Ethical Situations Research Articles

The art of not being neutral in qualitative research

ABSTRACT This article is a contribution to the ongoing dispute about ethical and methodological standards of neutrality within qualitative research. By invoking the notions of friendship-based research and situated ethics, we discuss important ethical dilemmas that can arise in research processes when informant and researcher develop friendship-like relations. We consider the benefits and drawbacks of such an approach, especially when working within sensitive fields – in this case, the impact of psychiatric diagnoses and gang exit processes on identity formation. We challenge traditional ideals of personal non-involvement in qualitative research, particularly with regard to ethical issues by analyzing and discussing a case of unforeseen events during the establishment of a research group that transformed a formal informant – researcher relationship into friendship-based research.

Fletcher’s Situation Ethics for Societal Moral Order

Situation ethics is aimed at regulating human actions and values based on the prevailing and forcible circumstances that may determine what should be valued as morals, Such “ethics of living” is necessary for the sake of the common or greater good. In most cases, the situations determine the survival of a greater number of persons, irrespective of the nature of causality that may be impeded. With situation ethics, Fletcher advocates that a human person is an agent of a conscious being. These human actions in society cannot be free from moral implications when the sense of common goodness prevails. Adopting expository and descriptive methods of inquiry, the essay examines Fletcher’s situation ethics in relation to the possibilities of moral order in our world that has been bedeviled by erotic and erratic actions, ideologies, interests, and values without meaningful responsibility that can guarantee authentic and integral living. The paper highlights the moral thrusts for one’s actions and choices not to be judged or evaluated at face value, but to consider the possible rationality based on the situations in which actions are expressed and choices are made. The objective of the paper is hinged on the indispensability of one’s situation as a conscientious determinant of one’s moral responsibility and interest. The paper concludes that Fletcher’s situation ethics will remain ever relevant in the face of other ethical theories, principles, movementsor ideologies, as it can lead the human persons and their world to an enduring possibility of peace and tranquility, and then, guarantees the sustainability of moral order when the principle of love and care is generally adopted to regulate the contents of human freedom and conscience.

#6211 THE OPPORTUNITY COSTS EXPERIENCED BY PATIENTS WHO INJECT DRUGS UNDERGOING HAEMODIALYSIS: A CASE SERIES

Abstract Background and Aims Patients who inject drugs (PWIDs) represent a uniquely difficult population to manage with haemodialysis, often with reliance on tunneled venous access. This population is historically difficult to reach, and their care is usually associated with higher per capita healthcare costs [1], unsurprisingly poor outcomes are reported [2] with a multitude of likely causes. Here we show the time associated opportunity costs these patients experience including the significant complication of tunnelled dialysis line infection in a person who actively injects drugs. Method This study follows on from the work by Burns [3]. In this retrospective observational study, the electronic health records of patients who were known to be ongoing users of recreational drugs were reviewed from January 2015 – August 2021. Patients were reviewed from their first tunneled line placement until either their death or until the end of the study time period. Stata 14 was used to generate descriptive statistics. Results 6 Patients were identified, 5 had a primary diagnosis of AA Amyloidosis with the other being IgA. This cohort of patients did poorly, 5 out of 6 of the cohort had died with a mean survival of 27 months. Patients were followed for an average of 769 days (range 485 - 1052). The majority of this time alive was spent as an inpatient with the mean percentage of time as an inpatient being 55% (Range 35–81%) with a mean of 411 total inpatient days. The first confirmed bacteraemia occurred within the first 100 days in 4 out of 6 of the patients. Conclusion With this case series we demonstrate the opportunity cost PWIDs experience in the form of time spent as an inpatient. This cost is further added to by the burden of outpatient maintenance haemodialysis. Consideration should also be given to the excess burden their care places on over-stretched healthcare systems. Infections and dialysis compliance are key components in the care of PWIDs and while moving away from tunneled access should be sought whenever possible a multidisciplinary approach should also be considered; these patients commonly lead chaotic lifestyles and in-center dialysis is usually the only option. Including addiction, social and psychiatric services alongside dialysis may be a way to engage with this historically difficult to reach population. The hope is that this study provides the incentive for further studies focusing on the opportunity costs and the quality of life this population can expect when embarking on haemodialysis. This would provide patients with realistic expectations while also aiding clinicians in navigating this difficult ethical situation.

Bulleh Shah’s Anti-Orthodox Views on Self-Purification and Their Implications for Social Reforms in Punjabi Society

Bulleh Shah is regarded as a social critic and reformer, though he was not a conventional preacher, but he was a true critic of his contemporary society. Sufis aimed at ethical character reformation of the society. This article discusses the moral and ethical situation in Punjabi society of Bulleh Shah’s time and his Sufi philosophy for social reforms. Bulleh Shah reflected on the social situation of his time in his poetry. This article relates Bulleh Shah’s views regarding social reforms to the concurrent social issues in Punjabi society. Bulleh Shah focused on the real character and criticized hypocrisy and duality in pursuit of social, political, and religious aims. Punjab remained a gateway for the invading forces in India. So, the social structure in Punjab remained complex with a clear distinction between the privileged and underprivileged classes. The exploitative social order inspired pride and hollow show among the upper elite and inferiority sentiments among the least privileged classes. Bulleh Shah’s philosophy for self-purification and salvation focuses on the negation of self-pride to achieve harmony with nature and humanity in general. Punjab was not a land of homogeneous class structure, race, and religion. Here was a merger of various cultures, and people belonged to different religions. These differences were so obvious that it was difficult to extract the uniform principle on which the Punjabi identity could be constructed. Religion, caste structure, sect, and biradari all played important roles in constructing Punjabi identity. These were the critical issues of concern for the intelligentsia of that time.

Ethics and Epistemic Injustice in the Global South: A Response to Hopman’s Human Rights Exceptionalism as Justification for Covert Research

Abstract This article investigates the risk of epistemic injustice in conducting sociolegal research in Global South contexts. Diving into the ethical imperatives of honouring knowledge, agency, and voice, we challenge extractive research practices and reframe participants as active, legitimate bearers of knowledge. Covert research is a highly controversial research practice which bypasses the right to informed consent of participants. Marieke Hopman’s article titled ‘Covert Qualitative Research as a Method to Study Human Rights Under Authoritarian Regimes’ advocates for covert research in the field of human rights, provided this covert research passes her proposed ‘ethical test’. We argue that this test permits and requires practices of knowledge-making which unjustly silence, undervalue, and exclude the capacity of systematically marginalised communities to produce knowledge claims. Hopman’s ethical test requires researchers to translate participants’ testimonies and situated knowledge into a doctrinal human rights framework, which comes with certain onto-epistemological assumptions which may not be shared by participants. Her approach frustrates research participants’ agency in choosing their own epistemic projects. Finally, her test exacerbates structural inequalities between the Global North and Global South by reinforcing unequal power relations. We advocate for a situated ethics approach to mitigate epistemic injustice in socio-legal research in the Global South. Cross-cultural ethical dialogue between western and non-hegemonic ethics on a non-hierarchical and equal basis can contribute to building ‘intercultural ethics’. Reflexivity – where researchers critically examine their worldviews and social position throughout the research process – can ensure greater accountability and integrity. Reciprocity – building mutual research relationships and producing research useful to the researched – can help shift the power imbalance between the researcher and researched.

An Ethico-Philosophical Disquisition of Homosexuality

The practice of homosexuality in several nations has been the subject of intense controversy recently. In addition to eroding the sense of identity of individuals who practice it, homosexuality—also known as same-sex relationships or marriage—has also been condemned for undermining the order of creation and endangering the survival of many societies. This paper examines homosexuality as an act and its consequent implications for the community in which the actor belongs. The paper employs the method of critical analysis; hence, using Kantian ethics, the utilitarian view, situation ethics, sexual ethics, and Christian ethics to look at the issue of homosexuality; and also, the natural law theory of morality, which states that since what is natural is morally right and what is unnatural is morally wrong, homosexuality as an act is unnatural, hence it is morally wrong. To conclude, we are of the opinion that an unauthentic lifestyle has detrimental consequences for society in general and the individual in particular

Ethical decision-making in purchasing channels: A context of developing B2B markets

ABSTRACT The present study analyses the responses of supply chain professionals facing certain ethical situations while performing their strategic tasks. The objective of this empirical investigation is to link the six dimensions of moral intensity (magnitude of consequences, proximity, probability of effect, social consensus, temporal immediacy, and concertation of effect) and two dimensions of ethical ideology (idealism and relativism) with three sequential phases of EDM (Ethical Decision Making), i.e. recognition, judgement, and intention, while purchasers are exposed to ethical dilemmas in B2B context. A mixed experimental research methodology was employed to analyse the responses of 289 purchasing professionals from a developing country. Six dimensions of moral intensity were manipulated into three conditions (Low, High, and Control) using 18 originally constructed purchase scenarios. The study’s findings reveal that idealism, relativism, and moral intensity are associated mainly with ethical decision-making stages. Among four sets of ethical ideologies, absolutists were found to be more ethical. The study concludes by giving future research directions and implications for practitioners.

A Qualitative Evaluation of Ethical Dilemma and Ethical Decision-Making Situations of Social Workers Working in Different Fields in Turkey

Bu çalışmanın amacı, sosyal hizmet uzmanlarının etik ikilem ve etik karar vermeye ilişkin görüşlerini tespit etmektir. Bu araştırmada nitel yöntem kullanılmıştır. Araştırmanın örneklemini kartopu örneklem yoluyla ulaşılan ve farklı alanlarda çalışan 15 sosyal hizmet uzmanı oluşturmaktadır. Çalışmada demografik bilgi formu ve yarı yapılandırılmış görüşme formu kullanılmıştır. Çalışmada elde edilen veriler mesleki açıdan, çalışılan alan açısından, tutum açısından ve sosyal politika açısından olmak üzere 4 temada toplanmıştır. Katılımcıların tamamının etik ikilem ile karşılaştığı; genel olarak müracaatçının yararını düşündükleri; etik ikilem karşısında süpervizyona ihtiyaç duydukları; savunuculuk rolüne önem verdikleri ve hizmet içi eğitimi gerekli gördükleri bulgularına ulaşılmıştır. Ulaşılan bulgulara göre sosyal hizmet uzmanlarına hizmet içi eğitim verilmesi, müfredatlara etik konusunda daha fazla ders saati eklenmesi, akademik çalışmaların arttırılması, politika ve mevzuatın etik ihlalleri göz önüne alarak düzenlenmesi ve sosyal hizmet uzmanlarına süpervizyon desteğinin arttırılması önerilmektedir.

Efek Narsisme dan Psikopati Terhadap Praktik Tidak Etis Akuntan

Personality factors play an important role when a person is faced with a situation that involves moral judgment of right or wrong. A person with dark personality characteristics (dark triad) is very likely to exhibit unethical behavior. Ethical behavior is an important issue for the accountant profession because published financial statements must be accountable to the public, especially for investors and creditors as parties who bear great risks in making their investment and credit decisions. Although many studies have examined the factors causing the unethical behavior of accountants, studies investigating the impact of accountants' dark personalities on ethical decision-making are still scarce. This study aims to examine the effect of two types of dark personalities, namely narcissism and psychopathy, on accountant decision making involving various business ethical situations. The study employed a quantitative approach with primary data obtained from questionnaires. Narcissism is measured through Narcisstic Personality Inventory, psychopathy is measured through Levenson Self-Report Psychopaty Scale, and attitude toward unethical practices used an instrument use d by Bailey (2019). The population was management accountants, public accountants, and public sector accountants with a sample of 103 respondents. Multiple linear regression analysis was performed to test the research hypotheses using SPSS software version 26. The results showed that accountants with dominant narcissistic and psychopathic personalities tend to make unethical decisions.

Ethics and frontline nursing during COVID-19: A qualitative analysis.

Nurses experienced intense ethical and moral challenges during the COVID-19 pandemic. Our 2020 qualitative parent study of frontline nurses' experiences during the COVID-19 pandemic identified ethics as a cross-cutting theme with six subthemes: moral dilemmas, moral uncertainty, moral distress, moral injury, moral outrage, and moral courage. We re-analyzed ethics-related findings in light of refined definitions of ethics concepts. To analyze frontline U.S. nurses' experiences of ethics during the COVID-19 pandemic. Qualitative analysis using a directed content methodology. The study included 43 nurses from three major metropolitan academic medical centers and one community hospital in the northeastern, mid-Atlantic, midwestern, and western United States. Participant privacy and data confidentiality were addressed. Moral dilemmas arose from many situations, most frequently related to balancing safety and patient care. Moral uncertainty commonly arose from lacking health information or evidence about options. Moral distress occurred when nurses knew the right thing to do, but were prevented from doing so, including with end-of-life issues. Moral injury (accompanied by suffering, shame, or guilt) occurred after doing, seeing, or experiencing wrongdoing, often involving authority figures. Nurses expressed moral outrage at events and people within and outside healthcare. Despite difficult ethical situations, some nurses exemplified moral courage, sometimes by resisting policies they perceived as preventing compassionate care, guided by thinking about what was best for patients. This content analysis of ethics-related subthemes revealed conceptual characteristics and clarified distinctions with corresponding exemplars. Conceptual clarity may inform responses and interventions to address ethical quandaries in nursing practice. Ethics education in nursing must address the moral dilemmas of pandemics, disasters, and other crises. Nurses need time and resources to heal from trying to provide the best care when no ideal option was available.

Connecting Ethical Reasoning to Global Challenges through Analysis of Argumentation.

Scientific literacy is built on critical thinking. The postbaccalaureate workforce enhances our economies and societies by contributing a wealth of knowledge and skill sets to local communities, respective industries, and beyond as our world becomes increasingly interconnected. Education in scientific literacy should teach students how to learn about science and how to cultivate and communicate a positive attitude about science. Learners in a 200-level nonmajors biotechnology course engaged with a series of ethical dilemmas after mastering the basic elements of argument structure and advanced tools in argument evaluation. To introduce collaboration as a constructive process in undergraduate education, student interactions with peers require guidance, flexibility, and compassion to learn from each other. Students gain critical thinking mastery from two modules addressing how we argue and evaluate claims. Students apply these critical thinking skills to various ethical arguments involving responsible conduct of research training. Using our structured and interdisciplinary approach, new scholars learn through practice how to read, analyze, and evaluate research scenarios and respond to potential ethical situations. This strategy allows students to develop important scholarly skills, including a systematic approach to evaluating credibility and applying generosity to theirs and others' understanding of their circumstances.

‘I’m aware of that, but … ’: breaking the silence on moral distress among language teachers

ABSTRACT Moral distress (MD) is defined as knowing what to do in an ethical situation but being unable to do it. Although this definition was originally meant for healthcare practitioners, it is instantly recognised by those in the teaching profession. This study adopted Q methodology to identify and characterise foreign language teachers’ viewpoints regarding morally distressing situations. Thirty-three teachers of English as a foreign language (EFL) performed a card-sorting task. The sources of MD were characterised into three categories: limited control, violation of personal values and lack of voice. Teachers may be reluctant to pathologise MD because it can arise within everyday scenarios. The findings contribute to the development of supportive strategies for EFL teachers in response to various sources of MD.

Pre-deployment aggressiveness, combat exposure and moral injury as contributors to posttraumatic stress symptoms among combatants: A two-year prospective study

Combatants who are exposed to events which transgress deeply held moral beliefs might face lasting psychopathological outcomes such as Moral Injury (MI) and posttraumatic stress symptoms (PTSS). However, insight about pre-deployment personality factors which might facilitate the MI process and its negative consequences is sparse. In this prospective study, we examined pre-deployment aggressiveness as a possible predictor of exposure to combat and potentially morally injurious events (PMIEs), trauma-related guilt and shame and PTSS among Israeli active-duty combatants. A sample of 335 active-duty Israeli combatants participated in a 2.5-year prospective study with three waves of measurements (T1: 12 months before enlistment, T2: 6 months following enlistment-pre deployment, and T3: 18 months following enlistment-post deployment). Participants' characteristics were assessed via semi-structured interviews (T1) and validated self-report measures of aggressiveness (T2), combat exposure, PMIEs and PTSS (T3) between 2019 and 2021. Results show that higher levels of pre-deployment aggressiveness predicted both combat exposure and PMIEs-‘betrayal’. Combat exposure mediated the association between aggressiveness and PTSS post deployment. Importantly, pre-deployment aggressiveness was significantly associated with the PMIEs-‘betrayal’ that are associated with trauma-related guilt and shame, which in turn were associated with high levels of PTSS post deployment. Our results highlight the implications of pre-deployment aggressiveness for different forms of exposure to potentially traumatic events during military service. Identification of at-risk combatants for PTSS following exposure to PMIEs of betrayal might provide these combatants with a tailor-made type of preparation regarding moral and ethical situations, which should be investigated in future studies.

Moral Injury and Pre-Deployment Personality Factors as Contributors to Psychiatric Symptomatology among Combatants: A Two-Year Prospective Study

IntroductionCombatants who are exposed to events which transgress deeply held moral beliefs might face lasting psychopathological outcomes, referred to as Moral Injury (MI). However, knowledge about pre-deployment factors which might moderate the negative consequences of MI is sparse.ObjectivesIn this prospective study, we examined pre-enlistment characteristics and pre-deployment personality factors as possible moderators in the link between exposure to potentially morally injurious events (PMIEs) and psychiatric symptomatology among Israeli active-duty combatants.MethodsA sample of 335 active-duty Israeli combatants participated in a 2.5-year prospective study with three waves of measurements (T1: 12 months before enlistment, T2: 6 months following enlistment- pre deployment, and T3: 18 months following enlistment- post deployment). Participants’ characteristics were assessed via semi-structured interviews (T1) and validated self-report measures of personality factors: emotional regulation, impulsivity, and aggression (T2) and combat exposure, PMIEs, psychiatric symptomology and post traumatic symptoms (T3) between 2019-2021.ResultsPre-enlistment psychiatric difficulties and negative life events contributed to higher exposure to PMIEs post deployment. Higher levels of pre-deployment aggression and lower levels of emotional regulation and impulsivity moderated the association between betrayal, PMIEs and psychiatric symptomology post deployment, above and beyond pre-enlistment psychiatric difficulties and life events.ConclusionsOur results highlight that pre-deployment emotional regulation, impulsivity and aggressiveness levels should be assessed, screened, and identified among combatants, as they all facilitate psychiatric symptomology (and PTSS) after combatants are exposed to PMIEs of betrayal. Such pre-assessment will enable identification of at-risk combatants and might provide them with tailor made preparation regarding moral and ethical situations that should be investigated in future researches.Disclosure of InterestY. Levi-Belz: None Declared, G. Zerach Shareolder of: no, Grant / Research support from: no, Consultant of: no, Employee of: no, Paid Instructor of: no, Speakers bureau of: no

Investigating the Relationship Between Nurses’ Attitude and Ethical Sensitivity Ability Towards the Elderly - A Case Study

Background: Older adults need more specialized care due to their complex conditions, and each part of the healthcare system plays a specific role. In addition, nurses have the most human relationship regarding patient duration and depth. Therefore, the quality of providing care to the elderly is influenced by many factors, including nurses’ attitudes and ethical sensitivity. Objectives: This study aimed to determine the relationship between nurses’ attitudes and ethical sensitivity ability towards the elderly in hospitals and their effective factors. Methods: This descriptive-analytical study was conducted on selected (training and non-training) hospitals affiliated with the Ilam University of Medical Sciences, Iran, in 2022. The population included 380 nurses, who were selected by random sampling. The data were collected using two questionnaires, including the standard questionnaire on nurses’ ethical sensitivity in decision-making and Kogan’s Attitudes Toward Old People Scale (Kogan OP Scale). Finally, the data were analyzed by descriptive-inferential statistical tests and SPSS software version 24. Results: The results showed no significant difference between the mean score of nurses’ ethical sensitivity and attitudes (P = 0.807). In addition, no significant relationship was found between the level of ethical sense and individual characteristics of nurses, including age, gender, education level, marital status, work experience, workplace sector, and nursing work type (P > 0.05). However, a significant relationship was found between age and attitude (P = 0.031). Conclusions: Nurses have to deal with many ethical situations when caring for elderly patients, so a positive attitude is essential when dealing with the elderly. As a result, nurses respect the rights of elderly patients to make decisions and preserve their independence. Further, educational programs such as workshops and continuous training courses can help develop nurses’ ethical sensitivity.

Exploring ethical challenges in Singapore physiotherapy practice: Implications for ethics education

Introduction: Workplace contexts, including political and sociocultural systems influence health professions’ perception and experience of ethical issues. Although established health ethics principles are relevant guiding values, they may be experienced and interpreted differently within different health contexts. How should ethics education account for this? This paper presents ethical dilemmas and concerns encountered by physiotherapists practicing in Singapore and discusses the implications for ethics education. Methods: Qualitative methods informed by interpretivism and phenomenology were employed. In-depth interviews with 42 physiotherapists from different workplace settings in Singapore were conducted. Participants described everyday ethical challenges they encountered. Inductive content analysis was used to analyse the interview transcript data. Results: Ethical issues occurred within and across three spheres of ethics: micro, meso and macro. Ethical issues at the micro sphere centered around physiotherapist-patient relationships, interactions with colleagues, and therapists’ feelings of moral distress. In the meso sphere, ethical challenges related to influences arising from the organizational resources or systems. In the macro sphere, ethical challenges developed or were influenced by sociocultural, religious, economic, and political factors. Conclusion: The findings reflect current literature indicating that context can influence ethical situations, as experienced and perceived by physiotherapists in their unique settings. Such empirical data might inform the development of ethics curricula to ensure that universal ethical principles are situated within the realities of clinical practice. Locally relevant and realistic ethical case studies will better enable students to recognise and address these situations.

Incorporating Faith into Ethics Education.

Preparing students for ethical situations they will face in practice should be incorporated into nursing curricula, especially programs with a Christian focus. Linking ethical concepts with tenets from Scripture can increase students' confidence in their ability to respond through a biblical worldview to ethical dilemmas in nursing practice. Specific assignments can be geared to help students think critically about the Code of Ethics for Nurses with Interpretive Statements (Code) and biblical responses to ethical situations. Sample assignments are presented for the nine provisions of the Code.

Ethical issues in community development: setting the scene

AbstractThis article introduces a special issue of the Community Development Journal designed to explore aspects of community development through an explicitly ethical lens. Arguing for a broad understanding of ethics as inextricably linked to practice and politics, it introduces the concept of ‘ethics work’ to capture the cognitive and emotional efforts community development workers expend to identify and handle matters of responsibilities, rights, harms, and benefits. Drawing inspiration and illustrations from contributions to the special issue, the article identifies ethical questions and concerns at three inter-related levels: micro (everyday relationships and interactions), meso (strategies for community development engagement and action), and macro (distribution of power and resources). After examining case examples of micro- and meso-ethical encounters, the article moves to consideration of macro-ethical questions linked to the political context of community development as a movement or project. The importance of interrogating the contradictory ideologies underpinning community development is stressed, ensuring the ethical lens is broad and versatile enough for practitioners to view their work reflexively with reference to postcolonial, postmodern, and posthuman perspectives. The article concludes with a call for a situated ethics of eco-social justice, seeing ethics as embedded in everyday practice while located in political and ecological contexts.

ETHICAL CONSIDERTIONS IN USAGE OF TWITTER DATA

Internet-based data, especially the ability to extract and analyze data from social media such as Twitter, is becoming more prevalent in providing data in empirical research. The public nature of Twitter and its more open access to data, compared to other social media, as well as the approval to use that data in accordance with the Twitter’s Terms of Service were considered a sufficiently ethical justification for the use of Twitter data in research. This tendency to collect data from the Internet, that is from social networks, in social research, has prompted a number of scientific societies to develop ethical guidelines for Internet research. This paper provides an overview of the recommendations contained in the ethical guidelines, compared to the requirements set out in the Twitter’s Terms of Service. Additionally, research on social media users’ perceptions regarding the use and publication of their data is analyzed. The tendency to apply the principle of situational ethics is evident in the ethical guidelines, starting from the existing collision between the established ethical principles for scientific research and the privacy policy on Twitter. However, there is a lack of consensus among ethical guidelines in determining the appropriate way of collecting, processing and presenting data in research and scientific publications. Also, in research on the perception of social media users, there is a significantly lower concern about the use of data by Twitter users, compared to users of other platforms. But in spite of that, the prevailing opinion among them is the need for prior consent for the use of their data in research and scientific publications, with a special emphasis on the request for anonymity. Given the complexity of this debate, which ultimately aims to preserve the academic integrity of research, the conclusion points to the need to summarize the various ethical aspects in establishing a methodological approach in studies that use Twitter data.

Medical-ethical decision-making-contribution of the clinical ethics committee by ethics consultation and development of ethical guidelines

Medical-ethical decision-making ranges between the poles of the medical indication on the one hand and the will of the informed and advised patient on the other, which do not necessarily have to coincide. Even if the definitive choice of action is made by the attending physician/the treatment team, it is particularly helpful in problematic conflicting situations to set up the corresponding decision-making as broadly as possible, with the result that ultimately an appropriate, acceptable, and well-founded decision is made for all parties involved. The clinical ethics committee (CEC) can perform the task of providing the most comprehensive and structured support possible in decision-making and problem-solving in amedical-ethical context with all its instruments of ethics consultation as well as by the development of "ethical guidelines". The CEC is not adecision-making body that makes unilateral decisions on its own authority and relieves the directly treating persons of the decision-making responsibility, but an advisory and supporting authority. For recurring, similar ethically sensitive questions, ethical guidelines can be created by the CEC of an institution with the aim of facilitating decision-making in acorresponding ethical problem situation. An ethical guideline provides orientation that can increase the quality of decision-making and relieve decision-makers ethically and legally. In doing so, the ethical guideline grants the decision-maker arange of possibilities by specifying ameaningful corridor for action, from which, in justified cases, deviations can also be made after individual evaluation.