American pragmatism as a guide for professional ethical conduct for engineers

The ethical choices faced by engineers today are increasingly complex. Competing and conflicting ethical demands from clients, communities, employees, and personal objectives combine to suggest that engineers employ ethical approaches that are adaptive yet grounded in three concrete professional circumstances: first, that engineers apply unique professional skills in the service of a client, subject to protecting the public interest; second, that engineers advance the state of knowledge of their professional field through reflection, research, and sharing experience in journals and conferences, and third, that they develop new professionals by active mentoring. This paper examines five features of American pragmatism and suggests that its emphasis on specific, context-based ethical decision making can assist engineers in a postmodern setting. In particular, it considers the venues of interpersonal ethical choices, institutional ethical conflicts, and social choices that have ethical components. Pragmatism suggests that in such a complex ethical climate, there is a need for the co-evolution of judgment and action, for individual reflective judgment in particular situations, and for ceasing to search for a single, immutable principle for ethical choice. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

The complex challenges of ethical choices by engineers in public service

This paper proposes that engineers in public service are confronted with unavoidable complexity in their ethical considerations. The complexity begins with interactions among venues of ethical choices. Engineers must make ethical choices simultaneously at the individual, professional, organizational and societal levels. These ethical domains often conflict. The complexity also stems from situations in which physical properties may remain stable, but important social, economic, institutional and political conditions can change substantially. The paper proposes that the reflective learning approach of pragmatism can help with these challenging situations. This approach depends upon employing Dewey’s five stage process of inquiry to engage the ethical complexity inherent in the practice of engineering in the public service. An earlier version of this paper was presented at the 2005 conference, Ethics and Social Responsibility in Engineering and Technology, Linking Workplace Ethics and Education, co-hosted by Gonzaga University and Loyola Marymount University, Los Angeles, CA, USA, 9–10 June 2005.     

Therapeutic misconceptions: when the voices of caring and research are misconstrued as the voice of curing

Research on doctor-patient communication has characterized such interactions as being asymmetrical. The present article tries to shift emphasis away from the different orientations individuals bring to the communicative setting and attempts to highlight the different orientations ("voices") within a given individual. We draw on an in-depth analysis of discourse between a 21-year-old man who can be ascribed the roles of both patient and potential research subject and an interviewer who acts in both the role of medical staff and researcher. Focusing our analysis on a limited number of linguistic forms (pronouns and demonstratives), it is argued that the use of the same form for different referents signals a conflation of two voices -- the voice of health care ("caring") and the voice of "research." Furthermore, we argue that the voice of research is most likely to be interpreted by the patient/research subject within the framework of curing. As such, the present article promotes a shift in emphasis from different institutional -- and as such often assumed to be preexisting -- orientations between the communicating parties to differing orientations within the individual that cannot help but be misconstrued in terms of the curing voice. Our conclusion focuses on the ethical and discourse analytic implications of analyzing voices in a discussion.     

How Can Ethics Support Innovative Health Care for an Aging Population?

The rapidly expanding aging population presents an urgent global challenge cutting through just about every dimension of worldly life, including the social, political, cultural, and economic. Developing innovations in health and assistive technology (AT) are poised to support effective and sustainable health care in the face of this challenge, yet there is scant (but growing) discussion of the ethical issues surrounding AT for older persons with dementia. Demands for ethical frameworks that can respond to frontline dilemmas regarding AT development and provision, and how the needs of aging persons themselves are defined throughout this development process, are increasing. This article suggests that fulfilling the promises of AT to provide effective and ethically informed solutions may demand shifting away from standard bioethical analyses that centralize the principle of respect for autonomy. An autonomy-centric paradigm is dubiously equipped to theorize the foundational ethical issues in dementia care and to effectively guide AT development and implementation. An agency-centered approach to dementia care, which could engage more adaptively with the perspectives and choices of older persons themselves while offering strong support to AT research and stakeholders, may offer an attractive alternative.     

Child Welfare Versus Parental Autonomy: Medical Ethics,The Law,and Faith-Based Healing

Over the past three decades more than 200 children have died in the U.S. of treatable illnesses as a result of their parents relying on spiritual healing rather than conventional medical treatment. Thirty-nine states have laws that protect parents from criminal prosecution when their children die as a result of not receiving medical care. As physicians and citizens, we must choose between protecting the welfare of children and maintaining respect for the rights of parents to practice the religion of their choice and to make important decisions for their children. In order to make and defend such choices, it is essential that we as health care professionals understand the history and background of such practices and the legal aspects of previous cases, as well as formulate an ethical construct by which to begin a dialogue with the religious communities and others who share similar beliefs about spiritual healing. In this paper, we provide a framework for these requirements.     

Nursing considered as moral practice: a philosophical-ethical interpretation of nursing

Discussions of ethical approaches in nursing have been much enlivened in recent years, for instance by new developments in the theory of care. Nevertheless, many ethical concepts in nursing still need to be clarified. The purpose of this contribution is to develop a fundamental ethical view on nursing care considered as moral practice. Three main components are analyzed more deeply -- i.e., the caring relationship, caring behavior as the integration of virtue and expert activity, and "good care" as the ultimate goal of nursing practice. For the development of this philosophical-ethical interpretation of nursing, we have mainly drawn on the pioneering work of Anne Bishop and John Scudder, Alasdair MacIntyre, Lawrence Blum, and Louis Janssens. We will also show that the European philosophical background offers some original ideas for this endeavor.     

Parallel,Embedded or Just Part of the Team: Ethicists Cooperating Within a European Security Research Project

Different methods have been developed to address ethical issues during research. Most of these methods were developed at universities. In this article ethical parallel research within a Research and Technology Organization is described. Within a European project about perceived security, CPSI, the ethical issues were identified by ethicists cooperating in the project. The project CPSI was aimed at developing a research method that can be used by (local) government to monitor or assess perceived and actual security. Together with the researchers a way was sought to address the ethical issues. Several issues could be addressed by choices with regard to the design of the validation study, in this case a survey. The ethical and legal reasons that were relevant for choices in the design of the validation study were made an integral part of these decisions. Some issues were already identified during the writing of the proposal others were only identified during the research. Participating in the research gave the ethicists access to all relevant information. It made it possible to address the ethical issues when they became relevant. Ethical reasons were part of some of the discussions on research method. It proved possible to address most ethical issues satisfactorily during the research project.     

To stay or to go, to speak or stay silent, to act or not to act: moral distress as experienced by psychologists

The moral distress of psychologists working in psychiatric and mental health care settings was explored in an interdisciplinary, hermeneutic phenomenological study situated at the University of Alberta, Canada. Moral distress is the state experienced when moral choices and actions are thwarted by constraints. Psychologists described specific incidents in which they felt their integrity had been compromised by such factors as institutional and interinstitutional demands, team conflicts, and interdisciplinary disputes. They described dealing with the resulting moral distress by such means as silence, taking a stance, acting secretively, sustaining themselves through work with clients, seeking support from colleagues, and exiting. Recognizing moral distress can lead to a significant shift in the way we perceive moral choices and understand the moral context of practice.     

Bioethics and the marginalization of mental illness

This paper explores why ethical issues associated with mental illness have been generally neglected in the literature and texts of the discipline of bioethics. I argue that the reasons for this are both philosophical and structural, involving the philosophical framework of principlism in bioethics, in particular the privileging of the principle of autonomy, and the institutional location and disciplinary boundaries of bioethics as a profession. Other contributing factors include developments outside of bioethics, in medicine and law and in the delivery patterns and funding sources of mental health services, and above all the pervasive stigma that attaches to mental illness. My goal is to show both how the attention bioethics could bring would benefit this neglected area of health care, and why attending to the issues surrounding mental illness would benefit bioethics in meeting its professional obligations as the public voice on matters of ethical significance in health care.     

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.     

Getting Beyond Form Filling: The Role of Institutional Governance in Human Research Ethics

It has become almost a truism to describe the interaction between research ethics committees and researchers as being marred by distrust and conflict. The ethical conduct of researchers is increasingly a matter of institutional concern because of the degree to which non-compliance with national standards can expose the entire institution to risk. This has transformed research ethics into what some have described as a research ethics industry. In an operational sense, there is considerable focus on modifying research behaviour through a combination of education and sanctions. The assessment of whether a researcher is ‘ethical’ is too often based on whether they submit their work for review by an ethics committee. However, is such an approach making a useful contribution to the actual ethical conduct of research and the protection of the interests of participants? Does a focus on ethical review minimise institutional risk? Instead it has been suggested that ethics committees may be distorting or frustrating useful research and are promoting a culture of either mindless rule following or frustrated resistance. An alternative governance approach is required. There is a need for a strong institutional focus on promoting and supporting the reflective practice of researchers through every stage of their work. By situating research ethics within the broader framework of institutional governance, this paper suggests it is possible to establish arrangements that actually facilitate excellent and ethical research.     

Resolving Ethical Dilemmas in Management: Experimental Investigations of Values, Accountability, and Choice

Hypotheses regarding the effects of personal values and accountability on the resolution of ethical dilemmas in management were formulated and tested experimentally with a sample of 135 M.B.A. students. Personal values were found to be related to how subjects chose to resolve an ethical dilemma presented to them; but, as expected, this relationship did not hold when subjects were made to feel accountable to another for their choices. Accountability, unexpectedly, however, did not have a main effect on choices. This lack of an effect tentatively was attributed to the inexplicitness of the accountability manipulations. In a second and third experiment, support for the importance of explicitness in accountability research was obtained. The theoretical and practical implications of the findings from all three experiments were discussed.     

Ethics in violence against women research: the sensitive, the dangerous, and the overlooked

Traditional disciplinary guidelines are inadequate to address some of the ethical dilemmas that emerge when conducting research on violence against women and girls. This article is organized according to the ethical principles of respect for persons, privacy and confidentiality, justice, beneficence, and nonmaleficence. In the article, I describe dilemmas involved in cross-cultural research, research on children, informed consent, voluntariness, coercion, deception, safety, mandated reporting, and dissemination. In the article, I include examples from qualitative and quantitative studies in many nations. I also offer suggestions for researchers and institutional review boards.     

Counseling Prisoners: Ethical Issues,Dilemmas, and Cautions

Counseling prisoners involves multiple ethical and therapeutic choices and risks. Prison environments emphasize external control and security. Thus, work in such settings challenges the role of the counselor as a facilitator of client responsibility for independent decision making.     

Ethics Consultant: Problem Solver or Spiritual Counselor?

The primary goal of ethics consultation should be to provide effective assistance to patients and families in obtaining care that is duly responsive to their rights and their needs. The consultation reported by Mark Bliton fails in this regard because it never ascertains why the consultation was called; makes little attempt to ascertain the motives of those involved; avoids exploration of the ethical concerns of family, attending or staff; makes no connection with institutional policies or practices; uncritically adopts and serves the medical treatment ethos; and substitutes fellowfeeling for compassionate action.     

Kierkegaard’s Analysis of Human Existence in Either/Or: There is No Choice Between Aesthetics and Ethics

Abstract

According to Alasdair MacIntyre, Kierkegaard fails to provide rational reasons to choose between an aesthetic lifestyle and an ethical lifestyle. This claim subsequently initiated a significant discussion that investigated whether one can rationally choose between ethics and aesthetics. I will be challenging both MacIntyre’s criticism and in large part the basis of the subsequent discussion by arguing that there is no choice between aesthetics and ethics at all. Specifically, I will be arguing that in Either/Or Kierkegaard demonstrates that the essence of human existence is the freedom to make choices. Given that the ethical is the existential reality of having to make choices, human existence is therefore necessarily ethical. This conclusion follows from my thesis that the essential difference between the aesthete and the ethicist in Either/Or is their opposing views on whether choices are necessary elements of experience.     

Responses of School Psychologists and Special Education Teachers to Administrative Pressures to Practice Unethically

Abstract

Responses of school psychologists (N = 141) and special educators (N = 130) to ethical dilemmas involving conflicts between administrative directives and ethical obligations were examined. Respondents completed a survey asking them to predict their own and others' responses to four ethical dilemmas. The majority of respondents predicted that they, immediate colleagues, and professional peers would make the choices judged as ethical in all situations. Predictions of ethical response were highest for self prediction and varied across the four dilemmas. Respondents who viewed their immediate colleagues as supportive of autonomous decision making were more likely to predict ethical choices than those who viewed their colleagues as supporting deference to administrative authority. No differences in predictions related to gender, degree level, job security, preservice training in or knowledge of professional ethics or special education law were found.