A draft model aggregated code of ethics for bioethicists

Bioethicists function in an environment in which their peers--healthcare executives, lawyers, nurses, physicians--assert the integrity of their fields through codes of professional ethics. Is it time for bioethics to assert its integrity by developing a code of ethics? Answering in the affirmative, this paper lays out a case by reviewing the historical nature and function of professional codes of ethics. Arguing that professional codes are aggregative enterprises growing in response to a field's historical experiences, it asserts that bioethics now needs to assert its integrity and independence and has already developed a body of formal statements that could be aggregated to create a comprehensive code of ethics for bioethics. A Draft Model Aggregated Code of Ethics for Bioethicists is offered in the hope that analysis and criticism of this draft code will promote further discussion of the nature and content of a code of ethics for bioethicists.     

A Code of Ethics for Health Care Ethics Consultants: Journey to the Present and Implications for the Field

For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here.     

Respect for People's Rights and Dignity

Summary

This article examines the nature and application of aspirational General Principle E (Respect for Peoples' Rights and Dignity) of the Ethical Principles of Psychologists and Code of Conduct (American Psychological Association [APA], 2002) and similar principles in other mental health professional ethics codes. Issues about aspirational versus enforceable standards are reviewed. Case examples and illustrations of the principle are provided.     

Neuroethics and National Security

This essay considers the potential role of bioethics in disaster response planning and preparedness. Bioethicists can make substantial contributions, by ensuring that decision-making and distribution of resources during crises is carried out in a fair and just manner, as well as by examining the assumptions upon which disaster planning are based. Bioethicists should also be aware of potential pitfalls of overly-hasty engagement with this new field.     

What can we learn by looking for the first code of professional ethics?

The first code of professional ethics must: (1)be a code of ethics; (2) apply to members of a profession; (3) apply to allmembers of that profession; and (4) apply only to members of that profession. The value of these criteria depends on how we define “code”, “ethics”, and “profession”, terms the literature on professions has defined in many ways. This paper applies one set of definitions of “code”, “ethics”, and “profession” to a part of what we now know of the history of professions, there by illustrating how the choice of definition can alter substantially both our answer to the question of which came first and (more importantly) our understanding of professional codes (and the professions that adopt them). Because most who write on codes of professional ethics seem to take for granted that physicians produced the first professional code, whether the Hippocratic Oath, Percival’s Medical Ethics, the 1847 Code of Ethicsof the American Medical Association (AMA), or some other document, I focus my discussion on these codes. This revised version was published online in June 2006 with corrections to the Cover Date.     

What the HEC-C? An Analysis of the Healthcare Ethics Consultant-Certified Program: One Year in

Abstract

Efforts to professionalize the field of bioethics have led to the development of the Healthcare Ethics Consultant-Certified (HEC-C) Program intended to credential practicing healthcare ethics consultants (HCECs). Our team of professional ethicists participated in the inaugural process to support the professionalization efforts and inform our views on the value of this credential from the perspective of ethics consultants. In this paper, we explore the history that has led to this certification process, and evaluate the ability of the HEC-C Program to meet the goals it has set forth for HCECs. We describe the benefits and weaknesses of the program and offer constructive feedback on how the process might be strengthened, as well as share our team’s experience in preparing for the exam.     

HIV and the obligation to treat

The paper is an attempt to review the basis for the claim that physicians have a professional obligation to treat AIDS patients. Considered are the historical record, two professional codes of ethics, and several recent articles. The paper concludes that the arguments considered, which attempt to support the claim that physicians have an obligation to treat, fail. It is suggested, rather, that common humanity, which physicians share with those who suffer from AIDS, ought to be the basis for engaging in the care of AIDS patients.     

Developing an ethical code for engineers: The discursive approach

From the Hippocratic Oath on, deontological codes and other professional self-regulation mechanisms have been used to legitimize and identify professional groups. New technological challenges and, above all, changes in the socioeconomic environment require adaptable codes which can respond to new demands. We assume that ethical codes for professionals should not simply focus on regulative functions, but must also consider ideological and educative functions. Any adaptations should take into account both contents (values, norms and recommendations) and the drafting process itself. In this article we propose a process for developing a professional ethical code for an official professional association (Colegio Oficial de Ingenieros Industriales de Valencia (COIIV) starting from the philosophical assumptions of discursive ethics but adapting them to critical hermeneutics. Our proposal is based on the Integrity Approach rather than the Compliance Approach. A process aiming to achieve an effective ethical document that fulfils regulative and ideological functions requires a participative, dialogical and reflexive methodology. This process must respond to moral exigencies and demands for efficiency and professional effectiveness. In addition to the methodological proposal we present our experience of producing an ethical code for the industrial engineers’ association in Valencia (Spain) where this methodology was applied, and we evaluate the detected problems and future potential. 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.     

International federation for information processing’s framework for computer ethics

This paper reviews codes of ethics and codes of conduct from different countries. The differences and similarities between code content and between attitudes are considered. Distinction is drawn between a code of ethics and a code of conduct. Recommendations are made for establishing a common framework for IFIP (International Federation for Information Process) Member or Affiliate Societies.     

Criticisms of the Ethical Principles for Psychologists and Code of Conduct

ABSTRACT

Beginning in 1953 the American Psychological Association (APA) has advanced twelve iterations of a professional ethical code. In recent years the adequacy of the Ethics Code as well as APA’s ethics enforcement has come under increased scrutiny. In 2015 the APA empaneled an Ethics Commission which made a series of recommendations; however, the Commission itself as well as its recommendations are also controversial. This paper presents criticisms of the Ethics Code that have generally not been discussed in the previous literature.     

Integrating emotion and other nonrational factors into ethics education and training in professional psychology

ABSTRACT

Any professional or scientific discipline has a responsibility to do what it can to ensure ethical behavior on the part of its members. In this context, this paper outlines and explores the criticism that to date the emphasis in ethics training in professional psychology, as with other disciplines, has been on the rational elements of ethical decision making, with insufficient attention to the role of emotions and other nonrational elements. After a brief outline of some of the historical background to the development and understanding of ethical decision making, relevant theoretical and empirical literature on the influence of emotional and other nonrational factors on our ethical decisions is reviewed. The implications of this literature for ethics education and training are outlined, particularly with respect to the use of case studies. An integrative approach is proposed, and conclusions and recommendations are offered with respect to such an approach.     

Certifying clinical ethics consultants: who pays?

The movement advocating the formal certification of clinical ethics consultants may result in major changes to the field of clinical ethics consultation by creating a new standard of care. The actual certification process is still in the development phase, but unanswered questions include: What will certification cost, and, Who will pay? Currently there is little salary support for ethics consultants and no regulation requiring healthcare institutions to offer clinical ethics consultation. Without the support of healthcare administrators and accreditation bodies, this may remain unchanged. Healthcare administrators may be unwilling to pay for certification or professional services if accreditation bodies do not require healthcare institutions to provide certified ethics consultants' services. If consultants will not be reimbursed or paid, they may not seek certification. If certified consultants are required, healthcare administrators may look for ways to cover the costs for providing this service, including insurance or third-party reimbursement and direct billing of patients for consultations, which may affect who performs and who participates in ethics consultation. However, this is less than ideal, as bioethicists believe ethics consultation should be available to all as part of providing safe, quality ethical care and support and guidance for patients, families, and healthcare staff. Going forward, bioethicists should study quality improvement, patient safety, and cost-savings resulting from certification-eligible clinical ethics consultants' activities. Administrators and financial personnel can be surveyed regarding their support for the certification process. Bioethicists should enlist the help of patient rights and safety advocacy groups, professional medical associations, and healthcare administrators. Bioethicists should invite accreditation bodies, healthcare administrators, and financial personnel to collaborate in the development of the certification process. Without their support, certification may be of value only to the bioethics community, and may have little standing in actual clinical healthcare institution settings.     

Believers and Skeptics: Where Social Worker Situate Themselves Regarding the Code of Ethics

Based on individual and focus-group interviews, this article describes how social workers in a variety of settings and geographical areas within Ontario approached ethical issues in their daily practices. Two primary approaches to professional ethics emerge from the data: principle based and virtue based, reflecting the orientation of groups we label believers and skeptics, respectively. The code of ethics appears to be the fulcrum from which our participants swing. The believers show faith in the code of ethics and the skeptics are dubious that codes are necessarily in the best interests of clients. The article describes the thinking behind the actions of the believers and skeptics and explores possibilities for future practice and research with respect to decision-making regarding ethical issues in the social work profession.     

The United States Cover-up of Japanese Wartime Medical Atrocities: Complicity Committed in the National Interest and Two Proposals for Contemporary Action

To monopolize the scientific data gained by Japanese physicians and researchers from vivisections and other barbarous experiments performed on living humans in biological warfare programs such as Unit 731, immediately after the war the United States (US) government secretly granted those involved immunity from war crimes prosecution, withdrew vital information from the International Military Tribunal for the Far East, and publicly denounced otherwise irrefutable evidence from other sources such as the Russian Khabarovsk trial. Acting in “the national interest” and for the security of the US, authorities in the US tramped justice and morality, and engaged in what the English common law tradition clearly defines as “complicity after the fact.” To repair this historical injustice, the US government should issue an official apology and offer appropriate compensation for having covered up Japanese medical war crimes for six decades. To help prevent similar acts of aiding principal offender(s) in the future, international declarations or codes of human rights and medical ethics should include a clause banning any kind of complicity in any unethical medicine—whether before or after the fact—by any state or group for whatever reasons.     

Some methodological aspects of ethics committees’ expertise: The Ukrainian example

Today local, national and international ethics committees have become an effective means of social regulation in many European countries. Science itself is an important precondition for the development of bioethical knowledge and ethics expertise. Cultural, social, historical and religious preconditions can facilitate different forms and methods of ethics expertise in each country. Ukrainian ethics expertise has some methodological problems connected with its socio-cultural, historical, science and philosophy development particularities. In this context, clarification of some common legitimacies or methodological approaches to ethics committee (EC) phenomena such as globalization, scientization and the prioritization of an ethics paradigm are very important. On the other hand, elaborate study and critical analysis of international experience by Ukraine and other Eastern European countries will provide the integration of their local and national ethics expertises into a world bioethics ethos. An earlier version of this paper was presented at the 6th International Bioethics Conference entitled ‘The Responsible Conduct of Basic and Clinical Research’, held in Warsaw, Poland, 3–4 June 2005.     

A Cross-Sectional Examination of International Competency Standards

The evaluation of competency in the field of psychology has gained international attention in recent years. Focusing on international competencies can promote high standards of care and identify common values of the profession. However, there is little research regarding international perceptions of competency. Examining ethics codes from different countries can highlight international standards of competent practice, as ethics codes outline professional expectations of the field. The current study compared the ethics standards found in 47 codes of ethics representing 51 countries. Seventeen competency standards emerged after ethics codes were analyzed. Implications for the international practice of psychology are discussed.     

The Concerned Mental Health Practitioner

Summary

A discussion is provided regarding a fundamental principle of psychology, a concern for other's welfare, as set out in the American Psychological Association's (2002) Ethical Principles of Psychologists and Code of Conduct. Although the principle concern for others' welfare is essentially aspirational in nature, this is an ethical principle that is at the core of the mental health professions' stated values, and that must be positively put into operation in a variety of professional contexts. Unlike so much else in professional ethics codes that involves injunctions of what not to do, or which attempts to limit the self-serving tendencies of professionals, this general principle is essentially positive, pointing to the need to approach others and to consider their welfare first.     

From Environmental to Ecological Ethics: Toward a Practical Ethics for Ecologists and Conservationists

Ecological research and conservation practice frequently raise difficult and varied ethical questions for scientific investigators and managers, including duties to public welfare, nonhuman individuals (i.e., animals and plants), populations, and ecosystems. The field of environmental ethics has contributed much to the understanding of general duties and values to nature, but it has not developed the resources to address the diverse and often unique practical concerns of ecological researchers and managers in the field, lab, and conservation facility. The emerging field of “ecological ethics” is a practical or scientific ethics that offers a superior approach to the ethical dilemmas of the ecologist and conservation manager. Even though ecological ethics necessarily draws from the principles and commitments of mainstream environmental ethics, it is normatively pluralistic, including as well the frameworks of animal, research, and professional ethics. It is also methodologically pragmatic, focused on the practical problems of researchers and managers and informed by these problems in turn. The ecological ethics model offers environmental scientists and practitioners a useful analytical tool for identifying, clarifying, and harmonizing values and positions in challenging ecological research and management situations. Just as bioethics provides a critical intellectual and problem-solving service to the biomedical community, ecological ethics can help inform and improve ethical decision making in the ecology and conservation communities.

Health Care Reform: What History Doesn’t Teach

The paper begins by tracing the historical development of American medicine as practice, profession, and industry from the eighteenth century to the present. This historical outline emphasizes shifting conceptions of physicians and physician ethics. It lays the basis for showing, in the second section, how contemporary controversies about the physician’s role in managed care take root in medicine’s past. In the final two sections, I revisit both the historical analysis and its application to contemporary debates. I argue that historical narratives can function as “master narratives” that suppress or leave out historical facts. I bring to the surface what is covered up by the master narrative approach, and show its relevance to contemporary ethical debates. I conclude by proposing that preserving the integrity of medicine will require modifying the master narratives we tell about physicians. The integrity of medicine also offers new perspectives for thinking about managed care and the broader topic of health care reform.