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January 26, 1966 r. In the Department of Surgery, Medical University of Warsaw, a team of doctors in Poland made the first successful kidney transplant. It was the beginning of a difficult path Polish transplantation. The increase in demand for services of transplantation medicine, the dynamic development of this field and the lack of alternative treatments for end-stage organ failure makes transplants are still hotly debated. The author discusses the legal regulations in Poland transplantation, ethical issues and presents the possibility of transplantation medicine and its importance in the light of the teachings of the Church. From the outset, the sine qua non of organ transplantation was a statement the death of a potential donor. This requirement, referred to in the literature dead donor rule (called. Dead donor rule, DDR) is a legal and ethical justification for thousands of transplants. However, according to some authors, this rule has a greater potential to undermine confidence in transplants than to promote them. In their opinion, better solution to protect the transplant the alleged abuse would be to obtain informed consent from patients or their families for organ donation and therefore to stop life-sustaining treatment in situations of irreversible neurological injuries. This position is confirmed by studies that suggest that reliable information related to the degree of neurological damage potential donor consent and respect for his family or for society are more important than concerns about its vital status. The aim of this paper is to discuss the issue of transplants in the dimension of legislative and legal and ethical.

INTRODUCTION: In a saturated market with an over-supply of undergraduate and graduate programs, social media have become attractive means of advertising in Dentistry. However, posts frequently contain ethical violations and lead to service commodification, and their contents are often in disagreement with the Code of Consumer Protection. OBJECTIVE: This article, which focuses on ethical and legal developments, contributes to the discussion and elucidation of questions associated with advertising that uses clinical images and photographs of patients in social media for commercial purposes and self-promotion. CONCLUSION: Social media and networks are valuable tools of dissemination and exchange of information because of their flexibility, democratic character and low cost. However, their abusive or misleading use, as well as the ethical and legal violations associated with the difficulty in controlling their use, may lead to serious damages and unfavorable court decisions.

ABSTRACT Introduction: In a saturated market with an over-supply of undergraduate and graduate programs, social media have become attractive means of advertising in Dentistry. However, posts frequently contain ethical violations and lead to service commodification, and their contents are often in disagreement with the Code of Consumer Protection. Objective: This article, which focuses on ethical and legal developments, contributes to the discussion and elucidation of questions associated with advertising that uses clinical images and photographs of patients in social media for commercial purposes and self-promotion. Conclusion: Social media and networks are valuable tools of dissemination and exchange of information because of their flexibility, democratic character and low cost. However, their abusive or misleading use, as well as the ethical and legal violations associated with the difficulty in controlling their use, may lead to serious damages and unfavorable court decisions.

This paper is an examination of the current Medical Assistance in Dying (MAiD) law in Canada and the various perspectives on this policy. This paper also examines the current state of knowledge and research conducted on this legislation in North America and Europe. `Clinical practice and ethical issues will also be explored from the perspectives of both social workers and physicians. The current state of palliative care in Canada and the services and supports available at end-of-life will be discussed. Alternatives to MAiD such as palliative sedation are examined. The debate over whether to extend access to vulnerable populations such as individuals living with a disability or using advance directives will also be analyzed. This paper will explore social work perspectives on MAiD and on end-of-life care issues and identify gaps and areas for future research. Additionally, the paper provides a list of recommendations based on current issues identified within the research.

This thesis analyses a few selected aspects of crop biotechnology in agriculture. The thesis contains two essays; the first addresses the topic of how ethical tools can help to, especially in democratic societies, improve ethical judgments on modern biotechnologies used in agriculture and food production. The second essay explores GM crops and the question of whether engaging and promoting agriculture biotechnology would be an expression of hubris. Essay I discusses ethical tools and more specifically what makes a tool a good one. It is argued that some of the previous attempts of evaluating ethical tools are unfruitful. Myself and Per Sandin propose that ethical tools be divided into three categories with regard to their different aim(s). We suggest that the quality of an ethical tool is decided by its purposiveness, i.e. how well the tool achieves its assigned purpose(s). Essay II discusses the concept of hubris with regard to agricultural biotechnology. Several authors have claimed that supporting agricultural biotechnology is an expression of hubris. Ronald Sandler has given the argument its most structured account of yet. I argue that Sandler fails to establish a presumption against the use of GM crops and that the concept of hubris should play no role in evaluating GM crops and agricultural biotechnology. ; QC 20150330 ; Mistra Biotech

A recent lawsuit that alleges that the American Society for Reproductive Medicine (ASRM) engages in price-fixing by capping the amount of compensation paid for human oocytes has several critical ethical and policy implications that have received relatively little attention. ASRM has argued that ceilings on donor compensation prevent enticement, exploitation, and oocyte commodification. Critics counter that low donor compensation decreases supply, because fewer women are then interested in donating, which then increases prices for the service that physicians, not donors, accrue, and that ethical goals can be better achieved through enhanced informed consent, hiring egg donor advocates, and better counseling and screening. Yet, if compensation caps are removed, questions emerge concerning what the oocyte market would then look like. Informed consent is an imperfect process. Beyond the legal and economic questions of whether ASRM violates the Sherman Anti-trust Act also lie crucial questions of whether human eggs should be viewed as other products. We argue that human eggs differ from other factory-produced goods and should command moral respect. Although eggs (or embryos) are not equivalent to human beings, they deserve special consideration, because of their potential for human life, and thus have a different moral status. ASRM's current guidelines appear to address, even if imperfectly, ethical challenges that are related to egg procurement for infertility treatment. Given public concerns about oocyte commodification and ASRM's wariness of government regulations, existing guidelines may represent a compromise by aiding patients who seek eggs, while simultaneously trying to avoid undue influence, exploitation, and eugenics. Although the ultimate outcome of this lawsuit remains unclear, policy makers, providers, lawyers, judges, and others should attend seriously to these issues. Alternatives to current ASRM guidelines may be possible (eg, raising the current caps to, say, $12,000 or $15,000, potentially increasing donation, while still avoiding certain ethical difficulties) and warrant close consideration. These complex conflicting ethical issues deserve more attention than they have received because they affect key aspects of clinical practice and the lives of countless patients.

The growth of the managed investment industry brings with it the potential for institutional investors to exert their influence on boards of listed companies to deliver strong and sustainable growth. The concepts of socially responsible investment (SRI), responsible investment (RI) or ethical investment (EI) have become part of mainstream investment practices in many financial markets. While SRI is largely a qualitative concept, its survival and adoption by the mainstream investment community may, in part, be due to the formalising of its concepts into language that investors, asset managers and analysts can more readily understand: the benchmark index. SRI indices may hold the key to attracting attention to ESG issues in listed corporates and to help bring about positive outcomes in sustainable development. Figures show SRI investments in emerging markets are minimal when compared to those in developed markets but emerging markets hold great potential for growth and development of these tools. This research develops a tool for bringing together social construction theory and stakeholder theory in understanding the construction of SRI Indices and in development of new indices. The core of this research is an analysis of SRI indices in three major emerging markets of Hong Kong, India and China, together with an analysis of different perspectives of SRI in Asia. The purpose is to identify opportunities to building SRI indices through a stakeholder engagement approach. The research was conducted over several phases between October 2008 and August 2010 and can be defined by three different studies: 1. a comparative study on SRI indices and their ESG criteria; 2. a comparative study on SRI indices and their stakeholder engagement approach; and 3. an analysis on the feasibility of building SRI indices in Asian markets. The findings from the three studies indicate three main arguments. First, ESG assessment and criteria of SRI indices does have an impact on the creditability and value of the SRI indices. Due to the lack of transparency on the ESG assessment and criteria, SRI investors and other stakeholder groups are deterred from adopting SRI indices as SRI tool. Second, stakeholder engagement is essential for SRI indices. And lastly, SRI indices in emerging markets, especially in the three studied markets, are attractive to both global and local SRI investors; however, these SRI indices need to include local ESG contexts to reflect the actual ESG concerns of the societies and avoid blindly following developed markets' SRI index model, which in the end become unrealistic and unpopular to investors and stakeholder groups. We recommend that stakeholder engagement in index criteria and corporate assessment be widened and deepened; that governments and stock exchanges can play a pivotal role in SRI development and should take the lead. We also recommend that SRI indices strengthen the institution of corporate research to rely less on secondary data when making their corporate assessments. ; published_or_final_version ; Kadoorie Institute ; Doctoral ; Doctor of Philosophy

Infertility treatments remain expensive and in many countries are covered by little, if any, insurance, raising critical questions concerning how patients and providers view and make decisions regarding these challenges. In-depth semi-structured interviews of approximately 1 hour were conducted with 37 IVF providers and 10 patients (17 physicians, 10 other providers and 10 patients), and were systematically analyzed. These data suggest current insurance policies and legislation pose critical ethical and logistical challenges for both patients and providers. These individuals face multiple uncertainties about costs and insurance, related to unclear causes of fertility, treatment length, costs and outcomes, and odds that insurers will cover expenses. Insurers frequently decline to agree to reimbursement beforehand, and decide only afterwards, case-by-case, generating stress. Patients and providers thus may not be able to predict how best to allocate limited resources. Providers may advocate for patients, but are usually unsuccessful. Patients may adopt several strategies: e.g., moving/seeking treatment elsewhere, switching or feeling "stuck" in jobs because of insurance, seeking "free" medications, going into debt, or using funds intended for other purposes. Patients do not perceive and respond to resource limitations as fixed phenomena—i.e., patients do not see treatment simply as "affordable" or not. Rather, patients face quandaries of how much to keep spending—how much a child is worth—and are forced to make complex risk/benefit calculations. Couples can disagree, straining relationships. In sum, these data, the first to explore how providers and patients struggle, view, and make decisions regarding limited insurance and resources for infertility, raise several critical ethical and policy issues. These data suggest that individuals have difficulty translating profoundly life-altering, deeply personal quests for meaning and fulfillment into purely economic terms. These findings thus have important implications for future policy, practice, research, and patient and provider education.

Health Impact Assessment, HIA is intended to contribute to public health by allowing those who make decisions on behalf of the public to anticipate how those decisions will affect people's health. It is a combination of procedures, methods and tools to be adapted in different contexts to evaluate projects, plans, and policies. The premise of HIA is thus the possibility to foresee impacts; the same is true for Environmental Impact Assessment, as well as Strategic Environmental Assessment. The difference is the inclusion of humans as subjects: local communities often require HIA where high impacts are present or suspected, because HIA produces numbers relating to people that could impact their lives. Here we find the first ethical implication of HIA. It is a decision support tool, based on the inclusion of communities in HIA design and process development; the inclusion of nonexpert knowledge is foreseen by HIA methods through both quantitative and qualitative data collection and evaluation. The roles of actors have to be considered, and their ethical duties linked to their responsibility. In addition, the power vested of assessors and decision-makers also needs to be considered. The ethical duty of assessors is to provide decision-makers with the information needed in order to make ethical decisions, describing existing inequalities, identifying positive and negative impacts under each option, and describing on whom these will fall. HIA involves multiple competencies, among which environmental epidemiology plays a central role. Ethical issues relate specifically to the hypothesis to be tested, which health impacts have to be considered, the scientific strength of evidence produced, the validity of results obtained, as well as the equity and equality considerations along the health-disease continuum. The ethical duty of decision-makers is linked to the responsibility to act and decide, supported by legislation, where the right of the public to information and participation is recognised, and by the practice of openness and transparency required by democracy.

Some organisations, and some individual humans, violate moral and ethical rules, whether or not they are written down in laws or codes of conduct. Corporate transgressions, as this behaviour is called, occur because of the actions of those in charge, usually bright and dedicated people. Immoral and unethical conduct can adversely affect the safety of workers, the general public and the environment. A scoping review method for a literature search is used to explore morality and ethics in relation to health and safety management. Our findings show that controlling the risks associated with misconduct and corporate transgression is not usually seen as a responsibility allocated to safety systems but is left to general management and corporate governance. The moral and ethical principles, however, can be applied in safety management systems to prevent misconduct and transgression-related safety risks. Our results show that ethical leadership, ethical behaviour, sustaining an ethical climate and implementation of an ethical decision-making process emerge as key preventive measures. The discussion presents a proposed way to include these measures in safety management systems. Conclusion and recommendations underline that unwanted behaviour and transgression risks can be brought under control, starting from a set of best practices. Not only the managers themselves but also board members, independent external supervisors and government regulators need to embrace these practices.

Tonight I would like to take your time consider the matters of how one can avoid simply seeing what one knows; and of how, not always but now and then, I have been able to know what I saw, in those very different decades of my life. So here is one story for each my seven decades here, and then a story at the end that speaks to the future in an unexpected way.

BACKGROUND: Ethical climate and moral distress have been shown to affect nurses' ethical behaviour. Despite the many ethical issues in paediatric oncology nursing, research is still lacking in the field. RESEARCH AIM: To investigate paediatric oncology nurses' perceptions of ethical climate and moral distress. RESEARCH DESIGN: In this cross-sectional study, data were collected using Finnish translations of the Swedish Hospital Ethical Climate Survey–Shortened and the Swedish Moral Distress Scale–Revised. Data analysis includes descriptive statistics and non-parametric analyses. RESPONDENTS AND RESEARCH CONTEXT: Ninety-three nurses, working at paediatric oncology centres in Finland, completed the survey. ETHICAL CONSIDERATIONS: According to Finnish legislation, no ethical review was needed for this type of questionnaire study. Formal research approvals were obtained from all five hospitals. Return of the questionnaire was interpreted as consent to participate. RESULTS: Ethical climate was perceived as positive. Although morally distressing situations were assessed as highly disturbing, in general they occurred quite rarely. The situations that did appear often reflected performing procedures on school-aged children who resist such treatment, inadequate staffing and lack of time. Perceptions of ethical climate and frequencies of morally distressing situations were inversely correlated. DISCUSSION: Although the results echo the recurrent testimonies of busy work shifts, nurses could most often practise nursing the way they perceived as right. One possible explanation could be the competent and supportive co-workers, as peer support has been described as helpful in mitigating moral distress. CONCLUSION: Nurturing good collegial relationships and developing manageable workloads could reduce moral distress among nurses.

Many decision-making situations today affect the safety of individuals and the environment,for instance hazardous waste management. In practice, many of these decisions are madewithout an overall view and with the focus on either the environment or safety. Now and then the areas of regulation are in conflict, i.e. the best alternative according to environmental considerations is not always the safest way and vice versa.A tool for taking an overall view within the areas of safety and environment would simplify matters and provide authorities and industry with a better basis for their work. This thesis forms part of a project which aims to develop a framework tool giving this overall view and supporting decision-making in which the issues (areas) of environment, safety, ethics and costs are all integrated. By developing a framework tool, different areas of interest could be taken into consideration more easily when a decision is to be made and could also help develop legislation and policy locally (at an industry or company), nationally and internationally. The project also aims to provide knowledge about different destruction/decommission methods, their good and bad points and their consequences, in order to provide different actors with a better basis for decision-making. This thesis focuses on development of the framework. The scope of the studies was restricted to environment, ethics and personnel safety due to the extent of the work and time limitations. In the next part of the project, the areas of costs and evaluation will be studied and a first draft of the framework tool will be presented. In order to develop the framework tool, two case studies were carried out here: an environmental analysis involving a life cycle assessment and an ethical analysis. With the help of these analyses, three different methods of destruction of ammunition were compared: Open detonation, modelled both with and without recovery and recycling of metals; incineration in a static kiln with air pollution control combined with ...

The prospect of creating children through somatic cell nuclear transfer has elicited widespread concern, much of it in the form of fears about harms to the children who may be born as a result. There are concerns about possible physical harms from the manipulations of ova, nuclei, and embryos, which are parts of the technology, and about possible psychological harms, such as a diminished sense of individuality and personal autonomy. There are ethical concerns as well about a degradation of the quality of parenting and family life if parents are tempted to seek excessive control over their children's characteristics, to value children according to how well they meet overly detailed parental expectations, and to undermine the acceptance and openness that typify loving families. Virtually all people agree that the current risks of physical harm to children associated with somatic cell nuclear transplantation cloning might justify a prohibition at this time on such experimentation[i]. In addition to physical harms, many worry about psychological harms associated with such cloning. One of the forms of psychological harm most frequently mentioned is the possible loss of a sense of uniqueness. Although the myth of genetic determinism is dispelled, but some doubts about cloning and identity remain that I am going to argue that somatic cell nuclear transfer cloning creates serious issues of identity and individuality especially in the Psychological identity and forces us to reconsider how we define ourselves because Cloned children each will be genetically virtually identical to a human being who has already lived and also the expectations for their lives may be shadowed by constant comparisons to the life of the "original."[ii] Moreover, comment on the importance of genetic uniqueness not only for individuals but also in the eyes of their parents [i] . See :National Bioethics Advisory Commission [NBAC], Cloning Human Beings, Bethesda, MD: Government Printing Office, June 1997.p.62 [ii] . See :President's Council on ...

Background: Ethical climate and moral distress have been shown to affect nurses' ethical behaviour. Despite the many ethical issues in paediatric oncology nursing, research is still lacking in the field. Research aim: To investigate paediatric oncology nurses' perceptions of ethical climate and moral distress. Research design: In this cross-sectional study, data were collected using Finnish translations of the Swedish Hospital Ethical Climate Survey–Shortened and the Swedish Moral Distress Scale–Revised. Data analysis includes descriptive statistics and non-parametric analyses. Respondents and research context: Ninety-three nurses, working at paediatric oncology centres in Finland, completed the survey. Ethical considerations: According to Finnish legislation, no ethical review was needed for this type of questionnaire study. Formal research approvals were obtained from all five hospitals. Return of the questionnaire was interpreted as consent to participate. Results: Ethical climate was perceived as positive. Although morally distressing situations were assessed as highly disturbing, in general they occurred quite rarely. The situations that did appear often reflected performing procedures on school-aged children who resist such treatment, inadequate staffing and lack of time. Perceptions of ethical climate and frequencies of morally distressing situations were inversely correlated. Discussion: Although the results echo the recurrent testimonies of busy work shifts, nurses could most often practise nursing the way they perceived as right. One possible explanation could be the competent and supportive co-workers, as peer support has been described as helpful in mitigating moral distress. Conclusion: Nurturing good collegial relationships and developing manageable workloads could reduce moral distress among nurses. ; publishedVersion ; Peer reviewed