Although ethics consultation services often engage in some of the most complex and delicate clinical situations, little is known about the qual­ity of these services or their effect on patient care and patient and provider satisfaction. There is still significant work to be done in the areas of training, credentialing, and standardization. This article articulates the essential “build­ing blocks” of the Proactive Ethics Integration model developed at Ascension as well as the lessons we have learned along the (...) way. (shrink)

This manuscript proposes a proactive framework for preventing or mitigating disruptive ethical conflicts that often result from delayed or avoided conversations about the ethics of care. Four components of the framework are explained and illustrated with evidenced-based actions. Clinical implications of adopting a prevention-based, system-wide ethics framework are discussed. While some aspects of ethically-difficult situations are unique, system patterns allow some issues to occur repeatedly—often with lingering effects such as healthcare providers’ disengagement and moral distress (McAndrew et (...) al. Journal of Trauma Nursing 18(4):221–230, 2011), compromised inter-professional relationships (Rosenstein and O’Daniel American Journal of Nursing, 105(1):54–64, 2005), weakened ethical climates (Pauly et al. HEC Forum 24:1–11, 2012), and patient safety concerns (Cimiotti et al. American Journal of Infection Control 40:486–490, 2012). This work offers healthcare providers and clinical ethicists a framework for developing a comprehensive set of proactive, ethics-specific, and evidence-based strategies for mitigating ethical conflicts. Furthermore, the framework aims to encourage innovative research and novel ways of collaborating to reduce such conflicts and the moral distress that often results. (shrink)

This article focuses on academics’ conceptions of teaching research ethics and integrity. Seventeen academics from a Finnish research intensive university participated in this qualitative study. The data were collected using a qualitative multi-method approach, including think-aloud and interview data. The material was scrutinized using thematic analysis, with both deductive and inductive approaches. The results revealed variation in academics’ views on the responsibility for teaching research integrity, the methods employed to teach it and the necessity of intervening when misconduct occurs. (...) The academics emphasized the responsibility of the individual teacher and the student to foster integrity as well as the shared responsibility of all members of the academic community. However, many academics felt that they themselves needed pedagogical training. Most shared the view that practices of responsible conduct in research can be explicitly and intentionally taught through demonstration, explanation, and practice. However, the academics also noted that learning research integrity and ethics takes place implicitly. A few questioned the need for and the utility of training in the form of courses or through an explicitly addressed topic included in, for instance, methods courses. Their views on the question of how to deal with alleged cases of misconduct varied. While many academics considered a proactive approach the best way to prevent misconduct, some trusted more in a reactive approach. The results show that, while in general academics agree on the importance of research ethics, their conceptions of teaching it vary. The teaching conception bears consequences for the teaching methods chosen, assignment of responsibility for both teaching and students learning, and for the way in which teachers believe that misconduct should be responded to. (shrink)

Artificial intelligence (AI) is transforming healthcare, but concerns about algorithmic biases and ethical challenges hinder patient acceptance. This study examined the effects of proactive versus passive algorithmic ethics practices on patient responses across different healthcare engagement types (privacy-focused vs. utility-focused). We conducted a 2 × 2 online experiment with 513 participants in China. The experiment manipulated the healthcare provider’s algorithmic ethics approach (proactive vs. passive) and the healthcare engagement type (privacy-focused vs. utility-focused). Participants were randomly assigned (...) to view a scenario describing a hospital’s AI diagnostic system, then completed measures of attitudes, trust, and intentions to use the AI-enabled service. Proactive algorithmic ethics practices significantly increased positive attitudes, trust, and usage intentions compared to passive practices. The positive impact of proactive practices was stronger for privacy-focused healthcare (e.g., mental health services) compared to utility-focused services emphasizing care optimization. This study underscores the critical role of proactive, context-specific algorithmic ethics practices in cultivating patient trust and engagement with AI-enabled healthcare. To optimize outcomes, healthcare providers must strategically adapt their ethical governance approaches to align with the unique privacy-utility considerations that are most salient to patients across different healthcare contexts and AI use cases. Not applicable. (shrink)

An increasing number of studies explore the relationship between ethical leadership and subordinates’ work behavior. However, it remains unclear whether ethical leadership affects subordinates’ perceptions of the person-job fit and perceived person-organization fit. We examine the effects of ethical leadership on subordinates’ sense of person-environment fit in terms of its effect on displays of positive and negative behaviors. We collected data from 414 employees from various industries over three time periods. Hypotheses were tested using structural equation modeling (SEM). The SEM (...) results show that person-job fit and person-organization fit mediate the effects of ethical leadership on proactive, and unethical behavior. Person-organization fit mediates the effects of ethical leadership on proactive behavior by the organization and unethical behavior by the organization. These results have implications for management. (shrink)

In recent years, the global need for clinical ethics consultation services (CECS) has increased to address ethical challenges, dilemmas, and moral distress in clinical environments. In Japan, many hospitals have introduced CECS over the past decade, but few such services work effectively because of the small number of consultations. To address this, we propose two proactive ethics consultation methods: inter-professional ethics rounds and patient note reviews. This paper provides a detailed explanation of these methods, complete with (...) scenarios based on actual cases. These methods can make CECS ‘well-functioning’ by shifting the starting points of consultation from consultees to CECS providers. We then examine the impact and value of proactive ethics consultation as well as four critical factors for its success including attitude, positioning, and competency of proactive consultation teams. We believe our suggestions will provide valuable insights for future clinical ethics consultations and stimulate academic debate about what constitutes a ‘well-functioning’ CECS. (shrink)

_Develop a practical and comprehensive view of professional ethics_ In the newly updated Second Edition of Positive Ethics for Mental Health Professionals: A Proactive Approach, distinguished psychologists Drs. Sharon K. Anderson and Mitchell M Handelsman deliver an insightful guide for mental health professionals and trainees to stregthen and/or develop their professional and ethical identities. Utilizing the same informal and inviting tone of the first edition, Anderson and Handelsman share the literature and provide positive discussions, exercises, case scenarios, and (...) writing assignments, to help you explore and develop your ethical core. You'll also develop your self-reflective skills to learn how to make excellent ethical choices regarding psychotherapy and couseling. This edition of the book also offers: An introduction of the idea of "tripping points", or predictable pitfalls, when making ethical choices. Discussions of nonrational factors in ethical decision-making, including biases, heuristics, and emotional influences. A renewed focus on ethical acculturation, which emphasizes the importance of your own background in the development of your ethical identity. Perfect for undergraduate and graduate students studying psychotherapy and mental health counseling, _Positive Ethics for Mental Health Professionals_, will also earn a place in the libraries of mental health practitioners seeking a primer on the complicated ethical issues that inevitably arise in their practices- and how to prepare for them and navigate them. (shrink)

Basics of awareness : knowing yourself -- Basics of awareness : privilege and social responsibility -- The process of acculturation : developing your professional ethical identity -- The ethical culture of psychotherapy -- "I can't believe it's not therapy" : boundaries of the psychotherapy relationship -- Confidentiality : a critical element of trust in the relationship -- Informed consent : the three-legged stool -- Making the most of supervision -- Ending psychotherapy : the good, the bad, and the ethical -- (...) Putting it all together : toward ethical excellence. (shrink)

With the advent of responsible business, ensuring social responsibility in sourcing is of interest to both academics and practitioners. In this study, we examine one way of achieving this goal: ethical sourcing initiatives (ESIs). ESIs refer to a firm’s formal and informal actions to manage sourcing processes in an ethical and socially responsible manner. While ESIs have been established as an important part of corporate social responsibility, it is unclear whether, how, and when this corporate effort is economically beneficial. We (...) conduct an event study estimating the shareholder value effect of 159 publicly traded firms’ ESIs and find that the stock market reacts positively to ESIs in general. We also compare market reactions under different conditions including reactive versus proactive ESIs, and their interactions with initiative timing, firm size, and financial risk. Additionally, we find that ESIs are associated with long-term stock price and operating performance. Overall, our findings clarify the potential economic benefits of corporate ESIs and encourage buying firms to take these initiatives selectively according to business contexts. (shrink)

As ethics committees and programs become integrated into the “usual business” of healthcare organizations, they are likely to face the predicament of responding to greater demands for service and higher expectations, without an influx of additional resources. This situation demands that ethics committees and programs allocate their scarce resources (including their time, skills and funds) strategically, rather than lurching from one ad hoc request to another; finding ways to maximize the effectiveness, efficiency, impact and quality of ethics (...) services is essential in today’s competitive environment. How can Hospital Ethics Committees (HECs) begin the process of strategic priority-setting to ensure they are delivering services where and how they are most needed? This paper describes the creation of the Clinical Ethics Needs Assessment Survey (CENAS) as a tool to understand interprofessional staff perceptions of the organization’s ethical climate, challenging ethical issues and educational priorities. The CENAS was designed to support informed resource allocation and advocacy by HECs. By sharing our process of developing and validating this ethics needs assessment survey we hope to enable strategic priority-setting in other resource-strapped ethics programs, and to empower HECs to shift their focus to more proactive, quality-focused initiatives. (shrink)

This study employed a Discourse Ethicality survey instrument to analyze the legitimacy and ethicality of one of Dow Chemical's externally focused, rhetorical, crisis management strategies. A stratified random sample of the issues management bulletin The Point Is . . ., published over a ten year time period, was evaluated. The bulletins were divided into three time periods corresponding to significant events in Dow's history over the ten year period. Statistical and thematic analysis determined that perceived legitimacy and ethicality increased in (...) the bulletins over time. The results showed that at the height of external criticism from the media and public interest groups in the early 80's, Dow's response was characterized as antagonistic and focused on technological arguments. By the late 1980's, the bulletins range of issues had broadened considerably, were perceived as less antagonistic in tone, and focused more on issues and projects that may be described as socially conscious. (shrink)

The use of Intelligent Assistive Technology in dementia care opens the prospects of reducing the global burden of dementia and enabling novel opportunities to improve the lives of dementia patients. However, with current adoption rates being reportedly low, the potential of IATs might remain under-expressed as long as the reasons for suboptimal adoption remain unaddressed. Among these, ethical and social considerations are critical. This article reviews the spectrum of IATs for dementia and investigates the prevalence of ethical considerations in the (...) design of current IATs. Our screening shows that a significant portion of current IATs is designed in the absence of explicit ethical considerations. These results suggest that the lack of ethical consideration might be a codeterminant of current structural limitations in the translation of IATs from designing labs to bedside. Based on these data, we call for a coordinated effort to proactively incorporate ethical considerations early in the design and development of new products. (shrink)

To identify the boundary conditions for proactive employees making whistle-blowing decisions, we developed a cross-level model comprising employee proactive personality and two types of whistle-blowing intentions that incorporates the influences of organizational- and individual-level attributes. Analyses of data collected from 432 Chinese employees in 32 companies indicated that proactive personality was positively related to internal whistle-blowing intention and even more positively related to external whistle-blowing intention when individuals were working in organizations characterized by an instrumental ethical climate (...) and employees with a high level of moral identity. (shrink)

Proactive corporate social responsibility (CSR) involves business strategies and practices adopted voluntarily by firms that go beyond regulatory requirements in order to manage their social responsibilities, and thereby contribute broadly and positively to society. Proactive CSR has been less researched in small and medium enterprises (SMEs) compared to large firms; and, whether SMEs are ideally placed to gain competitive advantage through such activity therefore remains a point of debate. This study examines empirically the association between three specified capabilities (...) (shared vision, stakeholder management and strategic proactivity), proactive CSR and financial performance in SMEs. Using quantitative data collected from a sample of 171 SMEs in the machinery and equipment sector of the Australian manufacturing industry, we find that all specified capabilities are positively associated with adoption of proactive CSR by SMEs, and that proactive CSR is, in turn, associated with an improvement in firm financial performance. Evidence of a fully mediating role for proactive CSR on the association between capabilities and financial performance presented in this study aligns with RBV theory that suggests adoption of value-creating strategies that make the most effective use of a firm’s capabilities is essential to financial success. The study contributes to the CSR literature by demonstrating a case for SMEs being able to maximise financial returns whilst proactively making progress towards CSR. (shrink)

Proactive corporate social responsibility (CSR) involves business practices adopted voluntarily by firms that go beyond regulatory requirements in order to actively support sustainable economic, social and environmental development, and thereby contribute broadly and positively to society. This empirical study examines the role of the economic, social and environmental dimensions of proactive CSR on the association between three specific capabilities—shared vision, stakeholder management and strategic proactivity—and financial performance in small and medium enterprises (SMEs). Using quantitative data collected from a (...) sample of 171 Australian SMEs in the machinery and equipment manufacturing sector and employing structural equation modelling, we find that the adoption of practices in each CSR dimension by SMEs is influenced slightly differently by each capability, and affects financial performance differentially. The study also demonstrates the importance of the interaction between the three dimensions of proactive CSR in positively moderating the deployment of each individual CSR dimension to generate financial performance. Paying primary attention to the economic dimension of proactive CSR and selectively focusing on social and environmental elements of proactive CSR that drive and support the economic dimension are of key importance to sustainable long-term financial success for SMEs. (shrink)

ABSTRACTIn the United States, constitutional and statutory law reinforce the right of all children to receive an education, regardless of their citizenship or immigration status. In a time of heightened anti-immigrant sentiment and law enforcement, however, partnerships among school districts, local law enforcement, and the U.S. Departments of Justice and Homeland Security subject undocumented and unaccompanied minor students to indefensible levels of risk for detention and deportation. We identify three stances that U.S. schools may take in the face of a (...) potential ‘school-to-deportation pipeline.’ Schools that engage in intentional collaboration actively increase detention and deportation by referring students to immigration officials for criminal, non-criminal, and even non-disciplinary activity. Schools that engage in predictable complicity may not intend to subject their undocumented and unaccompanied minor students to detention or deportation, but still put students at risk by involving police in school policies. We argue that U.S. schools should instead engage in proactive protection of immigrant students and families, including actively resisting federal policies when necessary. (shrink)

We argue that the stakeholder perspective on corporate social responsibility is in the process of being enlarged. Due to the process of institutional isomorphism, corporations are increasingly adopting organizational features designed to promote proactivity over mere reactivity in their stakeholder relationships. We identify two sources of pressure promoting the emergence of the proactive corporation -- stakeholder activism and the recognition of the social embeddedness of the economy. The final section describes four organizational design dimensions being installed by the more (...) proactive corporations today -- cooperation, participation, negotiation, and direct anticipation. (shrink)

Business ethics education is a cornerstone of preparing future leaders to navigate the complex ethical dilemmas inherent in modern management. Existing curricula often fall short of equipping students with actionable tools to address these challenges, frequently adopting reactive approaches rather than fostering proactive ethical reasoning. This paper addresses the gaps by creating a framework that applies normative ethics—consequentialism, deontology, and virtue ethics. We further propose a teaching protocol for an in-class activity in which student groups can (...) apply their understanding of the framework in real-world scenarios. (shrink)

Drawing on the transactional model of stress, we propose that organizational identification and positive affectivity moderate the relationship between abusive supervision and proactive behavior. In Study 1, we collected data from a sample of 165 dentists and 41 supervisors in two Chinese hospitals. In Study 2, we used a sample of 226 employee-supervisor dyads from a large Chinese transportation company. The results of two studies showed that the interaction between abusive supervision and organizational identification on proactive behavior occurred (...) only when positive affectivity was high. We discuss theoretical and managerial implications and indicate future research directions. (shrink)

Performance appraisals are widely used as an HR instrument. This study among 332 police officers examines the effects of performance appraisals from a behavioral ethics perspective. A mediation model relating justice perceptions of police officers’ last performance appraisal to their work affect, perceived supervisor and organizational support and, in turn, their ethical (pro-organizational proactive) and unethical (counterproductive) work behavior was tested empirically. The relationship between justice perceptions and both, ethical and unethical behavior was mediated by perceived support and (...) work affect. Hence, a singular yearly performance appraisal was linked to both ethical and unethical behaviors at work. The finding that ethical and unethical aspects of employee behavior share several of the same organizational antecedents, namely organizational justice perceptions, has strong practical implications which are discussed as well. (shrink)

Globally, family firms are the dominant organizational form. Family involvement in business and unique family dynamics impacts organizational strategy and performance. However, family control of business has rarely been adopted as a discriminating variable in the organizations and the natural environment (ONE) research field. Drawing on the theory of planned behavior we develop a conceptual framework of the drivers of proactive environmental strategy (PES) in family firms. We argue that family involvement in business influences the attitudes, subjective norms, and (...) perceived behavioral control of a firm’s dominant coalition. Together these factors determine the extent of the dominant coalition’s intentions to undertake PES. Further, family firms with lower levels of relationship conflict within the controlling family will be more successful in translating the dominant coalition’s intentions to allocate resources for the pursuit of PES. Research implications of the theory are discussed. (shrink)

As military institutions explore the use of enhancement technologies to improve combat readiness and operational effectiveness, critical ethical and policy questions emerge about the long-term consequences of these interventions. This paper examines the reintegration challenges facing enhanced veterans—those who undergo cognitive, neurological, genetic, or physiological modifications during service—and explores the military’s obligations to support their post-service lives. We analyze how enhancements, though often framed as temporary or mission-specific, may result in lasting changes to cognition, emotion, and identity that complicate veterans’ (...) ability to rejoin civilian life. Drawing from military ethics, bioethics, and neuroethics literature, we examine issues of autonomy, informed consent, and structural coercion within the hierarchical nature of military service. We argue that enhancement may not only exacerbate existing barriers to healthcare, employment, and social belonging but also generate novel forms of stigma and challenge existing systems of support. To address these challenges, we recommend policy interventions including the establishment of an enhanced veteran registry, expanded research funding, and the development of tailored long-term care strategies. We conclude that protecting the rights and dignity of enhanced service members requires proactive ethical and institutional planning—before, during, and long after their time in uniform. (shrink)

Common‐sense morality has it that parents are morally justified in acting partially toward their own children. More controversial, however, is the form of partiality that obtains between prospective parents and their yet‐to‐be‐conceived future children – or ‘pre‐parental partiality’, for short. Is pre‐parental partiality morally justified? On one hand, our intuitions seem to tell us that it is. On the other hand, we have philosophers like Douglas and Podgorski seeking to undermine its moral justifiability by arguing that we possess no reasons (...) of special concern at all to engage in pre‐parental partiality. This paper aims to rescue the moral justifiability of pre‐parental partiality in light of these arguments. In particular, a novel account of our pre‐parental partiality obligations is developed; one which sees our special reasons (as prospective parents) for engaging in pre‐parental partiality as arising from the special reasons for engaging in standard parental partiality that we come to possess (as parents) in the future. The result is a compelling moral justification for pre‐parental partiality that amends itself to a whole platitude of views of what our standard parental obligations of partiality amount to. (shrink)

Scholars have shown renewed interest in the construct of courage. Recent studies have explored its theoretical underpinnings and measurement. Yet courage is generally discussed in its broad form to include physical, psychological, and moral features. To understand a more practical form of moral courage, research is needed to uncover how ethical challenges are effectively managed in organizational settings. We argue that professional moral courage (PMC) is a managerial competency. To describe it and derive items for scale development, we studied managers (...) in the U.S. military and examined prior work on moral courage. Two methods were used to measure PMC producing a five dimensional scale that organized under a single second-order factor, which we termed overall PMC. The five dimensions are moral agency, multiple values, endurance of threats, going beyond compliance, and moral goals. Convergent and discriminant validity are analyzed by use of confirmatory factor analysis procedures. We conclude by presenting a framework for proactive organizational ethics, which reflects how to support PMC as a management practice. (shrink)

This study sheds new light on why healthcare organisations are having difficulty responding to the growing pressure from stakeholders to proactively address their responsibility to deliver high-quality services without harming the environment. Basing our work on past research on stakeholder pressure and environmental barriers, we conceptualise and empirically test the effect of the interplay between stakeholder pressure and internal barriers on healthcare organisations’ adoption of proactive environmental strategies. To test the proposed hypotheses, a survey was carried out among medical (...) directors of Italian healthcare organisations in 2012. Our results show that the lack of commitment to environmental issues within the organisation represents the main barrier to healthcare organisations’ implementing PESs. Furthermore, the difficulties in evaluating the impacts of advanced environmental practices negatively moderate the influence of stakeholders on developing PESs. Our findings contribute to extending previous knowledge on PESs in two ways: focusing on the healthcare sector, our study investigates the phenomenon in a research context that has been largely overlooked in the sustainability literature; and cross-cutting previous research on stakeholder pressure and internal barriers, the study conceptualises and tests a more complete framework for understanding the adoption of PESs. (shrink)

PurposeThis conceptual paper aims to examine theoretical issues in the proactive ethical assessment of technology development, with a focus on uncertainty. Although uncertainty is a fundamental feature of complex technologies, its importance has not yet been fully recognized within the field of ethics. Hence, the purpose of this paper is to study uncertainty in technology development and its consequences for ethics.Design/methodology/approachGoing on the insight of various scientific disciplines, the concept of uncertainty will be scrutinised and a typology (...) of uncertainty is proposed and introduced to ethical theory. The method used is theoretical and conceptual analysis.FindingsThe analysis results in questions with regard to the collection of information about the object of assessment (i.e. complex technologies and their development) and the framework of assessment (i.e. ethical theory and its practical aim of guiding the assessment of technology development). Moreover, based on the insights of the analysis of uncertainty, it is argued that substantive ethical theories prove to be inapt for the ethical assessment of complex technology development and therefore require a concomitant procedural approach. The paper concludes with requirements for any future ethics of technology under uncertainty.Originality/valueThe value of the paper consists in establishing the need of researching and incorporating uncertainty in ethics. The results are consequently of practical and theoretical interest for anyone working in the field of ethics and technology. (shrink)

This research proposes an explanation for the conflicting extant evidence about whether family ownership of a business promotes proactive environmental strategy (PES). Based on insights drawn from strategic reference point theory, organizational identity theory, and the socioemotional wealth preservation perspective, we propose that family ownership has a moderated–mediated relationship with PES, with commitment as a moderator and long-term orientation as a mediator. A test using 454 China private firms with different levels of family ownership supports the hypotheses. This shows (...) that PES as a strategy related to business ethics does not happen without commitment and long-term orientation. (shrink)

The ethics of artificial intelligence is a widely discussed topic. There are numerous initiatives that aim to develop the principles and guidance to ensure that the development, deployment and use of AI are ethically acceptable. What is generally unclear is how organisations that make use of AI understand and address these ethical issues in practice. While there is an abundance of conceptual work on AI ethics, empirical insights are rare and often anecdotal. This paper fills the gap in (...) our current understanding of how organisations deal with AI ethics by presenting empirical findings collected using a set of ten case studies and providing an account of the cross-case analysis. The paper reviews the discussion of ethical issues of AI as well as mitigation strategies that have been proposed in the literature. Using this background, the cross-case analysis categorises the organisational responses that were observed in practice. The discussion shows that organisations are highly aware of the AI ethics debate and keen to engage with ethical issues proactively. However, they make use of only a relatively small subsection of the mitigation strategies proposed in the literature. These insights are of importance to organisations deploying or using AI, to the academic AI ethics debate, but maybe most valuable to policymakers involved in the current debate about suitable policy developments to address the ethical issues raised by AI. (shrink)

Background While the theoretical benefits and harms of Artificial Intelligence (AI) have been widely discussed in academic literature, empirical evidence remains elusive regarding the practical ethical challenges of developing AI for healthcare. Bridging the gap between theory and practice is an essential step in understanding how to ethically align AI for healthcare. Therefore, this research examines the concerns and challenges perceived by experts in developing ethical AI that addresses the healthcare context and needs. Methods We conducted semi-structured interviews with 41 (...) AI experts and analyzed the data using reflective thematic analysis. Results We developed three themes that expressed the considerations perceived by experts as essential for ensuring AI aligns with ethical practices within healthcare. The first theme explores the ethical significance of introducing AI with a clear and purposeful objective. The second theme focuses on how experts are concerned about the tension that exists between economic incentives and the importance of prioritizing the interests of doctors and patients. The third theme illustrates the need to develop context-sensitive AI for healthcare that is informed by its underlying theoretical foundations. Conclusions The three themes collectively emphasized that beyond being innovative, AI must genuinely benefit healthcare and its stakeholders, meaning AI also aligns with intricate and context-specific healthcare practices. Our findings signal that instead of narrow product-specific AI guidance, ethical AI development may need a systemic, proactive perspective that includes the ethical considerations (objectives, actors, and context) and focuses on healthcare applications. Ethically developing AI involves a complex interplay between AI, ethics, healthcare, and multiple stakeholders. (shrink)

Evaluating clinical ethics support services has been hailed as important research task. At the same time, there is considerable debate about how to evaluate CESS appropriately. The criticism, which has been aired, refers to normative as well as empirical aspects of evaluating CESS. In this paper, we argue that a first necessary step for progress is to better understand the intervention in CESS. Tools of complex intervention research methodology may provide relevant means in this respect. In a first step, (...) we introduce principles of “complex intervention research” and show how CESS fulfil the criteria of “complex interventions”. In a second step, we develop a generic “conceptual framework” for “ethics consultation on request” as standard for many forms of ethics consultation in clinical ethics practice. We apply this conceptual framework to the model of “bioethics mediation” to make explicit the specific structural and procedural elements of this form of ethics consultation on request. In a final step we conduct a comparative analysis of two different types of CESS, which have been subject to evaluation research: “proactive ethics consultation” and “moral case deliberation” and discuss implications for evaluating both types of CESS. To make explicit different premises of implemented CESS interventions by means of conceptual frameworks can inform the search for sound empirical evaluation of CESS. In addition, such work provides a starting point for further reflection about what it means to offer “good” CESS. (shrink)

This paper examines the influence of internal barriers on the relationship between the organizational capability of stakeholder integration and proactive environmental strategies. We adopt a moderate hierarchical regression model to test the hypotheses using data from a sample of 73 managers in the business education industry. The paper contributes to stakeholder theory by showing that stakeholder integration positively influences the development of proactive environmental strategies when managers perceive internal barriers to the development of such strategies. This article also (...) explores an ethical dilemma—managers may use the stakeholder integration capability to support their own interests rather than to benefit stakeholders. (shrink)

Cognitive technology is an umbrella term sometimes used to designate the realm of technologies that assist, augment or simulate cognitive processes or that can be used for the achievement of cognitive aims. This technological macro-domain encompasses both devices that directly interface the human brain as well as external systems that use artificial intelligence to simulate or assist (aspects of) human cognition. As they hold the promise of assisting and augmenting human cognitive capabilities both individually and collectively, cognitive technologies could produce, (...) in the next decades, a significant effect on human cultural evolution. At the same time, due to their dual-use potential, they are vulnerable to being coopted by State and non-State actors for non-benign purposes (e.g. cyberterrorism, cyberwarfare and mass surveillance) or in manners that violate democratic values and principles. Therefore, it is the responsibility of technology governance bodies to align the future of cognitive technology with democratic principles such as individual freedom, avoidance of centralized, equality of opportunity and open development. This paper provides a preliminary description of an approach to the democratization of cognitive technologies based on six normative ethical principles: avoidance of centralized control, openness, transparency, inclusiveness, user-centeredness and convergence. This approach is designed to universalize and evenly distribute the potential benefits of cognitive technology and mitigate the risk that such emerging technological trend could be coopted by State or non-State actors in ways that are inconsistent with the principles of liberal democracy or detrimental to individuals and groups. (shrink)

Renewable energy has gained much-deserved prominence on the world stage of sustainable development, yet despite the surging interest there is a notable lack of understanding regarding best practices in business – stakeholder relations. Using a constructivist grounded theory approach (Charmaz, 2005) and drawing from complexity theory and social scientific theories of identity, our empirical study shows that core values and identity are strongly implicated in the formation and negotiation of stakeholder attitudes for both individuals and social groups. Specifically, we find (...) that personal and social identity are core drivers of community attitude development in a complex adaptive system, and that conflicts between strongly held identities are galvanized along bifurcated “axes of tension” that are also strongly implicated in community attitude formation processes. (shrink)

Ethical concerns in e-social science are often raised with respect to privacy, confidentiality, anonymity and the ethical and legal requirements that govern research. In this article, the authors focus on ethical aspects of e-research that are not directly related to ethical regulatory framework or requirements. These frameworks are often couched in terms of benefits or harms that can be incurred by participants in the research. The authors shift the focus to the sources of value in terms of which benefits or (...) harms are understood in real social situations. A central claim of this paper is that the technologies that are used for research are not value neutral, but serve to reinforce some values at the expense of others. The authors discuss databases, modelling and simulation, network analysis as examples of technologies which affect the articulation of values. A view of e-social science as a techno-scientific constellation of researchers, technologies and society, in which values are always already embedded, is put forward as a basis for a view of ethics as reflexive and active engagement, conducted with awareness. Methodological pluralism and proactive openness are also proposed as responses to this view of the ethical dimensions of e-social science. (shrink)

Background Artificial intelligence-driven Clinical Decision Support Systems (AI-CDSS) are increasingly being integrated into healthcare for various purposes, including resource allocation. While these systems promise improved efficiency and decision-making, they also raise significant ethical concerns. This study aims to explore healthcare professionals’ perspectives on the ethical implications of using AI-CDSS for healthcare resource allocation. Methods We conducted semi-structured qualitative interviews with 23 healthcare professionals, including physicians, nurses, administrators, and medical ethicists in Turkey. Interviews focused on participants’ views regarding the use of (...) AI-CDSS in resource allocation, potential ethical challenges, and recommendations for responsible implementation. Data were analyzed using thematic analysis. Results Participant responses are clustered around five pre-determined thematic areas: (1) balancing efficiency and equity in resource allocation, (2) the importance of transparency and explicability in AI-CDSS, (3) shifting roles and responsibilities in clinical decision-making, (4) ethical considerations in data usage and algorithm development, and (5) balancing cost-effectiveness and patient-centered care. Participants acknowledged the potential of AI-CDSS to optimize resource allocation but expressed concerns about exacerbating healthcare disparities, the need for interpretable AI models, changing professional roles, data privacy, and maintaining individualized care. Conclusions The integration of AI-CDSS into healthcare resource allocation presents both opportunities and significant ethical challenges. Our findings underscore the need for robust ethical frameworks, enhanced AI literacy among healthcare professionals, interdisciplinary collaboration, and rigorous monitoring and evaluation processes. Addressing these challenges proactively is crucial for harnessing the potential of AI-CDSS while preserving the fundamental values of equity, transparency, and patient-centered care in healthcare delivery. (shrink)

Background Ethical leadership is recognized as a key factor influencing proactive employee behaviors in healthcare. However, limited longitudinal evidence exists on its relationship with nurses’ voice behavior over time. Objectives This study examines the longitudinal relationship between ethical leadership and nurses’ voice behavior and investigates the mediating role of sense of professional mission. Research design A multicenter longitudinal survey was conducted with data collected at three time points over 6 months; validated scales measured all variables. Data were analyzed using (...) Pearson correlation and structural equation modeling. Participants and research context The study included 537 registered nurses from four hospitals in China, recruited through stratified cluster sampling. Ethical considerations The Biomedical Research Ethics Subcommittee of Henan University approved the study. Written informed consent was obtained, and anonymity was ensured. Results Ethical leadership at T1 was positively associated with sense of professional mission at T2 (β = 0.18, p < 0.001), which predicted voice behavior at T3 (β = 0.20, p < 0.001). A direct path from T1 ethical leadership to T3 voice behavior was also found (β = 0.18, p < 0.001). Sense of professional mission mediated 16.98% of the total effect. The model demonstrated good fit (χ 2 /df = 2.374, RMSEA = 0.051, CFI = 0.986). Conclusions Ethical leadership influences nurses’ voice behavior both directly and indirectly through enhancing sense of professional mission. Strengthening ethical leadership and fostering professional mission may promote voice behavior in clinical settings. (shrink)

A number of Artificial Intelligence (AI) ethics frameworks have been published in the last 6 years in response to the growing concerns posed by the adoption of AI in different sectors, including healthcare. While there is a strong culture of medical ethics in healthcare applications, AI-based Healthcare Applications (AIHA) are challenging the existing ethics and regulatory frameworks. This scoping review explores how ethics frameworks have been implemented in AIHA, how these implementations have been evaluated and whether (...) they have been successful. AI specific ethics frameworks in healthcare appear to have a limited adoption and they are mostly used in conjunction with other ethics frameworks. The operationalisation of ethics frameworks is a complex endeavour with challenges at different levels: ethics principles, design, technology, organisational, and regulatory. Strategies identified in this review are proactive, contextual, technological, checklist, organisational and/or evidence-based approaches. While interdisciplinary approaches show promises, how an ethics framework is implemented in an AI-based Healthcare Application is not widely reported, and there is a need for transparency for trustworthy AI. (shrink)

Transitional justice (TJ) must help a society move beyond a time when mass murder was happening. Transitional justice works toward a season when victims have their rights restored. One way to restore victims’ rights is to recognize them as having the right to defend themselves (R2D). Another way to restore victims’ rights is to have states embrace and act upon a responsibility to protect (R2P) the oppressed. It is an injustice to exercise the responsibility to protect (R2P) for a privileged (...) few. R2D is a positive right granted to potential victims as a collective. R2P is a duty assumed by a state as a collective. Individuals can lend moral and actual support to the discharge of both operations. Both proactive steps value those who are oppressed, and it is possible that R2D could be incorporated within a R2P plan. However, R2D requires oppressed people to adopt a proactive approach to protect their welfare. A state or international agency must initiate and uphold R2P. The ethical implications of both R2D and R2P are explored in this chapter. (shrink)

Previously diagnosed by symptoms alone, Alzheimer's disease is now also defined by measures of amyloid and tau, referred to as “biomarkers.” Biomarkers are detectible up to twenty years before symptoms present and open the door to predicting the risk of Alzheimer's disease. While these biomarkers provide information that can help individuals and families plan for long-term care services and supports, insurers could also use this information to discriminate against those who are more likely to need such services. In this article, (...) we evaluate whether state laws prohibit long-term care insurers from making discriminatory or unfair underwriting and coverage decisions based Alzheimer's disease biomarkers status. We report data demonstrating that current state laws do not provide meaningful protections from discrimination by long-term care insurers based on biomarker information. (shrink)

A product harm crisis undermines a firm’s reputation as well as its managers’ career outlook. To shake off the stigmatization resulting from the PHC and regain a firm’s legitimacy among stakeholders, managers usually face an ethical dilemma as they choose to be transparent about the crisis’ financial implications or to obfuscate them to neutralize the negative impact of the PHC. We find evidence that managers engage in income-increasing earnings management when their firms experience PHCs. Moreover, while income-increasing earnings management in (...) PHCs reduces the likelihood of customer loss and CEO forced turnover in the short run, such behavior can be deemed opportunistic and unethical as it carries long-run negative consequences in terms of a higher likelihood of accounting restatement and weaker future operating performance. Finally, managers in firms that are subject to stricter external monitoring and managers in firms with proactive ethical policies are less likely to engage in upward earnings management in PHCs. (shrink)

BackgroundOur human societies and certainly also (bio) medicine are more and more permeated with technology. There seems to be an increasing awareness among bioethicists that an effective and comprehensive approach to ethically guide these emerging biomedical innovations into society is needed. Such an approach has not been spelled out yet for bioethics, while there are frequent calls for ethical guidance of biomedical innovation, also by biomedical researchers themselves. New and emerging biotechnologies require anticipation of possible effects and implications, meaning the (...) scope is not evaluative after a technology has been fully developed or about hypothetical technologies, but real-time for a real biotechnology.Main textIn this paper we aim to substantiate and discuss six ingredients that we increasingly see adopted by ethicists and that together constitute “ethics parallel research”. This approach allows to fulfil two aims: guiding the development process of technologies in biomedicine and providing input for the normative evaluation of such technologies. The six ingredients of ethics parallel research are: (1) disentangling wicked problems, (2) upstream or midstream ethical analysis, (3) ethics from within, (4) inclusion of empirical research, (5) public participation and (6) mapping societal impacts, including hard and soft impacts. We will draw on gene editing, organoid technology and artificial intelligence as examples to illustrate these six ingredients.ConclusionEthics parallel research brings together these ingredients to ethically analyse and proactively or parallel guide technological development. It widens the roles and judgements from the ethicist to a more anticipatory and constructively guiding role. Ethics parallel research is characterised by a constructive, rather than a purely critical perspective, it focusses on developing best-practices rather than outlining worst practice, and draws on insights from social sciences and philosophy of technology. (shrink)

We develop a series of propositions regarding drivers of proactive environmental behavior. A grounded theory method, including interviews and focus groups of winery managers and other institutional agents, is used to test these propositions. Finally, we develop a conceptual framework illustrating the relevance and relative importance of certain drivers in determining proactive environmental behavior.

Many commonly prescribed medications contain animal-derived ingredients, such as gelatin, lactose, and magnesium stearate. For ethical vegans, who abstain from consuming animal products on moral grounds, this presents a serious but often overlooked challenge. Physicians rarely disclose the presence of such ingredients—partly due to poor labeling by manufacturers and partly due to their own lack of awareness—thereby undermining patient autonomy. Ethical veganism, while not a religion, plays a role in many patients’ lives comparable to religious belief, and thus merits similar (...) respect in clinical decision-making. Failure to disclose animal ingredients risks psychological harm, damages trust in the physician–patient relationship, and can lead to medication nonadherence with significant health consequences. In this paper, I argue that drug manufacturers should replace animal-derived excipients with plant-based or synthetic alternatives where feasible and must provide transparent labeling or accessible databases to inform patients and providers. Medical schools should include these issues in their curricula, and physicians should take a proactive approach to informed consent. Addressing these concerns would not only foster the autonomy of ethical vegans but also improve health outcomes and inclusivity in medical practice. (shrink)

Background: In 2019, an outbreak of COVID-19 broke out in Hubei, China. Medical workers from all over the country rushed to Hubei and participated in the treatment and care of COVID-19 patients. These nurses, dedicated to their professional practice, volunteered to provide compassion and expert clinical care during the pandemic. As with other acts of heroism, the ethical dilemmas associated with working on the front line must be considered for future practice. Purpose: To explore the ethical dilemmas of frontline nurses (...) of Jiangsu Province in China during deployment to Wuhan to fight the novel coronavirus pneumonia, and to provide a basis for developing strategies to help nursing staff address personal and practice concerns in order to work more effectively during this pandemic and other disasters in the future. Research design and method: Using the phenomenological research method and the purpose sampling method, semi-structured interviews were conducted with 10 nurses, post-deployment to Wuhan, who had worked on the front line to fight the novel coronavirus. Ethical considerations: The research proposal was approved by the Research Ethic Committee of Yangzhou University, China. Findings: From the analysis of the interviews of the 10 participants, three main themes were identified: ethical dilemmas in clinical nursing, ethical dilemmas in interpersonal relationships, and ethical dilemmas in nursing management. Conclusion: During a quick response to public health emergencies, where nurses are deployed immediately as a call to action, the issues surrounding ethical dilemmas from several perspectives must be considered. This research suggests that a team approach to proactive planning and open communication during the emergency is an efficient and productive strategy to improve the nurses’ experience and sense of well-being. (shrink)

Current philosophical literature positions socially disruptive innovation as a force that should be regulated and steered through coordinated societal response, anticipatory governance, and even a kind of engineering. To understand what is at stake, in this chapter several distinct meanings of social and moral disruption are distinguished, according to which new technologies such as artificial intelligence (AI) create severe risks to stakeholders, create interpretive and moral uncertainty, and threaten the breakdown of familiar systems for thinking about and acting upon reality. (...) Then, the philosophical landscape of disruptive innovation in relation to human agency and control is explored. Arguably, breakdowns associated with “ethics under disruption” cannot easily be rationally anticipated and morally acted upon, setting limits to the intelligibility of morally positive, disruptive innovation. Although there is reason to be cautious about the prospects for steering disruption because of the limits of control, categories of proactive strategies for morally positive disruption, such as conceptual engineering, are set forward here. (shrink)

While the literature on the effective management of business and natural environment interfaces is rich and growing, there are still two questions regarding which the literature has yet to reach a definitive conclusion: (1) what is the interactive effect between internal and external drivers on a proactive environmental strategy (PES)? and (2) does a PES influence firm's performance? Drawing on the resource-based view for the internal drivers' perspective and institutional and legitimacy theories for the external drivers' perspective, this study (...) suggests that the effect of entrepreneurial orientation on a PES is moderated by the intensity of government regulations and customers' sensitivity to environmental issues. The authors also examine the relationship between the PES and a firm's performance in terms of sales and profit growth. Implications are discussed regarding the role of a PES in achieving a competitive advantage in the marketplace. (shrink)

Clinical ethics support services are developing in Europe. They will be most useful if they are designed to match the ethical concerns of clinicians. We conducted a cross-sectional mailed survey on random samples of general physicians in Norway, Switzerland, Italy, and the UK, to assess their access to different types of ethics support services, and to describe what makes them more likely to have used available ethics support. Respondents reported access to formal ethics support services such (...) as clinical ethics committees (23%), consultation in individual cases (17.6%), and individual ethicists (8.8%), but also to other kinds of less formal ethics support (23.6%). Access to formal ethics support services was associated with work in urban hospitals. Informal ethics resources were more evenly distributed. Although most respondents (81%) reported that they would find help useful in facing ethical difficulties, they reported having used the available services infrequently (14%). Physicians with greater confidence in their knowledge of ethics (P = 0.001), or who had had ethics courses in medical school (P = 0.006), were more likely to have used available services. Access to help in facing ethical difficulties among general physicians in the surveyed countries is provided by a mix of official ethics support services and other resources. Developing ethics support services may benefit from integration of informal services. Development of ethics education in medical school curricula could lead to improved physicians sensititity to ethical difficulties and greater use of ethics support services. Such support services may also need to be more proactive in making their help available. (shrink)

The dynamic landscape of ethics in higher education is pivotal as organizations and individuals navigate diverse stakeholder needs. Ethical responsibility becomes an integral facet of all professionals, highlighting the crucial role of ethical education in preparing students for post-graduation success. The acquisition of ethical competence, rooted in knowledge of ethical principles, equips students with the tools to make ethical decisions, shaping their ethical behavior and responses. Yezreel Valley College exemplifies this commitment, with a well-defined Code of Academic Ethics (...) reflecting universal values and principles, overseen by the College Ethics Committee. In summary, this case study offers insights into Yezreel Valley College's ethical education practices, emphasizing the significance of ethics in higher education and the dynamic interplay between ethics and professionalism. The college's proactive approach positions it as a leader in addressing ethical challenges and adapting to changing environments while fostering ethical competence in its students. (shrink)