The “Ought-Is” Problem: An Implementation Science Framework for Translating Ethical Norms Into Practice

Abstract

We argue that once a normative claim is developed, there is an imperative to effect changes based on this norm. As such, ethicists should adopt an “implementation mindset” when formulating norms, and collaborate with others who have the expertise needed to implement policies and practices. To guide this translation of norms into practice, we propose a framework that incorporates implementation science into ethics. Implementation science is a discipline dedicated to supporting the sustained enactment of interventions. We further argue that implementation principles should be integrated into the development of specific normative claims as well as the enactment of these norms. Ethicists formulating a specific norm should consider whether that norm can feasibly be enacted because the resultant specific norm will directly affect the types of interventions subsequently developed. To inform this argument, we will describe the fundamental principles of implementation science, using informed consent to research participation as an illustration.     

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.     

Dilemmatics in Public Sector Assessment: A Framework for Developing and Evaluating Selection Systems

This research examined the effects of a break (incubation) on solutions to a geometric insight problem. Experiment 1 showed that subjects receiving an analogical hint during incubation obtained more solutions than continuously working controls. Experiment 2 tested the hypothesis that incubation effects are due to the total time (including intermittant problem solving during incubation) spent on a problem. Subjects given relaxation instructions and no task during a problem-solving break were more successful than those who worked continuously for 20 min or were given demanding mental work as an intervening task. Self-report data supported the explanation that incubation effects are a result of covert effort and that the effectiveness of an analogical hint depends on the solver's ability to relate it to the problem.     

Navigating the Road Ahead: Public Health Challenges and the Interactive Systems Framework for Dissemination and Implementation

Public health is currently faced with an array of critical challenges and disconnects. Research and evaluation have identified a number of evidence‐based strategies for effecting behavior change at individual, group, organizational, and environmental levels, all of which hold promise for leading to substantial reductions in morbidity and mortality, and increased quality of life. Unfortunately, there is huge variability across the public health system in awareness of the value of using evidence to inform decision making, let alone in capacity to locate, assess, compare, select, justify, adapt, implement, and evaluate evidence‐based strategies, or to participate in building the evidence base for practice‐based innovations. As a result, many communities may not be benefitting from research‐tested and practice‐based strategies that could help them to meet their public health goals more efficiently and effectively. CDC's Interactive Systems Framework for Dissemination and Implementation (ISF), released in 2008, was designed to help close this gap between research and practice. This commentary identifies the ways in which the ISF framework is useful in addressing the research practice gap; revisits the elements of the framework that have continued to guide research and practice in fruitful ways; and highlights areas that need further development to meet current public health challenges. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Toward Modeling and Automating Ethical Decision Making: Design, Implementation, Limitations, and Responsibilities

One recent priority of the U.S. government is developing autonomous robotic systems. The U.S. Army has funded research to design a metric of evil to support military commanders with ethical decision-making and, in the future, allow robotic military systems to make autonomous ethical judgments. We use this particular project as a case study for efforts that seek to frame morality in quantitative terms. We report preliminary results from this research, describing the assumptions and limitations of a program that assesses the relative evil of two courses of action. We compare this program to other attempts to simulate ethical decision-making, assess possibilities for overcoming the trade-off between input simplification and output reliability, and discuss the responsibilities of users and designers in implementing such programs. We conclude by discussing the implications that this project highlights for the successes and challenges of developing automated mechanisms for ethical decision making.     

The Development of a Standardized Assessment Framework for Animal Exhibits

Science centers, zoos, and aquariums share the common goal of engaging visitors in learning about the physical and natural world. Exhibits in zoos and aquariums, however, focus primarily on living organisms. Interactive exhibits are less common in these institutions and this differentiates the way visitors engage with exhibits from that of a typical science center visit. Based on the usefulness of the Visitor-Based Learning Framework (Barriault &; Pearson, 2010 Barriault, C. L., &; Pearson, D. (2010). Assessing exhibits for learning in science centres: A practical tool. Visitor Studies, 13(1), 90–106. doi:10.1080/10645571003618824[Taylor &; Francis Online] , [Google Scholar]) as an exhibit assessment tool in science centers, the purpose of this research was to develop a similar tool that assesses the potential learning impact of live animal exhibits in zoos and aquariums. A comprehensive framework of learning-related behaviors was developed and field-tested with a total of 900 visitors. The resulting Visitor-Based Assessment Framework for Animal Exhibits provides zoo and aquarium researchers and practitioners with a valuable tool to assess exhibits through observable behavioral indicators.     

The Interactive Systems Framework for Dissemination and Implementation: Enhancing the Opportunity for Implementation Science

This article reflects on the progress made in the development of the Interactive Systems Framework (ISF) for Dissemination and Implementation in recent years. Considering the ISF in the context of the broader field of dissemination and implementation research, the author offers commentary on the strengths of the framework and opportunities for further expansion and refinement.     

A Comprehensive Framework for the Analysis of Ethical Behavior,with a Focus on Sales Organizations

A model describing the process of ethical decision making is proposed. This model, termed the Ethical Decision/Action Process (EDAP), expands on the scope of prior models, and uses a four-component moral decision structure as its central focus. The behaviors which take place within the moral decision structure are influenced by the decision maker's characteristics and decision outcomes, and can vary in light of situational moderators. Research results related to the model configuration are presented and analyzed, drawn from selling, sales management, and other settings. Research and management implications are provided.     

Culturally Sensitive Family Assessment: An Evaluation of the Family Assessment Device Used with Hawaiian-American and Japanese-American Families

This article reports the results of a study of the McMaster Family Assessment Device (FAD) used with samples drawn from two non-Anglo ethnic groups: Hawaiian-Americans and Japanese-Americans living in Hawaii. The results showed that the FAD appeared to make appropriate assessments of Hawaiian-American study participants' families and inappropriate assessments of Japanese-American study participants' families. Results also suggested that cultural norms regarding family functioning may vary according to socioeconomic status. FAD modifications are suggested.     

伦理学发展面临的挑战、困境和出路

当代中国伦理学在取得巨大进步的同时,也面临着一些挑战和困境.它们主要表现在伦理学的学科性质、出发点和目的以及道德原则等方面.这需要从现代伦理学的发展趋势、唯物史观的人本理念、个人与集体的关系、马克思的"三形态理论"以及目的和手段的相互转化等方面对此进行回应和探讨.     

Ethical Design in the Internet of Things

Even though public awareness about privacy risks in the Internet is increasing, in the evolution of the Internet to the Internet of Things (IoT) these risks are likely to become more relevant due to the large amount of data collected and processed by the “Things”. The business drivers for exploring ways to monetize such data are one of the challenges identified in this paper for the protection of Privacy in the IoT. Beyond the protection of privacy, this paper highlights the need for new approaches, which grant a more active role to the users of the IoT and which address other potential issues such as the Digital Divide or safety risks. A key facet in ethical design is the transparency of the technology and services in how that technology handles data, as well as providing choice for the user. This paper presents a new approach for users’ interaction with the IoT, which is based on the concept of Ethical Design implemented through a policy-based framework. In the proposed framework, users are provided with wider controls over personal data or the IoT services by selecting specific sets of policies, which can be tailored according to users’ capabilities and to the contexts where they operate. The potential deployment of the framework in a typical IoT context is described with the identification of the main stakeholders and the processes that should be put in place.     

An Ethical Issue Scale for Community Pharmacy Setting (EISP): Development and Validation

Many problems that arise when providing pharmacy services may contain some ethical components and the aims of this study were to develop and validate a scale that could assess difficulties of ethical issues, as well as the frequency of those occurrences in everyday practice of community pharmacists. Development and validation of the scale was conducted in three phases: (1) generating items for the initial survey instrument after qualitative analysis; (2) defining the design and format of the instrument; (3) validation of the instrument. The constructed Ethical Issue scale for community pharmacy setting has two parts containing the same 16 items for assessing the difficulty and frequency thereof. The results of the 171 completely filled out scales were analyzed (response rate 74.89 %). The Cronbach’s α value of the part of the instrument that examines difficulties of the ethical situations was 0.83 and for the part of the instrument that examined frequency of the ethical situations was 0.84. Test–retest reliability for both parts of the instrument was satisfactory with all Interclass correlation coefficient (ICC) values above 0.6, (for the part that examines severity ICC = 0.809, for the part that examines frequency ICC = 0.929). The 16-item scale, as a self assessment tool, demonstrated a high degree of content, criterion, and construct validity and test–retest reliability. The results support its use as a research tool to asses difficulty and frequency of ethical issues in community pharmacy setting. The validated scale needs to be further employed on a larger sample of pharmacists.     

公私合营模式在医疗领域中应用的探讨——以镜湖医院在澳门的发展为例

在阐述公私合营模式定义的基础上,以澳门为典型案例介绍了该模式在医疗领域中的具体应用,并从理论上对中国内地实施公私合营的医院管理模式提出相关建议.中国内地在日后推行这种医院管理模式时应特别注意明确私立医疗机构的社会责任和使命、完善相关扶持政策和强化审批与监管制度.     

老年发展的伦理考量

老年人的发展是人的发展的伦理应然和社会发展的伦理必然.老年人的发展包括老年人的健康发展、角色发展、认知发展和价值发展等四个主要方面.我们要通过构筑适合老年人生存发展的社会伦理环境和幸福生活的家庭伦理环境,发展老年教育和社会保障事业,开发老年人力资源,促进老年人的全面发展.     

A Public Health Framework for Preventing Mental Disorders in the Context of Pandemics

The COVID-19 pandemic has universally threatened the building blocks of mental health, well-being, and quality of life, namely, expectations of safety, connectedness, hope, and individual and societal efficacy. Consequently, unprecedently large numbers of individuals are significantly stressed and many are at risk for relapse of mental health problems, exacerbations of existing mental and behavioral health problems, and new onset clinical problems. Because of the scope of the problem, a population-based public health perspective is needed, which in the context of disasters has well-established theories and prevention approaches. Public health approaches to disasters and pandemics focus on preventing subclinical problems from becoming clinical disorders, in comparison to clinical care approaches that focus on treating established disorders. Fortunately, specialty care clinicians who typically think about assessing and treating established disorders have the training and clinical competencies to deliver prevention-focused interventions. This paper is designed to help specialty care clinicians who use cognitive-behavioral strategies to understand the biopsychosocial impacts and resource deficits associated with COVID-19-related stressors and the public health perspective to address them. We also provide ways clinicians can help people who are suffering from significant stress and resource deficits bounce back and regain functioning. We describe psychological first aid, stress management, repeated ecological assessment, writing about stressors, problem-solving, and behavioral activation approaches to assist individuals at risk for enduring stress-linked problems.