Since 2020, the COVID-19 pandemic has had a major impact on personal, social and societal life worldwide. The virus threatens the physical health, social contacts and financial and economic security of many. The pandemic has led to polarisation in society, to an increase in social inequality, to a threat to democratic rights and to international tensions. Social work has not been left unaffected either. Based on research conducted by the Centre for Social Innovation of HU University of Applied Sciences Utrecht Netherlands and financed by ZonMw, a concise ethical manual was developed for social professionals in crisis situations. It contains a series of questions for reflection that can be used to make the most important ethical challenges explicit and to take action. The guide is also suitable for carrying out a brief ethical review, as it were, individually or collectively, in the hectic day-to-day work.
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Project objectives Radicalisation research leads to ethical and legal questions and issues. These issues need to be addressed in way that helps the project progress in ethically and legally acceptable manner. Description of Work The legal analysis in SAFIRE addressed questions such as which behavior associated with radicalisation is criminal behaviour. The ethical issues were addressed throughout the project in close cooperation between the ethicists and the researchers using a method called ethical parallel research. Results A legal analysis was made about criminal law and radicalisation. During the project lively discussions were held in the research team about ethical issues. An ethical justification for interventions in radicalisation processes has been written. With regard to research ethics: An indirect informed consent procedure for interviews with (former) radicals has been designed. Practical guidelines to prevent obtaining information that could lead to indirect identification of respondents were developed.
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The guidance offered here is intended to assist social workers in thinking through the specific ethical challenges that arise whilst practising during a pandemic or other type of crisis. In crisis conditions, people who need social work services, and social workers themselves, face increased and unusual risks. These challenging conditions are further compounded by scarce or reallocated governmental and social resources. While the ethical principles underpinning social work remain unchanged by crises, unique and evolving circumstances may demand that they be prioritised differently. A decision or action that might be regarded as ethically wrong in ‘normal’ times, may be judged to be right in a time of crisis. Examples include: prioritising individual and public health considerations by restricting people’s freedom of movement; not consulting people about treatment and services; or avoiding face-to-face meetings.
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Aim: Midwives are expected to identify and help resolve ethics problems that arise in practice, skills that are presumed to be taught in midwifery educational programs. In this study, we explore how midwives recognize ethical dilemmas in clinical practice and examine the sources of their ethics education. Methods: We conducted semi-structured, individual interviews with midwives from throughout the United States (U.S.) (n = 15). Transcripts of the interviews were analysed using an iterative process to identify themes and subthemes. Findings: Midwives described a range of professional ethical dilemmas, including challenges related to negotiating strained interprofessional relationships and protecting or promoting autonomy for women. Ethical dilemmas were identified by the theme of unease, a sense of distress that was expressed in three subthemes: uncertainty of action, compromise in action, and reflecting on action. Learning about ethics and ethical dilemmas occurred, for the most part, outside of the classroom, with the majority of participants reporting that their midwifery program did not confer the skills to identify and resolve ethical challenges. Conclusion: Midwives in this study reported a range of ethical challenges and minimal classroom education related to ethics. Midwifery educators should consider the purposeful and explicit inclusion of midwifery-specific ethics content in their curricula and in interprofessional ethics education. Reflection and self-awareness of bias were identified as key components of understanding ethical frameworks. As clinical preceptors were identified as a key source of ethics learning, midwifery educators should consider ways to support preceptors in building their skills as role models and ethics educators.
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This article aims to explore the moral ideas and experiences that students at Dutch universities of applied sciences (UAS) have of being a professional with an ‘ethical compass.’Semi-structured interviews were held with 36 fourth-year Bachelor students divided over four institutions and three different programmes: Initial Teacher Educa- tion, Business Services and Information and Communication Technology. Findings show that students say they strive to be(come) moral professionals, but that they have difficulties recognising and articulating the moral aspects of their professional roles. They seem to lack a moral vocabulary and the moral knowledge to verbalise their aspirations and to provide arguments to explicate or legitimise their moral behaviour. While most students were critical of the support they received from their universities, they indicated that various other role models and (work) experiences did have a strong and positive influence on their moral development. In this article, we reflect on the findings in relation to international empirical research on students’ moral development and highlight the characteristics of UAS students.
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Abstract for World Physiotherapy Congress 2021Title Ethical Considerations of Using Machine Learning for Decision Support in Occupational Physical Therapy: a narrative literature study and ethical deliberation. Authors Marianne W. M. C. Six Dijkstra1,4,7 · Egbert Siebrand2 · Steven Dorrestijn2 · Etto L. Salomons3 ·Michiel F. Reneman4 · Frits G. J. Oosterveld1 · Remko Soer1,5 · Douglas P. Gross6 · Hendrik J. Bieleman1 Presenter and contactName: Marianne W. M. C. Six DijkstraEmail: w.m.c.sixdijkstra@saxion.nlAdres: School of Health, Saxion University of Applied Sciences/AGZ, M.H. Tromplaan 28, 7500 KB, Enschede, The NetherlandsTel: +31(0)612379329 1 School of Health, Saxion University of AppliedSciences, Enschede, The Netherlands2 Research Group Ethics & Technology, Saxion Universityof Applied Sciences, Enschede, The Netherlands3 School of Ambient Intelligence, Saxion Universityof Applied Sciences, Enschede, The Netherlands4 Department of Rehabilitation Medicine, University MedicalCenter Groningen, University of Groningen, Groningen,The Netherlands5 University Medical Center Groningen, Pain Centre,University of Groningen, Groningen, The Netherlands6 Department of Physical Therapy, University of Alberta,Edmonton, Canada7 University of Groningen, Groningen, The Netherlands Funding This study was funded by Netherlands Organisation for Scientific Research (NWO) (023.011.076) and Saxion University of Applied Sciences in The Netherlands. The funding source had no involvementin study design, data collection, analysis or interpretation, in the writing of the report, or the decision to submit the article for publication.Ethical approvalThis study is part of a PhD project entitled “Development of a Decision Support System – Artificial Intelligence advices for Sustainable Employability”. The Ethics Board at the University Medical Center Groningen in The Netherlands decided that formal approval of the study was not necessary because all workers were subjected to care as usual only.AbstractBackground Computer algorithms and Machine Learning (ML) will be integrated into clinical decision support within physical therapy. This will change the interaction between therapists and their clients, with unknown consequences.Purpose The aim of this study was to explore ethical considerations and potential consequences of using ML based decision support tools (DSTs). We used an example in the context of occupational physical therapy.Methods We conducted an ethical deliberation. This was supported by a narrative literature review of publications about ML and DSTs in occupational health and by an assessment of the potential impact of ML-DSTs according to frameworks from medical ethics and philosophy of technology. We introduce a hypothetical clinical scenario in occupational physical therapy to reflect on biomedical ethical principles: respect for autonomy, beneficence, non-maleficence and justice. The reflection was guided by the Product Impact Tool.
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Abstract Background: Healthcare professionals encounter ethical dilemmas and concerns in their practice. More research is needed to understand these ethical problems and to know how to educate professionals to respond to them. Research objective: To describe ethical dilemmas and concerns at work from the perspectives of Finnish and Dutch healthcare professionals studying at the master’s level. Research design: Exploratory, qualitative study that used the text of student online discussions of ethical dilemmas at work as data. Method: Participants’ online discussions were analyzed using inductive content analysis. Participants: The sample consisted of 49 students at master’s level enrolled in professional ethics courses at universities in Finland and the Netherlands. Ethical considerations: Permission for conducting the study was granted from both universities of applied sciences. All students provided their informed consent for the use of their assignments as research data. Findings: Participants described 51 problematic work situations. Among these, 16 were found to be ethical dilemmas, and the remaining were work issues with an ethical concern and did not meet criteria of a dilemma. The most common problems resulted from concerns about quality care, safety of healthcare professionals, patients’ rights, and working with too few staff and inadequate resources. Discussion: The results indicated that participants were concerned about providing quality of care and raised numerous questions about how to provide it in challenging situations. The results show that it was difficult for students to differentiate ethical dilemmas from other ethical work concerns. Conclusion: Online discussions among healthcare providers give them an opportunity to relate ethical principles to real ethical dilemmas and problems in their work as well as to critically analyze ethical issues. We found that discussions with descriptions of ethical dilemmas and concerns by health professionals provide important information and recommendations not only for education and practice but also for health policy.
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Real-time location systems (RTLS) can be implemented in aged care for monitoring persons with wandering behaviour and asset management. RTLS can help retrieve personal items and assistive technologies that when lost or misplaced may have serious financial, economic and practical implications. Various ethical questions arise during the design and implementation phases of RTLS. This study investigates the perspectives of various stakeholders on ethical questions regarding the use of RTLS for asset management in nursing homes. Three focus group sessions were conducted concerning the needs and wishes of (1) care professionals; (2) residents and their relatives; and (3) researchers and representatives of small and medium-sized enterprises (SMEs). The sessions were transcribed and analysed through a process of open, axial and selective coding. Ethical perspectives concerned the design of the system, the possibilities and functionalities of tracking, monitoring in general and the user-friendliness of the system. In addition, ethical concerns were expressed about security and responsibilities. The ethical perspectives differed per focus group. Aspects of privacy, the benefit of reduced search times, trust, responsibility, security and well-being were raised. The main focus of the carers and residents was on a reduced burden and privacy, whereas the SMEs stressed the potential for improving products and services. Original article at MDPI: https://doi.org/10.3390/info9040080
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While there is much focus on interventions to foster ethical reflection in the design process of AI, there is less focus on fostering ethical reflection for (end)users. Yet, with the rise of genAI, AI technologies are no longer confined to expert users; non-experts are widely using these technologies. In this case study in a governmental organization in the Netherlands, we investigated a bottom-up approach to foster ethical reflection on the use of genAI tools. An approach of guided experimentation, including an intervention with a serious game, allowed civil servants to experiment, to understand the technology and its associated risks. The case study demonstrates that this approach enhances the awareness of possibilities and limitations, and the ethical considerations, of genAI usage. By analyzing usage statistics, we estimated the organization’s energy consumption.
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Background: Shared decision-making (SDM) is often considered the ideal for decision-making in oncology. Views of specific groups such as ethnic minorities have seldom been considered in its development. Aim: In this study we seek to assess in oncology if there is a need for adaptation of the current SDM model to ethnic minorities and to formulate possible adjustments. Design: This study is embedded in empirical bioethics, an interdisciplinary approach integrating empirical data with ethical reasoning to formulate normative conclusions regarding a practice. For the empirical social scientific part, a cross-sectional qualitative study will be conducted; for the ethical reflection the Reflective Equilibrium will be used to develop a coherent view on the application of SDM among ethnic minorities in oncology. Method: Semi-structured interviews combined with visual methods (timelines and relational maps) will be held with healthcare professionals (HCPs), ethnic minority patients, and their relatives to identify values steering the behavior of these actors in SDM. In addition, focus groups (FGs) will be held with ethnic minority community members to identify value structures at the group level. Respondents will be recruited through organizations with access to ethnic minorities and collaborating hospitals. Data will be analyzed using a reflexive thematic analysis through the lens of Schwartz’s value theory. The results of the empirical phase will be included in the RE to formulate possible adjustments of the SDM model, if needed. Discussion: The integration of empirical data with ethical reflection is an innovative method in decision-making. This method enables a systematic and profound assessment of the need for adaptation of SDM and the formulation of theoretically and empirically based suggestions for adaptations of the model. Findings of this study may enrich the SDM model.
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