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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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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

This article seeks to understand how values enter into political discourse via justification and how those values are negotiated over time. The article maps out the terrain of diversity discourses, both as a specific type of discourse and as an example of ethical, moral and pragmatic modes of argumentation. The author examines Swedish "diversity discourses" in the periods of 1968–1975 and 1991–1995 in an effort to tease out the pragmatic, moral and ethical aspects of these discourses. Diversity discourses are defined as discourses regarding how much and what kind of diversity is acceptable or desirable in a society, as well as how such diversity should be handled. I find that values, both contextually-dependent ethical values and universal moral values, rather than being "prior" to politics, arise out of the intersection of pragmatic, ethical and moral discourses. What is moral and ethical, then is colored by the particular nexus of moral, ethical and pragmatic concerns such that what is acceptable at one particular time and location, may be unacceptable in another, even coming from the same actors with the same ideological commitments. Shifts in the ethical/moral modes of justification, then, lead to shifts in who is included in a democratic community.

BACKGROUND: As 'disease detectives' and directors of public health programs, field epidemiologists play essential roles in protecting public health. Although ethical issues receive considerable attention in medical and research settings, less is known about ethical challenges faced by field epidemiologists in public health programs. Similarly, little is known about moral distress among field epidemiologists, i.e., situations in which they are constrained from acting on what they know to be morally right. Moral distress is strongly associated with empathy fatigue, burnout, reduced job retention, and disengagement. To better understand ethics training needs for field epidemiologists, in February 2019, members of TEPHIConnect, an online and mobile networking platform for Field Epidemiology Training Program (FETP) alumni, were invited to participate in an anonymous survey about ethical challenges and moral distress. RESULTS: Among 126 respondents from 54 countries, leading causes of ethical dilemmas included inadequate informed consent (61%), inequitable allocation of resources (49%), and conflicts of interest (43%). These occur primarily in settings of disease outbreaks (60%); research (55%); and public health programs at the state, province, or national level (45%) or community level (43%). Work-related moral distress was reported by 91% of respondents, including 26% who experience it "frequently" or "almost always." Field epidemiologists working in low- and low-middle income countries were more likely to report moral distress "frequently" or "almost always" than those in higher-income countries (33.0% vs 9.1%, P = 0.006). The most common perceived contributors to moral distress included excessive stress and work demands (30%) and inadequate support from leaders (25%). CONCLUSIONS: Field epidemiologists face significant work-related ethical challenges, which are endemic to public health and political systems. A substantial proportion of field epidemiologists also experience some degree of moral distress, often in ...