Being, Doing, and Knowing: Developing Ethical Competence in Health Care

There is a growing interest in ethical competence-building within nursing and health care practising. This tendency is accompanied by a remarkable growth of ethical guidelines. Ethical demands have also been laid down in laws. Present-day practitioners and researchers in health care are thereby left in a virtual cross-fire of various legislations, codes, and recommendations, all intended to guide behaviour. The aim of this paper was to investigate the role of ethical guidelines in the process of ethical competence-building within health care practice and medical research. A conceptual and critical philosophical analysis of some paragraphs of the Helsinki Declaration and of relevant literature was performed. Three major problems related to ethical guidelines were identified, namely, the interpretation problem (there is always a gap between the rule and the practice, which implies that ethical competence is needed for those who are to implement the guidelines); the multiplicity problem (the great number of codes, declarations, and laws might pull in different directions, which may confuse the health care providers who are to follow them); and the legalisation problem (ethics concerns may take on a legal form, where ethical reflection is replaced by a procedure of legal interpretations). Virtue ethics might be an alternative to a rule based approach. This position, however, can turn ethics into a tacit knowledge, leading to poorly reflected and inconsistent ethical decisions. Ethical competence must consist of both being (virtues) and doing (rules and principles), but also of knowing (critical reflection), and therefore a communicative based model is suggested.     

Custody Evaluations: Critical Contextual and Ethical Considerations

The area of custody evaluation is fraught with anxiety and tension for parents and children as well as therapists. This article encourages the use of a set of lenses that explores individual and family members' relationships within a variety of contexts. To advance the reader's understanding, a model employing various levels and domains will be presented and described. A variety of critical ethical issues, and challenges often encountered by therapists are also examined.     

人工神经网络在临床应用中的伦理思考

现代临床医学中的海量信息具有非线性特质,人工神经网络的自我学习、记忆和归纳功能,刚好适应了医学的新发展,在医学领域有良好的应用前景。事实上,人工神经网络临床应用的理论研究成果丰富,但商业应用并不多见。本文探讨人工神经网络在临床应用中可能引发的社会伦理争议,对其临床适用范围进行初步的论述。     

Evidence-Based Practice in Psychology: An Ethical Framework for Graduate Education,Clinical Training,and Maintaining Professional Competence

Evidence-based practice is often acknowledged as the future state of psychology, yet those graduate students who will soon be applying such practices tend to hold several misconceptions about the major components within this framework. This review highlights implications for graduate education, clinical training, and professional competence in light of the movement toward evidence-based practice in psychology. These implications are discussed in relation to the close parallel between the major components of the evidence-based framework and the current Ethical Principles of Psychologists and Code of Conduct. The evidence-based framework is discussed as an ideology that promotes lifelong learning and best prepares graduate students for ethical clinical practice throughout their careers as psychologists.     

Assent and Dissent: Ethical Considerations in Research With Toddlers

In accordance with ethical principles and standards, researchers conducting studies with children are expected to seek assent and respect their dissent from participation. Little attention has been given to assent and dissent in research with toddlers, who have limited cognitive and emotional capabilities. We discuss research with toddlers in the context of assent and dissent and propose guidelines to ensure that research with toddlers still adheres to ethical principles. These guidelines include designing engaging studies, monitoring refusal and distress, and partnering with parents. Research with toddlers requires flexibility and creativity to respect toddlers in the context of their developmental capabilities.     

Ethical Considerations in Crisis and Humanitarian Interventions

The need for professionals to volunteer their time in crisis situations and to reach across time and culture in the service of humanitarian interventions will likely not abate in the near future. This article provides readers with multiple venues for considering the ethical dimensions present in crisis and humanitarian interventions. Core ethical concerns common to helping situations are magnified in crisis work. In addition, issues unique to the nature of volunteer and crisis work must also be considered. Using hypothetical case examples, bioethical principles, and ethical decision-making models, helping professionals are encouraged to go beyond their particular ethical codes in contemplating ethically and clinically sensitive volunteering.     

Ethical and Regulatory Considerations for Using Social Media Platforms to Locate and Track Research Participants

As social media becomes increasingly popular, human subjects researchers are able to use these platforms to locate, track, and communicate with study participants, thereby increasing participant retention and the generalizability and validity of research. The use of social media; however, raises novel ethical and regulatory issues that have received limited attention in the literature and federal regulations. We review research ethics and regulations and outline the implications for maintaining participant privacy, respecting participant autonomy, and promoting researcher transparency when using social media to locate and track participants. We offer a rubric that can be used in future studies to determine ethical and regulation-consistent use of social media platforms and illustrate the rubric using our study team’s experience with Facebook. We also offer recommendations for both researchers and institutional review boards that emphasize the importance of well-described procedures for social media use as part of informed consent.     

Financial and Ethical Considerations for Professionals in Psychology

The profession of psychology is one of many entities affected by the current economic recession. The question of what to do when clients cannot pay agreed-upon charges will need to be answered. Ethical issues related to setting the fee for psychotherapy, insurance coverage, abandonment, pro bono psychotherapy, and lack of resources are addressed in light of the 2002 American Psychological Association's Ethical Principles of Psychologists and Code of Conduct and other relevant literature. The impact of the Mental Health Parity Act on the financial complexities that professionals in psychology now face is also discussed. Several recommendations are made for psychologists, calling them to be proactive in their communities, to be advocates for their clients, and to critically evaluate their financial practices.     

Ethical and Legal Considerations for Internet-Based Psychotherapy

The provision of mental health services over the Internet is becoming increasingly commonplace as new technologies continue to develop. Evidence in support of the efficacy of many such interventions is accumulating. Given the potential global reach of Internet-based psychological services, the authors examine ethical issues relating to this growing area of practice through the lens of the Universal Declaration of Ethical Principles for Psychologists (International Union of Psychological Science, 2008). They also raise issues relating to potential liability risks and offer recommendations intended to guide mental health practitioners who are considering involvement in the provision of Internet-based services.     

Including a Spiritual Dimension in Family Therapy: Ethical Considerations

The inclusion of a spiritual dimension in family therapy theory and clinical practice may well be viewed as an important professional challenge of the nineties. Following a working definition of terms, this paper explores the ethical complexities inherent in operationalizing a spiritual orientation in therapy in light of the following principles adopted from medical ethics: Respect for clients' autonomy, safeguarding clients' welfare, protecting them from harm, and treating them justly and honestly.     

Development of Social Problem Solving in Early Childhood: Stability,Change, and Associations With Social Competence

Kindergarten and 1st-grade boys were administered social cognitive interviews in 2 consecutive years to investigate the response-generation step of N. R. Crick and K. A. Dodge's (1994) social information processing model. Boys generated responses to 4 types of hypothetical social dilemmas. Responses to these situations were primarily prosocial, with a large minority of avoidant and antisocial solutions. In general, older boys provided more effective solutions than did their younger peers, and stabilities were modest but significant for subcategories of both prosocial and antisocial responses. Boys who were accepted by their peers provided more prosocial and effective solutions than did boys of lower peer status, but no status differences emerged for antisocial responses. The data also suggest that young children view aggression as an acceptable means to solving peer conflict.     

When Low-Warmth Targets Are Liked: The Roles of Competence,Gender, and Relative Status

Previous research has shown that people use warmth and competence as basic dimensions to evaluate others and to interpret their behavior, but little research has examined the conditions under which low-warmth targets are liked. A series of 3 experiments involving 4 vignettes showed, in general, that low-warmth targets were better liked when they exhibited higher competence and that high-status persons displayed greater tolerance toward the low-warmth person of low status. Exceptions to these patterns were predicted and found as a function of the type of organizational context in which evaluations were made: groups that place priority on individual goals over common goals and groups that are performance oriented rather than relationship oriented. Target gender interacted with competence and relative status.     

童年中期儿童社会能力与学业成就的交叉滞后研究

本研究采用同伴提名法、问卷法,对武汉市一所小学3、4、5、6年级儿童进行6个月的追踪调查。采用交叉时序滞后设计,考察了同伴关系4个特征水平(群体水平、双向关系水平、人际互动水平和个体特征水平)的变量与学业成就的相互预测关系。结果表明,在控制了前测学业成就后,前测的社会喜好、积极友谊质量、社交领导行为可以分别正向预测后测的学业成就,而前测的攻击行为可以负向预测后期的学业成就;在控制了前测的社交自我知觉后,学业成就可以正向预测后期的社交自我知觉。     

大学生社会能力的类型特征

本研究的前期研究确定了大学生的三种社会能力,即事务处理能力、一般人际交往能力和建立与发展友谊的能力各自所包含的维度。本研究的目的在于进一步揭示这些能力因素在不同个体中的组合方式,概括大学生三种社会能力的类型特征。对1048名大学生的聚类分析发现,大学生的事务处理能力可分为5种类型：主动—干练型、退缩—犹豫型、积极—刻板型、积极—犹豫型;一般人际交往能力可分为4种类型：乐群—独立型、平和—被动型、取悦他人型和封闭—冷淡型;建立与发展友谊的能力可分为5种类型：积极和谐型、孤僻—冷漠型、期望友谊型、积极获取友谊型和不善表达型。     

Influence Opportunities and the Development of Argumentation Competencies in Childhood

Whether argumentation competencies are associated with the kind of influence opportunities children have in their lives is the focus of this study. The hypothesis is that when children have the opportunity to initiate and evaluate arguments, hear others make and examine arguments, and participate equally in resolving disputes, children are able to develop their argument skills. Four argumentation competencies associated with critical discussions of proposals are identified: creating consensus about problematic situations, advocating proposals, facilitating behavioral commitment, and integrating identities. Second, fourth, and sixth grade children completed tasks that assessed their influence opportunities and argument competencies. Children who perceived themselves to have many collaborative influence opportunities, that is, opportunities in which they could engage in mutual influence, had more highly developed argument competencies than children who did not have such opportunities. As predicted, this relationship occurred with the argument competencies of problem conception, proposal advocacy and facilitating commitment. Measures of non-collaborative influence opportunities were not associated with argument competencies. Together, the results suggest that discussions in which children are given the opportunity to influence and be influenced with arguments may provide the best context for children to develop their argument skills.     

Justice and Long-Term Care: A Theological Ethical Perspective

The relevance of justice for the current debate on long-termcare is explored on the basis of demographic and economic data,especially in the U.S. and Germany. There is a justice questionconcerning the quality and availability of long-term care fordifferent groups within society. Mapping the justice debateby discussing the two main opponents, John Rawls and RobertNozick, the article identifies fundamental assumptions in boththeories. An exploration of the biblical concept of the "optionfor the poor" and its influence on a new "ecumenical socialteaching from below" leads to the conclusion that a Christianethical account of long-term care will argue for a system thatguarantees decent care to every citizen. The German model ofSoziale Pflegeversicherung is presented as one possible optionfor putting this ethical guideline into political practice.In a final reflection, the role of religious affiliation forlong-term care is discussed by looking at empirical data andby naming seven dimensions of faith-driven long-term care.     

Ethical Challenges in the Treatment of Individuals With Intellectual Disabilities

The effective provision of psychotherapy services to individuals with intellectual disability requires consideration of ethical issues related to clinical competence, access to services, obligations to multiple parties, guardianship, and appropriate assessment practices. This article provides an overview of major ethical considerations with guidance for clarifying and resolving common ethical concerns. Psychologists are encouraged to expand access to psychotherapy services for this population while maintaining awareness of potential modifications, training needs, and boundaries of professional competence. The authors provide recommendations and resources for effective and ethical treatment of psychotherapy clients with intellectual disabilities.     

儿童孤独感与同伴关系、社会行为及社交自我知觉的研究

本研究采用同伴提名法和问卷调查法对3-6年级儿童共600名进行了研究,试图考察儿童孤独感与同伴关系、社会行为及社交自我知觉的关系。结果表明:(1)受欢迎组儿童的孤独感显著低于被拒绝组、被忽视组、有争议组和一般组;一般组儿童的孤独感显著低于被拒绝组和被忽视组。(2)社交自我知觉较高的儿童的孤独感显著低于社交自我知觉一般和较低的儿童,社交自我知觉一般的儿童的孤独感显著低于社交自我知觉较低的儿童。(3)高攻击型儿童的孤独感高于低攻击型儿童,但没有达到显著水平;高退缩型儿童的孤独感显著高于一般退缩型和低退缩型儿童,一般退缩型儿童的孤独感显著高于低退缩型的儿童。     

Social Competence and Eating Disorders: Development and Validation of the Anorexia and Bulimia Problem Inventory

Incompetence at solving interpersonal problems is a possible antecedent of anorexic and bulimic behaviors in college-age women. A role-play measure of interpersonal competence, the Anorexia and Bulimia Problem Inventory (ABPI), was developed empirically and then was tested in two validation studies. ABPI scores for two samples of college women were compared: a subclinical sample [extremely high scores on the Eating Attitudes Test (EAT)] and a control sample (extremely low EAT scores). Groups differed as predicted. The second study replicated and extended these findings. The ABPI scores of clinical, subclinical, and control samples of college women differed significantly. Bulimic bingers, purgers, and laxative users were least competent on the ABPI. A lack of group differences on the Helping Situations Inventory supported the ABPI's discriminant validity. A correlation between the ABPI and Beck Depression Inventory supported the ABPI's convergent validity. ABPI competence appears to be related to certain subtypes of eating disorders.     

The Ethics of Opinion in Academe: Questions for an Ethical and Administrative Dilemma

If we accept that all plagiarism is wrong, the issue is black and white. But are there more challenging questions that color the issue with shades of gray that may influence or help clarify the ethical underpinnings of the act? Does intent matter? Does the venue matter? Does the form of writing matter? What about a professor when working as a private citizen, rather than in his/her academic role? Might plagiarism be mitigated when there is no associated financial gain? Is a writer’s history that exhibits impeccable ethical integrity relevant? Should these factors, and/or other factors, even be considered in a university’s administrative response — or non-response? What might employing an ethical approach contribute to wrestling with the dilemma? The authors explore critical issues that might face a senior academic administrator when confronting the need to respond on behalf of a university to a charge of plagiarism leveled by an influential newspaper against a university professor for a social responsibility-focused opinion-editorial published in this newspaper.