A Philosophical YetUser-friendly Framework For Ethical Decision Making in Critical Care Nursing

Wueste, Daniel E.

doi:10.1097/00003465-200503000-00006

Cited by 12 publications

(9 citation statements)

References 1 publication

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“…In order to analyze the ethical challenges of a policy recommending investigators to return incidental findings, consisting of the 78 medically actionable genes from the ACMG guidance to research participants, Wueste’s four-step IAJD Framework: Identify, Analyze, Justify, and Decide will be applied. The analysis begins with the identification of the key stakeholders in this ethical and policy debate [ 12 ]. The research participant and investigator have much to gain or lose in this situation, in addition to the participant’s family and the research laboratory.…”

Section: Identifymentioning

confidence: 99%

Incidental Findings in Study Participants: What Is the Researcher’s Obligation?

Schaare

Ward

Boccuto

2022

Genes

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Background: As technology advances and genomic testing becomes commonplace, incidental findings, or the discovery of unrelated results, have increased. The American College of Genetics and Genomics (ACMG) established recommendations for the return of pathologic variants in 78 genes in the clinical setting based on medically actionable conditions from genes linked with preventable or treatable diseases. However, the lack of policy in the research setting poses a serious ethical dilemma for researchers, potentially threatening the participant’s trust and willingness to contribute to a process with more significant risk than benefit. Purpose: Our goal was to determine the preferred ethical approach to handling incidental research findings and suggest a new standard for investigators and participants. Methods: By employing Wueste’s IAJD Framework of ethical evaluation, the current research policy, as well as a proposed policy, were analyzed, and then a policy analysis was employed to ascertain feasibility. Results and Discussion: The current policy of leaving the decision of returning incidental findings up to the researcher’s discretion is an ethical failure from the consequential, deontological, and intellectual freedom perspectives. However, the proposed policy of implementing the ACMG guidance for researchers to satisfy ethical demands reinforces its moral fortitude. In a period of increasing public awareness, the community, which is the prospective research pool, has increased demands for autonomy and less paternalistic behavior from medicine and science. This paper synthesizes recommendations by numerous organizations to establish a mutually beneficial policy that will ensure the U.S. Department of Health and Human Services (HHS) goal, stated in the 2014 Joint Rule, of making participants “partners” in research a reality.

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Section: Identifymentioning

confidence: 99%

Incidental Findings in Study Participants: What Is the Researcher’s Obligation?

Schaare

Ward

Boccuto

2022

Genes

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“…Most scientists and engineers are familiar with a professional code of ethics, which may provide a succinct statement of ethical values, but more often focuses on obligations and duties of the profession. Such statements can serve as tools for addressing ethical problems, but often have limited usefulness due to lack of guidance on implementation, little explanation of the theoretical basis, and lack of interpretative statements (Wueste, 2005). Additionally, merely learning a concise list of bullet points is unlikely to provide the depth of understanding necessary for handling ethical dilemmas.…”

Section: Ethicsmentioning

confidence: 99%

“…Luckily, there are a variety of different strategies for incorporating ethics into decision-making. One of these involves the consideration of three major approaches in moral philosophy with a ‘convergence begets confidence’ methodology (Wueste, 2005; Martinez and Wueste, 2016). These three approaches are consequentialist ethics, deontological ethics, and virtue ethics, which focus, respectively, on the consequences of our actions, the alignment of actions with our moral duty, and the promotion of good character (Fig.…”

Section: Ethicsmentioning

confidence: 99%

The 2018 Bo Lindell Laureate Lecture: Finding common ground between science, ethics, and experience

Martínez

2020

Ann ICRP

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The present system of radiological protection has evolved with the advancement of science; evolution of ethical and societal values; and the lessons of our individual, collective, and historical experience. In communicating with each other and members of the public, words are often not enough to completely relay thoughts, ideas, or experiences. Art is a shared experience, beyond the spoken language, where many can find common ground. This paper provides several examples of utilising the visual arts, cinema, and popular culture for communication in different contexts, with discussion of how each relates to the ethical values of the system of radiological protection. In this way, we find inter-relationships between science, ethics, and experience. Experience improves understanding; empathy, or the awareness and feeling of another’s experience, can lead to similar understanding. Drawing on art and the broader human experience will help us improve our communication, promote transparency, and encourage empathy. Through this, we will be more likely to develop trust with stakeholders, which is an essential, yet challenging, aspect of radiological protection.

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“…A partir de la búsqueda se identificaron 15 modelos de toma de decisiones éticas. Se excluyeron 4 modelos (Cassells, Jenkins, Lea, Calzone y Johnson, 2003;Schmidt, 2008;Toren, 2010;Wueste, 2005), debido a que no presentaban los supuestos teóricos en los que están basados o la lista de pasos cognitivos para alcanzar la toma de decisiones. El análisis se hizo sobre los 11 modelos restantes.…”

Section: Modelo De Toma De Decisiones éTicasunclassified

Modelo de toma de decisiones bioéticas en ciencias de la salud

Montoya

Piedad²

2018

Rev. latinoam. bioet

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La importancia de la toma de decisiones éticas en ciencias de la salud ha promovido la generación de esquemas que orientan este proceso. El objetivo es proponer un modelo teórico de toma de decisiones bioéticas. Se hizo una búsqueda y revisión de la literatura en bases de datos y bibliotecas electrónicas con palabras clave, se identificaron y analizaron once modelos de toma de decisiones éticas según parámetros establecidos y se incluyeron resultados de estudios sobre el tema. Los esquemas analizados plantean una toma de decisiones basada en la razón a partir de un número variable de pasos cognitivos y, en general, aportan pocos elementos para su aplicación práctica. Se planteó el Modelo de Integración Razón Emoción para la Toma de Decisiones Bioéticas en Ciencias de la Salud. Este modelo sintetiza los pasos cognitivos para tomar decisiones adecuadas, mediante la integración de la razón y la emoción, la posibilidad de aplicación de diversos marcos éticos y la puesta en juego de la competencia ética y las habilidades de pensamiento crítico.

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A Philosophical YetUser-friendly Framework For Ethical Decision Making in Critical Care Nursing

Abstract: Nurses must frequently make ethical decisions. These decisions require judgment, knowledge, and skills. This article will provide one framework for ethical decision making and provide several examples of the process.

Cited by 12 publications

References 1 publication

Incidental Findings in Study Participants: What Is the Researcher’s Obligation?

Incidental Findings in Study Participants: What Is the Researcher’s Obligation?

The 2018 Bo Lindell Laureate Lecture: Finding common ground between science, ethics, and experience

Modelo de toma de decisiones bioéticas en ciencias de la salud

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