The Asian Disease Problem and the Ethical Implications Of Prospect Theory

We discuss the bearing of Daniel Kahneman and Amos Tversky's Prospect Theory on some central issues in ethics. It has been argued that the theory provides a better explanation of our intuitive responses to some important ethical decision cases—like some famous cases put by Philippa Foot and others—than traditional and widely acknowledged ethical principles do. In this way, Prospect Theory contributes to the new wave of skepticism, emanating from the social sciences, about the role of intuitive judgments in ethical theory and philosophy more generally. We focus on Kahneman and Tversky's famous Asian Disease Problem. We show that the case fails to support Prospect Theory over traditional ethical theory as an explanation of the most common intuitive responses to the case, and, moreover, fails as an account of the most common intuitive responses to Foot's famous trolley case and related cases. We maintain that careful critical attention to all these cases shows that Prospect Theory has not made a successful incursion into ethics, whatever it may have established about non‐ethical decision‐making.     

A Comparative Analysis of Ethical and Professional Challenges Experienced by Australian and U.S. Genetic Counselors

Ethical issues are an inevitable part of genetic counseling practice. Prior research identified 16 domains of ethical and professional challenges encountered by practitioners in the United States. In order to further validate these domains, the present study surveyed Australian genetic counselors. Sixty-three respondents rated the frequency with which they encountered each domain, and 39 individuals also provided personal anecdotes detailing their most challenging ethical and professional dilemmas. Every domain reportedly was experienced by the Australian sample. However, there were some differences between Australian respondents and U.S. genetic counselors in frequencies of domain occurrence, and in strategies recommended for resolving them. Several anecdotes illustrate challenging situations due to Australia’s geography, universal healthcare system, and the genetic counseling profession’s evolution in that country. The results generally validate domains identified for U.S. genetic counselors. They further suggest that certain ethical issues may manifest in ways unique to a given country, and therefore they must be addressed in a culturally-appropriate manner.     

Equating Innocent Threats and Bystanders

abstract Michael Otsuka claims that it is impermissible to kill innocent threats because doing so is morally equivalent to killing bystanders. I show that Otsuka's argument conflates killing as a means with treating a person herself as a means. The killing of a person can be a means only if that person is instrumental in the threat to Victim's life. A permission to kill a person as a means will not permit killing bystanders. I also defend a permission to kill innocent threats against Otsuka's Trolley Cases. Otsuka depicts a person tied to an oncoming trolley as a bystander. I argue that such characters are threats whom Victim can permissibly kill.     

Ethical Concepts and Future Challenges of Neuroimaging: An Islamic Perspective

Neuroscience is advancing at a rapid pace, with new technologies and approaches that are creating ethical challenges not easily addressed by current ethical frameworks and guidelines. One fascinating technology is neuroimaging, especially functional Magnetic Resonance Imaging (fMRI). Although still in its infancy, fMRI is breaking new ground in neuroscience, potentially offering increased understanding of brain function. Different populations and faith traditions will likely have different reactions to these new technologies and the ethical challenges they bring with them. Muslims are approximately one-fifth of world population and they have a specific and highly regulated ethical and moral code, which helps them deal with scientific advances and decision making processes in an Islamically ethical manner. From this ethical perspective, in light of the relevant tenets of Islam, neuroimaging poses various challenges. The privacy of spirituality and the thought process, the requirement to put community interest before individual interest, and emphasis on conscious confession in legal situations are Islamic concepts that can pose a challenge for the use of something intrusive such as an fMRI. Muslim moral concepts such as There shall be no harm inflicted or reciprocated in Islam and Necessities overrule prohibitions are some of the criteria that might appropriately be used to guide advancing neuroscience. Neuroscientists should be particularly prudent and well prepared in implementing neuroscience advances that are breaking new scientific and ethical ground. Neuroscientists should also be prepared to assist in setting the ethical frameworks in place in advance of what might be perceived as runaway applications of technology.     

From Theory to Practice: Facing Ethical Challenges as a Clinical Intern

Although formal ethics classes provide a basic foundation in managing ethical dilemmas, professionals often point to their experiences on internship as an important training ground for consolidation of their ethical development. Clinical interns face many personal and professional transitions that can lead to a number of ethical dilemmas. Effective collaboration between administrative staff, supervisors, and interns can create a pragmatic model for negotiating these dilemmas. In this paper, issues related to balancing intern competency with training and patient/client needs, managing dual relationships with supervisory staff, and dealing with differences in orientation are addressed from the perspective of both the site and the intern. We also discuss ways in which problems can arise and how both sides can work together systematically to negotiate those problems. To illustrate this process, we discuss cases involving effective collaboration between interns and sites. Finally, the authors assert the need for formal, empirically supported training in classic ethical issues, but also in contemporary ethical issues arising from the ever-evolving field of mental health service delivery and unique challenges accompanying these advances.     

"Broken covenant": healthcare aides' "experience of the ethical" in caring for dying seniors in a personal care home

Canada's population is aging, and seniors constitute the fastest growing demographic in the nation. The chronic health conditions, limited social support, functional decline, and cognitive impairment experienced by seniors may necessitate admission to a personal care home (PCH) setting up until the time of their death. The ethical problems that arise in the care of dying patients are numerous and complicated. The care of dying seniors in PCHs, however, is largely provided by frontline workers such as healthcare aides (HCAs), who usually have little training in palliative care or ethics. Research examining the identification and resolution of ethical problems in care of the dying has been conducted from the perspectives of nurses and physicians in various clinical settings, but the voice of HCAs in PCHs is virtually absent from clinical ethics. Given that the inability to satisfactorily resolve ethical issues in clinical practice is associated with feelings of guilt, powerlessness, avoiding contact with patients, failing to provide good physical care, and increased staff turnover, an empirical examination of HCAs' experiences of ethically challenging situations is warranted. We conducted a phenomenological study to access the lived experience of HCAs (N = 12) working in proprietary and nonproprietary care homes as they encountered situations they deemed ethically challenging in providing end-of-life care to dying seniors. The findings reported here explicate: (1) the types of situations that are ethically problematic for HCAs; (2) the meanings they assign to these situations, and (3) the impact such situations have on the provision of end-of-life care.     

Ethics,Violence, and Counseling: Hear No Evil,See No Evil,Speak No Evil?

Situations involving violence directed either at a client or by a client pose ethical and legal dilemmas for the mental health professional. The authors present information concerning both ethical and legal aspects of violence as they relate to client welfare, dangerousness, confidentiality or duty to warn, and counselor violence. In certain situations, case material is used to illustrate both the ethical standards and the laws and statutes that provide directives for professional behavior.     

On the dynamics of work identity in atypical employment: setting out a research agenda

Starting from the notion that work is an important part of who we are, we extend existing theory making on the interplay of work and identity by applying them to (so called) atypical work situations. Without the contextual stability of a permanent organizational position, the question “who one is” will be more difficult to answer. At the same time, a stable occupational identity might provide an even more important orientation to one’s career attitudes and goals in atypical employment situations. So, although atypical employment might pose different challenges on identity, identity can still be a valid concept to assist the understanding of behaviour, attitudes, and well-being in these situations. Our analysis does not attempt to “reinvent” the concept of identity, but will elaborate how existing conceptualizations of identity as being a multiple (albeit perceived as singular), fluid (albeit perceived as stable), and actively forged (as well as passively influenced) construct that can be adapted to understand the effects of atypical employment contexts. Furthermore, we suggest three specific ways to understand the longitudinal dynamics of the interplay between atypical employment and identity over time: passive incremental, active incremental, and transformative change. We conclude with key learning points and outline a few practical recommendations for more research into identity as an explanatory mechanism for the effects of atypical employment situations.     

Community Data Collection with Children of Mothers Living with HIV: Boundaries of the Researcher Role

The TRACK‐II program is a multi‐site, community‐based randomized controlled trial evaluating an intervention to assist mothers living with HIV (MLH) in disclosing their HIV status to their young children. Many participants—both mothers and children—reported significant depression and/or suicidal ideation, a phenomenon that presented ethical challenges. This article focuses on participants at one site (Atlanta). Through the vignette of “Jordan,” we describe ethical challenges that may arise when faced with the responsibility of maximizing participants’ safety while maintaining the boundaries of the researcher role. Guided by community psychology values, our team has taken measures within our role as researchers to empower and protect children and mothers endorsing suicidal ideation. For example, we have relied on relationships with community‐based organizations and AIDS service organizations to connect HIV‐affected families to mental health services. Furthermore, we have expanded our system of documentation to follow‐up adequately with families at risk, and we track family resources to promote a strengths‐based framework. We have solicited families’ feedback about their supports and needs to understand how we may best serve them by connecting them to the resources they report needing most and empowering them to care for themselves.     

From posts to protection: Ethical considerations regarding forensic psychiatrists and a duty to warn based on social media

Increasing use of social media in forensic mental health evaluations will lead to new challenges that must be resolved by forensic practitioners and the legal system. One such dilemma is the discovery of information that would typically trigger a legal duty and professional ethics obligation for mental health professionals to breach doctor-patient confidentiality to promote public safety and prevent harm to vulnerable third parties. Although the law and professional organizations offer clear guidance for practitioners in the treatment role, there is currently no clarity from the law or instruction from professional organizations on what mental health professionals should do if they discover such information during a confidential forensic evaluation. For example, a forensic evaluator may find evidence on social media of an evaluee’s threats to seriously harm others, abuse of children and the elderly, or severely impaired driving. There are no clear guidelines for how a forensic psychiatrist should respond in these complicated situations. We review the legal concepts and historical evolution of confidentiality, privilege, and mandated reporter duties that forensic practitioners should consider in these legally ambiguous situations. Finally, we discuss ethics frameworks practitioners can implement to determine their most ethical course of action when faced with such dilemmas.     

Facilitating Informed Consent: A Multicultural Perspective

Respect for the dignity and autonomy of patients has long been a fundamental principle of ethical decision making. As a practical matter, a primary way of maintaining this ethical standard is by obtaining an individual’s informed consent prior to intervening or collecting data. By giving individuals clear information about alternative treatments and potential risks and benefits, the practitioner tries to ensure that the patient can make an informed choice. However, there are cases in which those seeking informed consent have very different values and belief systems from those whose consent is being sought. In this article we explore such discrepancies using informed consent with Navajo clients as an example, illustrate potential challenges with case examples, and propose ways in which ethical dilemmas may be successfully navigated.     

Creating Space for Therapeutic Change: Boundary Expansions with Autism Spectrum Clients

ABSTRACT

Boundaries provide safety for both clinicians and clients. Specifically chosen boundary crossings can serve therapeutic progress when proper ethical safeguards are used. Clients with High Functioning Autism Spectrum Disorder (HFASD) have neurodevelopmental challenges and delays linked to the activation of the autonomic nervous system (ANS), and often experience problems socially, emotionally, and adjusting to change. Creating space for therapeutic change by expanding boundaries can help the client with HFASD overcome neurodevelopmental challenges through an expanded relationship with the clinician, who plays many different roles in the helping relationship. Creating this space assists the client with HFASD in overcoming neurodevelopmental challenges, in addition to providing a model of relationship that expands to other people and situations in the client’s life.     

Ethical and Legal Guidance for Mental Health Practitioners Who Wish to Conduct Research in a Private Practice Setting

Mental health practitioners, even when they have research training, rarely contribute to the scientific literature. One reason for this may be that they need help addressing the ethical and legal issues they encounter as they contemplate undertaking research in a clinical practice setting. To address that need, we offer several types of guidance for conducting research in a private practice setting in a way that meets high ethical and legal standards. We describe the situations in which ethical review of a research proposal by a federally registered institutional review board (IRB) is legally required, and identify alternate mechanisms that practitioners can use to obtain an ethical review when a formal IRB review is not required by law. We discuss legal and ethical requirements of conducting single-case studies in a practice setting. We provide a rationale, and free and inexpensive options, for obtaining a formal certificate of training in human subjects research. And we offer guidance for obtaining informed consent and Health Insurance Portability and Accountability Act (HIPAA) authorization from research participants. We conclude with a brief discussion of other legal and professional issues to consider when conducting research in private practice.     

Using Insights from Applied Moral Psychology to Promote Ethical Behavior Among Engineering Students and Professional Engineers

In this essay I discuss a novel engineering ethics class that has the potential to significantly decrease the likelihood that students (and professionals) will inadvertently or unintentionally act unethically in the future. This class is different from standard engineering ethics classes in that it focuses on the issue of why people act unethically and how students (and professionals) can avoid a variety of hurdles to ethical behavior. I do not deny that it is important for students to develop cogent moral reasoning and ethical decision-making as taught in traditional college-level ethics classes, but as an educator, I aim to help students apply moral reasoning in specific, real-life situations so they are able to make ethical decisions and act ethically in their academic careers and after they graduate. Research in moral psychology provides evidence that many seemingly irrelevant situational factors affect the moral judgment of most moral agents and frequently lead agents to unintentionally or inadvertently act wrongly. I argue that, in addition to teaching college students moral reasoning and ethical decision-making, it is important to: 1. Teach students about psychological and situational factors that affect people’s ethical judgments/behaviors in the sometimes stressful, emotion-laden environment of the workplace; 2. Guide students to engage in critical reflection about the sorts of situations they personally might find ethically challenging before they encounter those situations; and 3. Provide students with strategies to help them avoid future unethical behavior when they encounter these situations in school and in the workplace.     

Ethics, Engineers and Drama

This paper describes four plays which illustrate ethical themes relevant to engineers and which could be used as a resource for engineers who wish to explore ethical topics and their relationship with professional practice. The plays themselves have been chosen because a character in the play is involved in engineering activities. Each play is analysed to highlight some of the ethical issues the play raises. Often ethical topics are presented in abstract terms but the plays relate ethical issues to individuals and individual actions in specific situations that connect either directly or figuratively to practical situations engineers find themselves in. The paper describes how the resources have or could be used in an educational programme.     

The New Trolley Problem: Driverless Cars and Deontological Distinctions

Discussion of the ethics of driverless cars has often focused on supposed real-life versions of the famous trolley problem. In these cases, a driverless car is in a position where crashing is unavoidable and all possible crashes risk harm: for example, it can either continue on its current path and crash into five pedestrians or swerve and crash into one pedestrian. There are significant disanalogies between the human versions of the trolley problem and situations faced by driverless cars which affect the application and moral significance of key deontological distinctions, such as the distinction between doing and allowing harm. The application and moral significance of the doing/allowing distinction in the context of the behaviour of driverless cars depend on (a) our conception of the behaviour of driverless cars; (b) the forms of driverless cars that are developed and used; (c) the background expectations of programmers/manufacturers/owners of driverless cars and the conditions of being able to put those cars on the roads. These are as yet unsettled – and may even be undetermined. Nonetheless, trolley problems may still be useful in thinking about the ethics of driverless cars.     

Ethical Issues in HIV/STD Prevention Research With High Risk Youth: Providing Help,Preserving Validity

Many preventive intervention studies with adolescents address high-risk behaviors such as drug and alcohol use, and unprotected sex. Randomized controlled trials (RCT) are the gold standard methodology used to test the effectiveness of these behavioral interventions. Interventions outside the rigidly described protocol are prohibited. However, there are ethical challenges to implementing inflexible intervention protocols, especially when the target population is young, experiences many stressful events, and lives in a resource-poor environment. Teens who are at high risk for substance use or sexual risk behaviors tend to be at risk for other problems such as exposure to violence, sexual and physical abuse, depression, and homelessness. How should investigators deal with the psychological and social needs of teenagers in prevention programs in an ethically appropriate way and at the same time preserve the validity of RCT results? We have identified program characteristics, participant characteristics, interaction with parents, and problems with adolescents not in the study as sources of ethical dilemmas in RCT with at-risk adolescents. As a result of our experience, we recommend that every behavioral intervention study develop an ethics protocol, which should include rules for providing help to participants, has contact information for experts to provide guidance, and an emergency procedure for dealing with life threatening situations. In addition, studies should have a resource manual, train research staff in these ethical issues, and work with a data safety and monitoring board or ethics committee.     

Sacrificing one to save many

Attempts to solve the Trolley Problem by means of a single principle have proved unpersuasive. Nor can the intuition about Transplant be adequately grounded in the hypothetical dissent of rational contractors. It is explained by the initial liability principle, that loss should lie where it falls unless there is sufficient reason to shift it. If we did not think we should accept misfortune in such cases and thought that minimising loss of life was sufficient reason to shift the loss we should not be according others the minimum respect and treatment we feel is their due. The intuition about Trolley is explained by the affinity of that case to the pure case where the choice is between saving many and saving fewer, where minimising misfortune is the only credible option. But these considerations are not yet enough to accommodate the cases that lie between the extremes of Trolley and Transplant. We can handle the intermediate cases by attempting to assimilate them to one or other paradigm and to one another with a sensitivity to morally relevant and irrelevant differences that seeks initially to be faithful to the values reflected by our moral intuitions. Those intuitive judgements are unlikely to survive such an examination wholly unmodified.     

领导风格与员工创新绩效关系的元分析：基于自我决定视角

领导对员工创新起到重要作用。什么样的领导风格与员工创新相关更高? 实际研究中存在一定争议。为了回答这个问题, 基于自我决定理论, 我们提出一个理论框架, 来解释不同领导风格与员工创新相关系数的差异。我们使用元分析汇集432篇独立的实证研究的证据(中文研究229篇, 英文研究203篇, 样本总量达161599), 来检验我们的假设。研究发现：(1)交易型领导、伦理型领导、变革型领导、服务型领导、领导-成员交换、授权型领导、包容型领导及真实型领导与员工创新绩效之间均存在显著的正相关, 且相关递增; (2)个人主义、绩效评价方式、数据收集时间点、领导风格测量方式、创新测量方式以及发表语言部分调节领导风格和员工创新绩效的关系。研究结果符合理论预测, 研究促进自我决定理论的发展。更为重要的是, 研究结论为管理者提供重要的实践意义, 即使用合适的领导风格进而促进员工创新。