the German Ethical Culture Scale (GECS). Drawing on a prominent approach that has received much attention from scholars and practitioners alike, the GECS attempts to integrate the notion of compliance- and integrity-based ethics programs (with its focus on how to steer organizations) with the notion of ethical culture (with its focus on what factors inhibit or foster ethical behavior). Three studies with heterogeneous samples of German and Swiss employees and managers were conducted to develop, test and validate the multidimensional scale (total N > 2000). Overall, the studies provide first evidence of the measure’s construct, criteria-related and incremental validity. The paper concludes with a discussion of the strengths and weaknesses of the GECS and implications for future research.

Talking About Ethical Issues in Surgery—Results of a Novel Online Pilot Curriculum

Surgical ethics has been suggested as a distinct field of study apart from clinical ethics due to a unique practice type and treatment dynamic. At our institution, most if not all teaching of clinical ethics is undertaken by nonsurgical faculty. We introduced a novel online Surgical Ethics Program (SEO) in a pilot form (SEO-P) for initial presentation to learners in our environment. The overall goal of our educational intervention was to enhance knowledge, understanding and appreciation for surgical ethics in medical students and to evaluate our curriculum. SEO-P was undertaken over a 4-week period in 2018 with 9 fourth-year medical students enrolled in a surgery elective at our institution. These learners all had career plans in general surgery or a surgical subspecialty. There was 3 weeks of content: (1) background in clinical ethics as it applies to surgical practice, (2) surgical consents and autonomy, and (3) the impaired physician. All pilot learners were evaluated with: (1) postprogram final exam assessment (compared to preprogram knowledge base test), (2) self-reflection essay of ethical practice in surgery, (3) evaluation of 2 case studies, and (4) an assessment of participation in online discussion forums. Postprogram survey of the learners was also undertaken in an anonymous fashion. Four of 9 or 44.4% of students scored greater than or equal to 80% on the postprogram knowledge assessment test. A preprogram knowledge-based examination of all learners yielded a mean and standard deviation of 57.1 ± 6.0%. Postprogram knowledge-based test with mean and standard deviation was 78.8 ± 15%. This was a statistically significant increase in scores (p = 0.004; t test). All 9 passed the course with a mean final summative course grade of 95.2 ± 3.2%. From the postprogram evaluation survey, all 7 students who responded felt that the SEO-P would help them become an "ethical" practitioner. Surprisingly, only half of the learners (57.1%) thought "technology used to support the SEO Course (i.e., the chosen curriculum management system) was effective in conducting the course." We set forth to use "web-based" technology to enhance exposure of medical students in our institution to surgical ethics. Hence, we designed our pilot curriculum to be a completely online offering. We feel that the utilization of the surgical voice, that is a surgical ethics curriculum developed by surgeons to explore surgically related clinical ethical issues, is an essential theme and goal of our program. Future challenges will be to present this voice in an effective manner with either an improved curriculum delivery system or by potentially utilizing a blended approach.

Safety measures for nurses working abroad

Safety measures for nurses working abroad

Abstract 3369: NCI’s Office of Data Sharing: Promoting broad & equitable policies and processes to improve cancer care

Abstract Data sharing increases our understanding of factors that influence health and diseases by enabling additional research questions from secondary data users, improving statistical power through combining multiple data sources, facilitating reproducibility and validation of research results, and supporting innovation with the development of research tools and methodologies. The NCI recently established an Office of Data Sharing (ODS), whose goal is to promote broad and equitable data sharing policies and processes to improve cancer knowledge and care. ODS advocates for open-access and broad data sharing policies to enable reproducibility, secondary use, knowledge sharing and innovation. ODS key priorities include: 1) coordinating the interpretation and implementation of the NCI and NIH Data-Sharing policies across the NCI, 2) streamlining data-access and -submission processes for NCI- and/or NIH-supported data repositories, 3) advocating for the proper balance of open-access, open-source, open-data-sharing policies while respecting the needs of research and participant communities. The NIH and NCI Data Sharing policies facilitate scientific progress by encouraging data access and sharing of genomic, phenotype, environmental, and behavioral data. Data access and sharing management, stewardship, and operating procedures are coordinated through a NIH governance structure of senior leadership and staff across NIH Institutes/Centers (ICs). NIH Data Access Committees (DACs) ensure data access based on shared principles and procedural standards of data management, security, privacy, and research participant protections. In efforts to improve data access efficiency, the ODS consolidated The Cancer Genome Atlas, intramural and extramural NCI DACs into a centralized operation, the NCI DAC. In comparison to other ICs, the NCI DAC receives the largest volume of data access requests (DARs) for access to controlled-tier level data. Specifically, the NCI DAC received 9214 DARs in 2017, representing 30% of all DARs received by NIH with a mean review time of 53 days, in comparison to the combined average of 35 days for all other NIH DACs. The NCI DAC oversees 216 studies registered in dbGaP, with 93 general research use (GRU) and 22 health, medical, biomedical (HMB) consent groups that allow data to be used for broader research uses. The centralized NCI DAC implemented data access review procedures for all DARs and expedited processes for projects requesting access to datasets with GRU and HMB data use limitations. These expedited procedures have produced a 26.5-fold decrease in time-to-decision from 53 to 2 days for researchers requesting access to NCI datasets. Additionally, ODS is committed to addressing health disparities ethics and is developing an Ethical, Economic, Legal, and Social Implications program that will address policies, practices, and ethical issues that arise from data sharing. Citation Format: Freddie L. Pruitt, Sylvia Shabaya Gayle, Nina Ghanem, Anna V. Mencarelli, Anthony R. Kerlavage, Vivian Ota Wang, Jaime M. Guidry Auvil. NCI’s Office of Data Sharing: Promoting broad & equitable policies and processes to improve cancer care [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3369.

Creative and emotional labour

Film festival curation and programming remain highly individualistic practices, that negotiate several discourses/tensions, including the responsibility of the curator to others (artists and audiences) and the creative independence of the curator. Much remains to be written about the creative process of curation, and how aesthetic judgements are articulated by those who practice it. While progress in this direction has been made in relation to some festivals (LGBT, African), human rights film festivals have only recently started to be part of academic scholarship, which tended to focus on the main functions and spectatorship roles that they encourage (Tascón; Tascón and Wils; Davies). This article focuses on the creative process of programming human rights film festivals using the case study of Document Human Rights Film Festival in Glasgow. Part of a practice-led collaborative research project between the Universities of Glasgow, St Andrews and the festival, this article is based on my reflections and experience as a co-opted member of the programming team for the 2016 and 2017 editions. Drawing on practice-led ethnography, I argue that this festival adopted a form of ethical programming, sharing authorship and responsibility towards the audience, the filmmakers and the profession, as well as a form of emotional labour.

THE PEDAGOGICAL IMPARTIALITY REQUIREMENT IN QUEBEC’S ETHICS AND RELIGIOUS CULTURE CURRICULUM: IS IT CONSISTENT WITH TEACHER AUTONOMY AND CHARTER RIGHTS?

Quebec’s Ethics and Religious Culture program (ERC) requires teachers to adopt a professional stance of pedagogical impartiality. This article examines the complex regulatory framework surrounding the impartiality requirement from the perspectives of teachers’ legally recognized right to professional autonomy, their constitutional rights to religious freedom and freedom of expression, and the related issue of impartiality as a pedagogical device when teaching about controversial issues. The paper’s brief review of the jurisprudence does not support a decisive answer to the question of whether the legal basis of the impartiality ERC’s impartiality requirement is sound. However, it does reveal that the impartiality requirement is more legally fragile than it might appear at first glance.

Obedience as Belonging: Catholic Guilt and Frequent Confession in America

From the late 19th to the mid-20th century, the practice of private confession to a priest was a mainstay of Catholic parish life in the United States. By the 1970s, Catholics had largely abandoned the practice of private confession. One dominant narrative among Catholic theologians and clergy, identified chiefly with the papacy of John Paul II, attributes the decline in confession to the loss of healthy guilt that took place during the cultural upheaval of the 1960s. In conversation with the work of psychologist and philosopher Antoine Vergote, the present article challenges this narrative, arguing that a collective and unhealthy Catholic guilt existed among American Catholics well before the 1960s and in fact characterized the period in which private confession was practiced most frequently. I contend that obedience to moral prescriptions was not, for ordinary Catholics, part of an ethical program of self-reform but the condition for belonging to a church body that emphasized obedience. Finally, examining the relationship between weekly reception of communion and confession, I suggest that private confession emerged to support frequent communion, persisting only until the latter became standard practice among Catholics in the United States.

The Effect of Ethics Education Programme on The Nurses’ Level Of Ethical Decision Making: A Phenomenology Study

Objective: This study was carried out to examine the effect of the ethical training program applied to the nurses on the nurses’ level of capability for ethical decisions. Methods: This study was carried out as a qualitative research methods of descriptive phenomenology and the research sample consisted of 13 nurses. The research was carried out in three stages. In the first stage, the first data were collected by the face to face individual interviews lasting approximately 90-120 minutes.In the second stage of the research, “Ethical Training Program” was applied. In the third stage of the research, data were collected by the depth interview method. Nvivo 11 package software and “Content Analysis” method were used in evaluation of the qualitative data. Results: In the interviews with the nurses before the ethics education, 8 themes and 33 sub-themes were determined. After the ethics education, 10 main themes and 22 sub-themes were determined. After the education, the nurses could express their opinions about ethical decision making and ethical decision process which they couldn’t express before the education. Conclusions: In conclusion, after the “Ethical Training Program”, there was a positive change in the nurses’ “Ethical Basic Knowledge” and “Level of Capability of Ethical Decision”.

Fundamentals of Enterprise Photodocumentation: Connecting the Clinical and Technical-a Review of Key Concepts.

Photodocumentation is an invaluable tool in many specialties, including dermatology, facial plastic and reconstructive surgery, and wound management. As digital cameras and camera-enabled smartphones have become omnipresent in our society, they have brought photodocumentation to all corners of healthcare organizations including the emergency department as well as family medicine and pediatrics. Simultaneously, enterprise imaging programs have evolved enabling access to all medical images for all providers throughout these organizations. Through their unique perspective, enterprise imaging teams have an opportunity to guide development of high quality, ethical programs that are compliant with legal and regulatory requirements. Clinical and technical standards for photodocumentation are not fully evolved and thus establishing an enterprise photodocumentation program will require communication and education. Development of such a program requires an understanding of the clinical, ethical, and technical issues around photodocumentation. This article explores how photodocumentation is utilized, the patient's experience, current quality concerns, tools and technical issues around image acquisition, and the topics of informed consent, privacy, security, and lifecycle and health information management.

Big Data from the South(s): Beyond Data Universalism

This article introduces the tenets of a theory of datafication of and in the Souths. It calls for a de-Westernization of critical data studies, in view of promoting a reparation to the cognitive injustice that fails to recognize non-mainstream ways of knowing the world through data. It situates the “Big Data from the South” research agenda as an epistemological, ontological, and ethical program and outlines five conceptual operations to shape this agenda. First, it suggests moving past the “universalism” associated with our interpretations of datafication. Second, it advocates understanding the South as a composite and plural entity, beyond the geographical connotation (i.e., “global South”). Third, it postulates a critical engagement with the decolonial approach. Fourth, it argues for the need to bring agency to the core of our analyses. Finally, it suggests embracing the imaginaries of datafication emerging from the Souths, foregrounding empowering ways of thinking data from the margins.

Beyond silos: An interprofessional, campus-wide ethics education program.

Ethics education is essential to the education of all healthcare professionals. The purpose of this study was to evaluate an interprofessional approach to ethics education to all students across an academic health science center. The objectives were to (1) compare student perception of ethics education before and after the implementation of the campus-wide ethics program and (2) determine changes in student ethical decision-making skills following implementation of a campus-wide ethics program. This study was a quasi-experimental design with seniors graduating prior to the intervention serving as the control group. The setting was a comprehensive health science center in the southwestern United States. All students enrolled in the university participated in the intervention; however, 976 graduating students were used for evaluation of the intervention. Study materials for each survey were submitted to the university's IRB, and the project was approved as exempt by the Committee for the Protection of Human Subjects. Student participation in the surveys was voluntary. No names or other identifying information were collected, and responses to the survey questions were kept confidential. Students' perception of the adequacy of time spent on the ethics content in course instruction and practical training decreased from the baseline to the fifth-year survey. Students' overall comfort level with their abilities to deal with ethical issues increased from the baseline to the fifth year. Student ethical decision-making skills were higher at the third-year evaluation for all indicators. For the fifth-year survey, responses were also higher scoring on all four indicators. After participation in an interprofessional campus-wide effort on health professions ethics, students demonstrated higher ethical decision-making scores according to the Health Professional Ethics Rubric. However, their scores still did not reach the proficiency level identified in the rubric. Examination of the effectiveness of each part of the intervention is needed.

Measuring Military Professionalism in Partner Nations: Guidance for Security Assistance Officials

ABSTRACTThe U.S. spends billions of dollars in its security cooperation program to develop “professional, accountable, and capable security forces” in other nations, part of a grand strategy to improve global stability and counter violent extremism. Despite its great investment in professionalizing foreign militaries, however, the U.S. has no functional definition of military professionalism – a term that until now has been considered too vague and multi-faceted to operationalize. In this article, the author seeks to remedy this oversight, drawing from twenty years of security cooperation fieldwork in Latin America and Africa, as well as a vigorous literature review, to define four important components of military professionalism: (1) formal military education and vocational training, (2) military subordination to elected civilian officials, (3) knowledge and practice of the law of armed conflict and human rights law, and (4) a clearly established program of professional military ethics. This article provides guidelines for U.S. and European officials who work with partner nations to develop more professional military forces and, in particular, for officials managing security assistance programs with developing countries.

Contextual determinants of HR professionals’ self-perceptions of unethical HRM practices

PurposeThe purpose of this paper is to examine human resources (HR) professionals’ self-perceptions of ethically questionable human resource management (HRM) practices (i.e. disregard for the individual, favoring those in power and discrimination). The research sought specifically to determine how these perceptions are influenced by their organizations’ ethical infrastructure and corporate social responsibility (CSR) practices.Design/methodology/approachData were collected from 134 HR professionals using an anonymous structured questionnaire.FindingsThe scope of organizations’ ethics programs and the degree of importance given to developing an ethical infrastructure were found to predict the level of acceptance of unethical HRM practices related to discrimination. These practices are also less acceptable to professionals from organizations that are perceived as more socially responsible regarding their employees.Research limitations/implicationsAdditional studies with larger samples are needed to determine more clearly not only the influence of contextual determinants, but also the practical consequences of high levels of acceptance of unethical practices in HRM.Practical implicationsOrganizations can decrease their HR professionals’ acceptance of ethically questionable HRM practices by developing and emphasizing a strong ethical infrastructure and CSR practices, especially those affecting employees.Originality/valueHR professionals’ perceptions of ethical issues have rarely been analyzed using empirically tested methods. By surveying HR professionals, this study contributes to a fuller understanding of their perceptions regarding the ethics of their own practices. The results show that contextual determinants play an important role in predicting the level of acceptance of unethical HRM practices, especially those leading to discrimination.

Virtuous human hacking: The ethics of social engineering in penetration-testing

This paper offers a virtue ethics analysis of social engineering in penetration-testing. It begins by considering previous research on this topic and argues that such attempts misconstrue or more often overlook this Aristotelian tradition. It articulates the core tenets of virtue ethics and applies them to an analysis of white hat social engineering. A virtue ethics analysis requires that individuals and the firms that initiate the penetration-test be placed within a larger communal context which obligates individuals who are potential human hacking victims to participate in the constitution and flourishing of larger communities. As such, for virtue ethics consent is not a necessary condition for the positive ethical status of white hat social engineering. If methods are consistent with moderation (i.e. the golden mean) manipulation at lower orders within the hierarchy of communities can be justified if it can reasonably be understood as part of an individual's participatory obligation and the results of this participation is essential to ensure the eudaimonia of the larger community. Nevertheless, the golden mean requires that robust mitigation strategies lessen the degree of harm inflicted on social engineering victims. Where possible, a degree of consent should be attained as part of this mitigation. Finally, penetration-testing firms must be able to demonstrate that a robust ethical training program governs its use of social engineering.

Moral intensity, ethical decision making, and whistleblowing intention

Given the importance of organizational whistleblowing, the purpose of this study is to investigate the relationships among individuals' perceptions of moral intensity, ethical decision making, and whistleblowing intentions. Using information collected from employees' working for varied firms, the analysis indicates that several dimensions of moral intensity, predominantly seriousness of consequences and social consensus, are positively related to components of ethical decision making, namely the recognition and perceived importance of an ethical issue, ethical judgment, and ethical intention. The results also show that the recognition and perceived importance of an ethical issue and ethical judgment are positively related to whistleblowing intention. Finally, seriousness of consequences is positively related to whistleblowing intention. The managerial implications of these findings are discussed, including the development of an ethical work context and programs that enhance ethical sensitivity. The research limitations and suggestions for future research are also highlighted.

Normative and conceptual ELSI research: what it is, and why it’s important

The Ethical, Legal, and Social Implications (ELSI) Research Program of the National Human Genome Research Institute sponsors research examining ethical, legal, and social issues arising in the context of genetics/genomics. The ELSI Program endorses an understanding of research not as the sole province of empirical study, but instead as systematic study or inquiry, of which there are many types and methods. ELSI research employs both empirical and nonempirical methods. Because the latter remain relatively unfamiliar to biomedical and translational scientists, this paper seeks to elucidate the relationship between empirical and nonempirical methods in ELSI research. It pays particular attention to the research questions and methods of normative and conceptual research, which examine questions of value and meaning, respectively. To illustrate the distinct but interrelated roles of empirical and nonempirical methods in ELSI research, including normative and conceptual research, the paper demonstrates how a range of methods may be employed both to examine the evolution of the concept of incidental findings (including the recent step toward terming them ‘secondary findings’), and to address the normative question of how genomic researchers and clinicians should manage incidental such findings.