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Ethical Considerations (ethical + consideration)
Selected AbstractsEthical Considerations for a Child's Participation in ResearchJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 1 2004Sheri Kanner MSN ISSUES AND PURPOSE To analyze ethical considerations for a child's involvement in research. CONCLUSIONS Pediatric research can proceed only when the welfare of children is protected. Although research with children as research subjects constitutes only a small portion of research efforts, its continual growth requires nurses be aware of the rights of pediatric subjects. PRACTICE IMPLICATIONS As nursing research increases in sophistication, the nurse should include an assessment of the informed consent process in the care of the patient, including the child's comprehension, the age and development of the child, and the child's perception of the research. [source] Ethical Considerations for Administering Alcohol or Alcohol Cues to Treatment-Seeking Alcoholics in a Research Setting: Can the Benefits to Society Outweigh the Risks to the Individual?ALCOHOLISM, Issue 9 2009A commentary in the context of the National Advisory Council on Alcohol Abuse, Alcoholism, Recommended Council Guidelines on Ethyl Alcohol Administration in Human Experimentation (2005) First page of article [source] An Education Grounded in Biology: Interdisciplinary and Ethical ConsiderationsMIND, BRAIN, AND EDUCATION, Issue 2 2009Howard Gardner ABSTRACT ABSTRACT,Work in the new area of Mind, Brain, and Education (MBE) raises epistemological and ethical issues. With respect to epistemology, the norms of the component disciplines must be honored and the resulting amalgam must be more than a mere sum of the parts. With respect to ethics, the roles of scientist, educator, and practitioner each raise ethical dilemmas and the MBE worker must be cognizant of each set of dilemmas and the possible strains among them. Only if both of these spheres are confronted can good work be achieved in MBE. [source] Ethical Considerations for Participation of Nondirected Living Donors in Kidney Exchange ProgramsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2010E. S. Woodle Kidneys from nondirected donors (NDDs) have historically been allocated directly to the deceased donor wait list (DDWL). Recently, however, NDDs have participated in kidney exchange (KE) procedures, including KE ,chains', which have received considerable media attention. This increasing application of KE chains with NDD participation has occurred with limited ethical analysis and without ethical guidelines. This article aims to provide a rigorous ethical evaluation of NDDs and chain KEs. NDDs and bridge donors (BDs) (i.e. living donors who link KE procedures within KE chains) raise several ethical concerns including coercion, privacy, confidentiality, exploitation and commercialization. In addition, although NDD participation in KE procedures may increase transplant numbers, it may also reduce NDD kidney allocation to the DDWL, and disadvantage vulnerable populations, particularly O blood group candidates. Open KE chains (also termed ,never-ending' chains) result in a permanent diversion of NDD kidneys from the DDWL. The concept of limited KE chains is discussed as an ethically preferable means for protecting NDDs and BDs from coercion and minimizing ,backing out', whereas ,honor systems' are rejected because they are coercive and override autonomy. Recent occurrences of BDs backing out argue for adoption of ethically based protective measures for NDD participation in KE. [source] RESEARCH ON PRISONERS , A COMPARISON BETWEEN THE IOM COMMITTEE RECOMMENDATIONS (2006) AND EUROPEAN REGULATIONSBIOETHICS, Issue 1 2010BERNICE S. ELGER ABSTRACT The Institute of Medicine (IOM) Committee on Ethical Considerations for Revisions to DHHS Regulations for Protection of Prisoners Involved in Research published its report in 2006. It was charged with developing an ethical framework for the conduct of research with prisoners and identifying the safeguards and conditions necessary to ensure that research with prisoners is conducted ethically. The recommendations contained in the IOM report differ from current European regulations in several ways, some being more restrictive and some less so. For example, the IOM report suggests limiting the percentage of prisoners that should be involved in a biomedical study to 50%, a limit that does not exist in Europe. However, the report does not specifically advise against research without a direct benefit to an individual prisoner: the European regulations are more restrictive than the IOM committee recommendations in this respect. The definition of minimal risk varies, as well as the proposed role of the minimal risk requirement and of the principle of subsidiarity (research that can only be done effectively in prisons). The IOM report proposes a number of thoughtful suggestions, which it would be beneficial to implement everywhere, such as registers of research on prisoners. The European regulations offer pragmatic solutions to several thorny issues. In summary, the IOM committee report represents an admirable effort to tackle the present inconsistencies and deficiencies of federal regulations in the US on research on prisoners (45 CFR 46 Subpart C). Nonetheless, before acting on the recommendations, US regulators might consider revisiting international guidelines such as those published by the Council for International Organizations of Medical Science (CIOMS) and the Declaration of Helsinki. [source] Knowledge Translation at the Macro Level: Legal and Ethical ConsiderationsACADEMIC EMERGENCY MEDICINE, Issue 11 2007Gregory Luke Larkin MD, MSPH Macro-level legal and ethical issues play a significant role in the successful translation of knowledge into practice. The medicolegal milieu, in particular, can promote clinical inertia and stifle innovation. Embracing new clinical practice guidelines and best practice models has not protected physicians from superfluous torts; in some cases, emerging evidence has been used as the dagger of trial lawyers rather than the scalpel of physicians. Beyond the legal challenges are overarching justice issues that frame the broad goals of knowledge translation (KT) and technology diffusion. Optimal implementation of the latest evidence requires attention to be paid to the context of the candidate community and the key opinion leaders therein, characterized by the "8Ps" (public, patients, press, physicians, policy makers, private sector, payers, and public health). Ethical and equitable KT also accounts for the global burdens and benefits of implementing innovation such that disparities and gaps in health experienced by the least advantaged are prioritized. Researchers and thought leaders must attend to questions of fairness, economics, and legal risk when investigating ways to promote equity-oriented KT. [source] Ethical considerations in drama and conflict resolution research in Swedish and Australian schoolsCONFLICT RESOLUTION QUARTERLY, Issue 3 2005Dale Bagshaw This article discusses ethical considerations arising from drama and conflict research with adolescents in schools in two reasonably similar Western countries, Sweden and Australia. It proposes guidelines in sensitivity and ethical responsiveness for qualitative researchers who are working with adolescents in these areas in an educational context. [source] Ethical considerations concerning laser medicineLASERS IN SURGERY AND MEDICINE, Issue 2 2001Christian Raulin MD No abstract is available for this article. [source] Launching invasive, first-in-human trials against Parkinson's disease: Ethical considerations,MOVEMENT DISORDERS, Issue 13 2009Jonathan Kimmelman PhD Abstract The decision to initiate invasive, first-in-human trials involving Parkinson's disease presents a vexing ethical challenge. Such studies present significant surgical risks, and high degrees of uncertainty about intervention risks and biological effects. We argue that maintaining a favorable risk-benefit balance in such circumstances requires a higher than usual degree of confidence that protocols will lead to significant direct and/or social benefits. One critical way of promoting such confidence is through the application of stringent evidentiary standards for preclinical studies. We close with a series of recommendations for strengthening the internal and external validity of preclinical studies, reducing their tendency toward optimism and publication biases, and improving the knowledge base used to design and evaluate preclinical studies. © 2009 Movement Disorder Society [source] Just democracy: Ethical considerations in teachingNEW DIRECTIONS FOR ADULT & CONTINUING EDUCATION, Issue 123 2009Talmadge C. Guy The author offers examples from his teaching about race and gender and discusses the ethical challenges faced and strategies employed to confront these challenges. [source] Ethical considerations in drama and conflict resolution research in Swedish and Australian schoolsCONFLICT RESOLUTION QUARTERLY, Issue 3 2005Dale Bagshaw This article discusses ethical considerations arising from drama and conflict research with adolescents in schools in two reasonably similar Western countries, Sweden and Australia. It proposes guidelines in sensitivity and ethical responsiveness for qualitative researchers who are working with adolescents in these areas in an educational context. [source] Contemplating the murine test tube: lessons from natural killer cells and Cryptococcus neoformansFEMS YEAST RESEARCH, Issue 4 2006Kaleb J. Marr Abstract Murine experimentation has provided many useful tools, including the ability to knockout or over-express genes and to perform experiments that are limited by ethical considerations. Over the past century, mice have imparted valuable insights into the biology of many systems, including human immunity. However, although there are many similarities between the immune response of humans and mice, there are also many differences; none is more prominent than when examining natural killer cell biology. These differences include tissue distribution, effector molecules, receptor repertoire, and cytokine responses, all of which have important implications when extrapolating the studies to the human immune responses to Cryptococcus neoformans. [source] The pros and cons of noninferiority trialsFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 4 2003Stuart J. Pocock Abstract Noninferiority trials comparing new treatment with an active standard control are becoming increasingly common. This article discusses relevant issues regarding their need, design, analysis and interpretation: the appropriate choice of control group, types of noninferiority trial, ethical considerations, sample size determination and potential pitfalls to consider. [source] Nurses' attitudes to the use of seclusion: A review of the literatureINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2010Brenda Happell ABSTRACT Seclusion is now widely recognized as a coercive strategy with negative consequences for the consumers and staff involved. Nevertheless, this intervention continues to be used frequently in mental health services internationally. Due to their direct care role, nurses are commonly involved in the initiation or management of seclusion. Understanding nurses' attitudes to seclusion is therefore essential for the success of any attempts to reduce its use. A review of the literature was conducted using the search terms ,patient', ,seclusion', ,attitudes', ,nurses' and ,containment'. Twenty-eight articles which met the inclusion criteria were identified. Analysis of these articles identified six main themes: a necessary intervention; workplace culture; staff composition and experience; conflict; ethical considerations; and consumer characteristics. An overview of the literature is presented according to these main themes. The research suggests that most nurses support the continued use of seclusion as a strategy for the management of violence and aggression. A deeper understanding of the factors that influence attitudes is necessary if seclusion rates are to be effectively reduced. [source] Ethical Considerations for a Child's Participation in ResearchJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 1 2004Sheri Kanner MSN ISSUES AND PURPOSE To analyze ethical considerations for a child's involvement in research. CONCLUSIONS Pediatric research can proceed only when the welfare of children is protected. Although research with children as research subjects constitutes only a small portion of research efforts, its continual growth requires nurses be aware of the rights of pediatric subjects. PRACTICE IMPLICATIONS As nursing research increases in sophistication, the nurse should include an assessment of the informed consent process in the care of the patient, including the child's comprehension, the age and development of the child, and the child's perception of the research. [source] The ethics of research using electronic mail discussion groupsJOURNAL OF ADVANCED NURSING, Issue 5 2005Debbie Kralik PhD RN Aim., The aim of this paper is to identify and discuss the ethical considerations that have confronted and challenged the research team when researchers facilitate conversations using private electronic mail discussion lists. Background., The use of electronic mail group conversations, as a collaborative data generation method, remains underdeveloped in nursing. Ethical challenges associated with this approach to data generation have only begun to be considered. As receipt of ethics approval for a study titled; ,Describing transition with people who live with chronic illness' we have been challenged by many ethical dilemmas, hence we believe it is timely to share the issues that have confronted the research team. These discussions are essential so we can understand the possibilities for research interaction, communication, and collaboration made possible by advanced information technologies. Discussion., Our experiences in this study have increased our awareness for ongoing ethical discussions about privacy, confidentiality, consent, accountability and openness underpinning research with human participants when generating data using an electronic mail discussion group. We describe how we work at upholding these ethical principles focusing on informed consent, participant confidentiality and privacy, the participants as threats to themselves and one another, public,private confusion, employees with access, hackers and threats from the researchers. Conclusion., A variety of complex issues arise during cyberspace research that can make the application of traditional ethical standards troublesome. Communication in cyberspace alters the temporal, spatial and sensory components of human interaction, thereby challenging traditional ethical definitions and calling to question some basic assumptions about identity and ones right to keep aspects of it confidential. Nurse researchers are bound by human research ethics protocols; however, the nature of research by electronic mail generates moral issues as well as ethical concerns. Vigilance by researchers is required to ensure that data are viewed within the scope of the enabling ethics approval. [source] Videotaped recording as a method of participant observation in psychiatric nursing researchJOURNAL OF ADVANCED NURSING, Issue 5 2000Eila Latvala RN PhD Videotaped recording as a method of participant observation in psychiatric nursing research This paper describes videotaped recording as a data collection method when conducting participant observation in a psychiatric nursing study. The videotaped episodes were part of the daily life of psychiatric nursing in a hospital environment. The advantages and limitations of using videotaped recording in nursing research will be discussed. This paper is based on two studies. The data consisted of 21 videotaped episodes of nursing report sessions or interdisciplinary team meetings in the psychiatric clinic of a university hospital. The participants consisted of patients, their significant others, nurses, doctors, social workers and physiotherapists. All videotaped material was transcribed verbatim. An essential advantage of videotaping is that most potentially useful interaction and behaviour can be captured. The advantage in terms of the credibility of videotaping was that the investigator was able to review the same videotaped situations again and again. Videotaped material is rich and provides several possibilities for analysing the data. In these studies data and source triangulation enabled the researchers to reduce personal influence on the results. The investigator must also be aware of the limitations concerning this method. The most essential limitations are mechanical problems and the influence of videotaping on behaviour. Careful ethical considerations are important concerning personal privacy, informed consent and respect for the self-determination of psychiatric patients. [source] In Defence of Entrapment in Journalism (and Beyond)JOURNAL OF APPLIED PHILOSOPHY, Issue 2 2002Neil Levy The use of ,proactive' methods of newsgathering in journalism is very frequently condemned, from within and without the media. I argue that such condemnation is too hasty. In the first half of the paper, I develop a test which distinguishes between legitimate and illegitimate uses of proactive methods by law enforcement agencies. This test combines the virtues of the standard objective and subjective tests usually used, while avoiding the defects of both. I argue that when proactive methods pass this test, they are always legitimate; but that in addition they are sometimes mandatory. In the second half, I apply this test to journalism. I show that actual uses of proactive methods by journalists pass the test, and are therefore (at least) permissible. There are other ethical considerations which are relevant to the use of such techniques by journalists, which ought to be taken into account before it is decided to employ such methods, but I show that they are rarely of sufficient weight to render proactive newsgathering impermissible. [source] Reflection, the way to professional development?JOURNAL OF CLINICAL NURSING, Issue 3 2004Christine Gustafsson MA Background., Many studies have focused on reflection and the advantages that can be gained from the practice of reflection among Registered Nurses (RNs) but, what are the implications of the nurses' reflections, what do they reflect about, and how do they deal with their reflections? Aims and objectives., The aim of this study was to describe the RNs' experiences of reflection in relation to nursing care situations, and to understand how RNs use reflection in their daily work. What are the implications of the nursing care situations that the RNs' reflect upon? What consequences did the practice of reflection have in nursing care situations in relation to the RNs professional development? Design and method., The study was carried out with interviews and the phenomenographic method. Interviews were carried out with four RNs. The choice of informants was made with purposive sampling with the aim of finding informants who could bring the kind of knowledge that was necessary for the study. Results., The qualitative differences regarding the RNs' experiences of reflection were categorized as follows: to reflect (to think back , consider, mirroring, to reflect before and reflect after, to use experiences), nursing care situations (ethical considerations, to have courage, to use one's imagination, empathy) and consequences (to meet the unique, empathy, development). Finally, the findings were implicated in the model of professional development. Conclusion., By using reflection as a tool, many advantages can be gained in the development of nursing care. Encouraging RNs to reflect upon nursing situations, in order to promote the nurse's professional development, will imply better nursing care for the patients. The model for professional development implies a simplified representation of the thoughts pertaining to professional nursing development. Relevance to clinical practice., The relevance for clinical practice will be to understand the contents of the RNs reflections, to recognize the advantages of reflective practice and how and when to use such measures. Furthermore, to show how the model for professional development can be used in order to create a framework for evaluating these observations and consequently, for expressing tacit knowledge. [source] A critical appraisal of evidence-based medicine: some ethical considerationsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2003M. Gupta MD CM FRCPC MA Abstract Evidence-based medicine (EBM) is a concept that has grown to dominate the medical literature over the last decade. EBM has provoked a variety of criticisms, scientific, philosophical and sociological. However, while its basic conclusion , that we should practise EBM , is ethical, there has been limited ethical analysis of EBM. This paper aims to provide an analysis of EBM from an ethical perspective and identify some of EBM's potential ethical implications. Following a description of what constitutes EBM, this paper will identify and assess some of the basic values and epistemological assumptions of EBM that provide support for the moral duty to practise EBM. It will then examine potential ethical implications that could arise from practising EBM, given the challenges that have been made of EBM's assumptions and claims to authority. This paper will conclude by arguing that practitioners could strengthen the ethics of EBM by embracing a broader definition of evidence and including ethical criteria in the critical appraisal of research studies. [source] Feasibility of infusion pumps for continuous spinal administration of local anesthetics in post-operative pain therapyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2009M. WENK Background and Objectives: For completion of perioperative care and for general ethical considerations, any intraoperatively used catheter technique should be utilizable for post-operative pain therapy. Continuous spinal anesthesia (CSA) is an established form of local anesthetic application. However, for its use in post-operative therapy, infusion pumps are required that are technically able to deliver low rates and are distinctive in design to avoid possible pump or medication swaps. Because of a lack of devices specifically designed for CSA, we investigated the potential deployability of infusion pumps for post-operative pain therapy via CSA microcatheters, which were originally designed and approved for different applications. Methods: The accuracy of infusion rates of three different pumps was measured in a liquor model environment. Furthermore, we investigated safety and user-friendliness by interviewing 30 anesthesiologists and 15 pain nurses. Results: Except for the first hour of infusion, all pumps provided comparable and adequate flow profiles. However, interviews revealed significant risk factors for all pumps in terms of swapping devices, lines or medications and misprogramming the units. Discussion: All pumps tested were technically able to deliver accurate flow rates; however, because the non-CSA-specific design involves the risk of medication overdosage and syringe swaps, none of the systems tested can be recommended for routine use in post-operative CSA, irrespective of the fact that it was an off-label application anyway. Therefore, to ensure patient safety, continuous spinal administration of local anesthetics via microcatheters is a questionable method of post-operative pain therapy as long as non-specific pumps are used. [source] Scandinavian Clinical practice guidelines for therapeutic hypothermia and post-resuscitation care after cardiac arrestACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2009M. CASTRÉN Background and aim: Sudden cardiac arrest survivors suffer from ischaemic brain injury that may lead to poor neurological outcome and death. The reperfusion injury that occurs is associated with damaging biochemical reactions, which are suppressed by mild therapeutic hypothermia (MTH). In several studies MTH has been proven to be safe, with few complications and improved survival, and is recommended by the International Liaison of Committee on Resuscitation. The aim of this paper is to recommend clinical practice guidelines for MTH treatment after cardiac arrest from the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI). Methods: Relevant studies were identified after two consensus meetings of the SSAI Task Force on Therapeutic Hypothermia (SSAITFTH) and via literature search of the Cochrane Central Register of Controlled Trials and Medline. Evidence was assessed and consensus opinion was used when high-grade evidence (Grade of Recommendation, GOR) was unavailable. A management strategy was developed as a consensus from the evidence and the protocols in the participating countries. Results and conclusion: Although proven beneficial only for patients with initial ventricular fibrillation (GOR A), the SSAITFTH also recommend MTH after restored spontaneous circulation, if active treatment is chosen, in patients with initial pulseless electrical activity and asystole (GOR D). Normal ethical considerations, premorbid status, total anoxia time and general condition should decide whether active treatment is required or not. MTH should be part of a standardized treatment protocol, and initiated as early as possible after indication and treatment have been decided (GOR E). There is insufficient evidence to make definitive recommendations among techniques to induce MTH, and we do not know the optimal target temperature, duration of cooling and rewarming time. New studies are needed to address the question as to how MTH affects, for example, prognostic factors. [source] Titration of hepatitis B virus infectivity in the sera of pre-acute and late acute phases of HBV infection: Transmission experiments to chimeric mice with human liver repopulated hepatocytesJOURNAL OF MEDICAL VIROLOGY, Issue 12 2008Ayako Tabuchi Abstract Studies of hepatitis B virus (HBV) infection in non-human primates such as chimpanzees are no longer possible due to ethical considerations and the endangered status of chimpanzees since April 2007 in Japan. A human hepatocyte transplanted chimeric mouse was used to characterize HBV infectivity in serial stages of acute infection. Chimeric mice were inoculated intravenously with serum samples obtained from an experimentally infected chimpanzee with HBV. Sera from the pre-acute phases (i.e., rump-up viremia prior to anti-HBc) and late acute phases (i.e., declining phase of HBsAg and anti-HBcAb positive) were collected from the chimpanzees 57 and 244 days after inoculation. These sera contained 2.6,×,106 and 2.8,×,106 copies/ml of HBV DNA, respectively. Three chimeric mice inoculated intravenously with 100 µl of pre-acute serum (equivalent to 100 copy of HBV DNA) developed an HBV infection. The three chimeric mice that received 100 µl of pre-acute serum (equivalent to 101 copies of HBV DNA), developed high levels of serum HBV DNA. None of the three chimeric mice inoculated with 100 µl of 1:104 dilution (equivalent to 101 copies of HBV DNA) of late-acute serum was infected, while only one of three chimeric mice inoculated with 100 µl of 1:103 dilution (equivalent to 102 copies of HBV DNA) of late-acute serum developed an HBV infection. Based on these results, chimeric mice can be used as animal models for the study of HBV infectivity, pathogenesis and control. The results show that pre-acute phase HBV serum is about 100-times more infectious than late acute phase serum. J. Med. Virol. 80:2064,2068, 2008. © 2008 Wiley-Liss, Inc. [source] Basal replication of hepatitis C virus in nude mice harboring human tumorJOURNAL OF MEDICAL VIROLOGY, Issue 3 2002Patrick Labonté Abstract Hepatitis C virus (HCV) can infect and propagate in humans and chimpanzees. Whereas the chimpanzee has been used as an animal model for infection, ethical considerations, conservation, and the prohibitively high cost preclude progress for experimental research on the biology of the virus. The development of a small animal model for HCV infection is thus desirable to facilitate studies on the infectious cycle of the virus and for the evaluation of drugs for the treatment of HCV infections in humans. As an alternative to the chimpanzee model, we have established a model based on ex vivo infection of orthotopically-implanted human hepatocellular carcinoma cells (HCC) in athymic nude mice. The results show that up to 42 days post-infection, HCV RNA was present in the tumor cells as well as in the liver and serum of infected mice. Furthermore, a direct correlation between size of the tumor and the presence of HCV RNA in the liver was observed, which is concordant with the finding that HCV RNA was detectable only in mice harboring human tumor. Immunohistochemistry analysis of infected liver specimens showed cells expressing the HCV encoded NS5B protein. A few mice developed a humoral response against the nonstructural viral proteins, providing further evidence for expression of these proteins during viral infection. In summary, these results suggest that mice harboring orthotopic tumors support a basal level of HCV replication in vivo. J. Med. Virol. 66:312-319, 2002. © 2002 Wiley-Liss, Inc. [source] The Ethical Outlook of Micro Business OperatorsJOURNAL OF SMALL BUSINESS MANAGEMENT, Issue 4 2002Stuart Dawson This paper reports the findings of an investigation into the ethical outlook of micro business operators. The study was conducted in Australia and is the first such examination of ethical perspectives in this segment of the business population. Micro business is internationally recognizable, economically significant, and strongly entrepreneurial, and it has a high level of control over the values it enacts. The study indicates that ethical considerations are important to Australian micro business operators. While no one single ethical perspective was dominant, nonreligious beliefs and principles were found to be the most important determinant of their ethical values. Some variation was discovered in operator attitudes based on age, gender, and education. [source] Retransplantation for hepatic allograft failure: Prognostic modeling and ethical considerationsLIVER TRANSPLANTATION, Issue 4 2002Scott W. Biggins Retransplantation already accounts for 10% of all liver transplants performed, and this percentage is likely to increase as patients live long enough to develop graft failure from recurrent disease. Overall, retransplantation is associated with significantly diminished survival and increased costs. This review summarizes the current causes of graft failure after primary liver transplant, prognostic models that can identify the subset of patients for retransplantation with outcomes comparable to primary transplantation, and ethical considerations in this setting, i.e., outcomes-based versus urgency-based approaches. [source] Modes of rationality in nursing documentation: biology, biography and the ,voice of nursing'NURSING INQUIRY, Issue 2 2005Abbey Hyde Modes of rationality in nursing documentation: biology, biography, and the ,voice of nursing' This article is based on a discourse analysis of the complete nursing records of 45 patients, and concerns the modes of rationality that mediated text-based accounts relating to patient care that nurses recorded. The analysis draws on the work of the critical theorist, Jürgen Habermas, who conceptualised rationality in the context of modernity according to two types: purposive rationality based on an instrumental logic, and value rationality based on ethical considerations and moral reasoning. Our analysis revealed that purposive rationality dominated the content of nursing documentation, as evidenced by a particularly bio-centric and modernist construction of the workings of the body within the texts. There was little reference in the documentation to central themes of contemporary nursing discourses, such as notions of partnership, autonomy, and self-determination, which are associated with value rationality. Drawing on Habermas, we argue that this nursing documentation depicted the colonisation of the sociocultural lifeworld by the bio-technocratic system. Where nurses recorded disagreements that patients had with medical regimes, the central struggle inherent in the project of modernity became transparent , the tension between the rational and instrumental control of people through scientific regulation and the autonomy of the subject. The article concludes by problematising communicative action within the context of nursing practice. [source] Snap-shots of live theatre: the use of photography to research governance in operating room nursingNURSING INQUIRY, Issue 2 2003Robin Riley Snap-shots of live theatre: the use of photography to research governance in operating room nursing The use of photography is an underreported method of research in the nursing literature. This paper explores its use in an ethnographic research project, the fieldwork of which was undertaken by the first author. The aim was to examine the governance of operating room nursing in the clinical setting and the theoretical orientation was the work of Michel Foucault. The focus of this paper is on how photography was used as a means of data generation. To establish some context we begin by drawing on writers from sociology and anthropology to provide an overview of the status of vision and visual research methods in contemporary social research. We then move to a brief discussion of the uses of photography in social research and the limitations imposed by ethical considerations of its use in clinical nursing settings. As well, the process and approach involved in this research project, and issues of analysis are discussed. Three ,snap-shots' of operating room nursing, taken by participants, are presented. Each is analysed in terms of its contributions to the research process as well as its substantive contribution to the theoretical framework and the research aims. [source] The Kalgoorlie Otitis Media Research Project: rationale, methods, population characteristics and ethical considerationsPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2008Deborah Lehmann Summary Otitis media (OM) is one of the most common paediatric illnesses for which medical advice is sought in developed countries. Australian Aboriginal children suffer high rates of OM from early infancy. The resultant hearing loss can affect education and quality of life. As numerous factors contribute to the burden of OM, interventions aimed at reducing the impact of single risk factors are likely to fail. To identify key risk factors and understand how they interact in complex causal pathways, we followed 100 Aboriginal and 180 non-Aboriginal children from birth to age 2 years in a semi-arid zone of Western Australia. We collected demographic, obstetric, socio-economic and environmental data, breast milk once, and nasopharyngeal samples and saliva on seven occasions. Ear health was assessed by clinical examination, tympanometry, transient evoked otoacoustic emissions and audiometry. We considered the conduct of our study in relation to national ethical guidelines for research in Aboriginal and Torres Strait Islander health. After 1 year of community consultation, the study was endorsed by local committees and ethical approval granted. Fieldwork was tailored to minimise disruption to people's lives and we provided regular feedback to the community. We saw 81% of non-Aboriginal and 65% of Aboriginal children at age 12 months. OM was diagnosed on 55% and 26% of routine clinical examinations in Aboriginal and non-Aboriginal children respectively. Aboriginal mothers were younger and less educated, fewer were employed and they lived in more crowded conditions than non-Aboriginal mothers. Sixty-four per cent of Aboriginal and 40% of non-Aboriginal babies were exposed to environmental tobacco smoke. Early consultation, provision of a service while undertaking research, inclusion of Aboriginal people as active members of a research team and appropriate acknowledgement will assist in ensuring successful completion of the research. [source] Ethical Issues for Psychologists in Pain ManagementPAIN MEDICINE, Issue 2 2001Mary Lou Taylor PhD Pain management is relatively young as a specialty. Although increasing attention is being paid to issues such as pain at the end of life and pain in underserved populations, only recently has an open discussion of ethical issues in chronic pain treatment come to the fore. Psychologists specializing in pain management are faced with a myriad of ethical issues. Although many of these problems are similar to those faced by general clinical psychologists or other health psychologists, they are often made more complex by the multidisciplinary nature of pain management and by the psychologists' relationships to third-party payers (health maintenance organizations, workers' compensation), attorneys, or other agencies. An open forum exploring ethical issues is needed. This article outlines major ethical considerations faced by pain management psychologists, including patient autonomy and informed consent, confidentiality, reimbursement and dual relationships, patient abandonment, assessment for medical procedures, clinical research, and the interface of psychology and medicine. American Psychological Association ethical principles and principles of biomedical ethics need to be considered in ethical decision making. Further exploration and discussion of ethics for pain management psychologists are recommended. [source] | ||||||||||||||||||||||||||||||||||||||||||||||