Australia II: A Case Study in Engineering Ethics

Australia II became the first foreign yacht to win the America's Cup in 1983. The boat had a revolutionary wing keel and a better underwater hull form. In official documents, Ben Lexcen is credited with the design. He is also listed as the sole inventor of the wing keel in a patent application submitted on February 5, 1982. However, as reported in New York Times, Sydney Morning Herald, and Professional Boatbuilder, the wing keel was in fact designed by engineer Peter van Oossanen at the Netherlands Ship Model Basin in Wageningen, assisted by Dr. Joop Slooff at the National Aerospace Laboratory in Amsterdam. Based on telexes, letters, drawings, and other documents preserved in his personal archive, this paper presents van Oossanen's account of how the revolutionary wing keel was designed. This is followed by an ethical analysis by Martin Peterson, in which he applies the American NSPE and Dutch KIVI codes of ethics to the information provided by van Oossanen. The NSPE and KIVI codes give conflicting advice about the case, and it is not obvious which document is most relevant. This impasse is resolved by applying a method of applied ethics in which similarity-based reasoning is extended to cases that are not fully similar. The key idea, presented in Peterson's book The Ethics of Technology (Peterson, The ethics of technology: A geometric analysis of five moral principles, Oxford University Press, 2017), is to use moral paradigm cases as reference points for constructing a "moral map".

[Clinical information, informed consent and medical deontology. A recent relationship]

In Spain, the right to clinical information and informed consent as a practical expression of the principle of autonomy, are legal conquests achieved in the late twentieth century. From the law they have been transferred to the codes of medical deontology. The aim of this work is to study the pace of this transfer. Historical review of the different codes of medical deontology in Spain since the Civil War, seeking the presence of these ideas in them. Until code of medical deontology of 1979, the idea of clinical information did not appear in the contemporary deontological norm, and the rules on consent did so in very restricted cases. As of that date, their appearance is progressive in the successive codes. Currently, both concepts are fully developed in Spanish deontological regulations. Medical Deontology has take on the ideas of patient information and informed consent. This has been a long process which have brought considerable changes the deontological orientations of the traditional form of doctor-patient relationship. In these aspects, medical deontology has drifted, from emphasizing the prudence of the doctor, to emphasize the duty to inform and give ample space to the patient's decisions, which he recognizes as an autonomous and reflective moral agent, capable of taking his own decisions about your health.

Medical Ethics in Radiography

The medical field often requires radiologic technologists to make complex decisions that affect patients, employers, and colleagues. Technologists must consider practice standards when making choices, and also must act ethically to protect patients' safety and respect their autonomy. To make the most informed and ethical decisions, technologists should know the history of medical ethics, as well as be familiar with philosophical tools and ethical codes that can guide them in their daily practice.

The Physician's Duty to Treat During Pandemics

Physicians assume a primary ethical duty to place the welfare of their patients above their own interests. Thus, for example, physicians must not exploit the patient-physician relationship for personal financial gain through the practice of self-referral. But how far does the duty to patient welfare extend? Must physicians assume a serious risk to their own health to ensure that patients receive needed care? In the past, physicians were expected to provide care during pandemics without regard to the risk to their own health. In recent decades, however, the duty to treat during pandemics has suffered from erosion even while the risks to physicians from meeting the duty has gone down. After exploring the historical evolution of the duty to treat and the reasons for the duty, I conclude that restoring a strong duty to treat would protect patient welfare without subjecting physicians to undue health risks.

Oath Taking at U.S. and Canadian Medical School Ceremonies: Historical Perspectives, Current Practices, and Future Considerations

The widespread use of oaths at medical commencements is a recent phenomenon of the late 20th century. While many are referred to as "Hippocratic," surveys have found that most oaths are modern, and the use of unique oaths has been rising. Oaths taken upon entry to medical school are even more recent, and their content has not been reported. The authors surveyed all Association of American Medical Colleges-member schools in the United States and Canada in 2015 and analyzed oath texts. Of 111 (70.2%) responses, full texts were submitted for 80 commencement and 72 white coat oaths. Previous studies have shown that while oaths before World War II were commonly variations on the original Hippocratic text and subsequently more often variations on the Geneva or Lasagna oath, now more than half of commencement ceremonies use an oath unique to that school or written by that class. With a wider range of oath texts, content elements are less uniformly shared, so that only three elements (respecting confidentiality, avoiding harm, and upholding the profession's integrity) are present in as many as 80% of oaths. There is less uniformity in the content of oaths upon entry to medical school. Consistently all of these oaths represent the relationship between individual physicians and individual patients, and only a minority express obligations to teach, advocate, prevent disease, or advance knowledge. They do not reflect obligations to ensure that systems operate safely, for example. None of the obligations in these oaths are unique to physicians.

[The code of ethics for nurses, history and perspectives]

The French decree of 25 November 2016 relating to the code of ethics for nurses reinforces the principles guiding their missions and the corresponding responsibilities. It is the fruit of a collaboration between nurses from all backgrounds heavily involved in the Order. Imbued with the nursing spirit, reflecting the sensitivities and concerns of professionals, it is a unique project and, in every regard, quite remarkable, as it has been produced by a profession which is often reluctant to put pen to paper to express its vision of health.

[ICOH International Code of Ethics for Occupational Health Professionals: Historical fortune and future perspectives in Italy]

The Working Group responsible for the Italian translation of the third edition of the International Code of Ethics, appointed by the President of the International Commission on Occupational Health (ICOH), Dr. Jukka Takala, completed last April the revision work. The final text, already available on the ICOH website, has been printed and distributed by the Italian National Institute for Insurance against Accidents at Work (INAIL) at the 79th National Congress of the Italian Society of Occupational Medicine and Industrial Hygiene (SIMLII), in Rome. The curators of this third Italian edition have accomplished the delicate task of adaptation in Italian, taking into account the specificities of the practice of medicine in the Italian work environment. It involves many professionals with diverse roles and responsibilities in the public and private sectors for safety, hygiene, health and environment in relation to work. More than twenty years after the first Italian edition, we trace the evolution of the ICOH International Code of Ethics, in order to focus its birth, national and international distribution, and continuous improvement as well as its ability to direct the stakeholders towards a participatory prevention model, in a legislative framework that has seen over the past two decades a radical change in the Italian world of work.

The History of Ethics and Professionalism within Optometry in the United States of America 1898-2015, Part 1

BACKGROUND

The history surrounding the development of codes of ethics and other official statements of desired professional conduct adopted by the American Optometric Association (AOA) reveals the struggle optometry faced in the United States ofAmerica (USA) in establishing itself as a leading primary health care profession.

METHODS

Information regarding the events and documents reported in this paper were obtained through research of the historical literature and archival material held in The Archives & Museum of Optometry at the American Optometric Association's headquarters at 243 N. Lindbergh Boulevard, St. Louis, MO; through current Association documents; and from discussions with those participating in the drafting of the more recent updates to the Association's ethical statements; codes, oaths, standards, and resolutions. This writing is an update to an earlier paper by the author, The history of ethics in the American Optometric Association 1898-1994. J Am Optom Assoc 1994; 65:427-444, which was written to celebrate the 50th anniversary of the then current Code of Ethics of the AOA. An additional purpose of this present writing is to help the reader understand, from a historical perspective, some of the driving forces and imperatives for the advancement of optometry's professional stature.

RESULTS

Forces outside as well as within the profession were found to have influenced the drafting and redrafting of the official ethical and professional conduct statements meant to guide the professional behavior of the membership of the AOA.

CONCLUSIONS

Ethical codes and other statements of desired conduct have been essential to the establishment of the profession of optometry. As optometry has grown and matured as a provider of primary eye and vision care services, so have its ethical emphases. To further understand the ethical and legal challenges for optometry as it worked to establish itself as a reputable profession, it is suggested the reader investigate in more detail the information provided in the references. Any views expressed in this paper are those of the author and do not necessarily reflect the views of the American Optometric Association.

Summary of Code of Ethics

The Guide to the Code of Ethics for Nurses is an excellent guideline for all nurses regardless of their area of practice. I greatly enjoyed reading the revisions in place within the 2015 edition and refreshing my nursing conscience. I plan to always keep my Guide to the Code of Ethics for Nurses near in order to keep my moral compass from veering off the path of quality care.

[Not Available]

During the last October, we celebrated the 10th anniversary of The Universal Declaration on Bioethics and Human Rights of UNESCO. This Declaration was particularly important for bioethics discourse. The result of a meticulous preparation process in which there were controversies and debates, showing new paths to follow. All of this has led the author to make a first analysis of their achievements and future goals.

The Nursing Code of Ethics: Its Value, Its History

To practice competently and with integrity, today's nurses must have in place several key elements that guide the profession, such as an accreditation process for education, a rigorous system for licensure and certification, and a relevant code of ethics. The American Nurses Association has guided and supported nursing practice through creation and implementation of a nationally accepted Code of Ethics for Nurses with Interpretive Statements. This article will discuss ethics in society, professions, and nursing and illustrate how a professional code of ethics can guide nursing practice in a variety of settings. We also offer a brief history of the Code of Ethics, discuss the modern Code of Ethics, and describe the importance of periodic revision, including the inclusive and thorough process used to develop the 2015 Code and a summary of recent changes. Finally, the article provides implications for practicing nurses to assure that this document is a dynamic, useful resource in a variety of healthcare settings.

[How do first codes of medical ethics inspire contemporary physicians?]

First codes of medical ethics appeared between 18th and 19th century. Their formation was inspired by changes that happened in medicine, positive in general but with some negative setbacks. Those negative consequences revealed the need to codify all those ethical duties, which were formerly passed from generation to generation by the word of mouth and individual example by master physicians. 210 years has passed since the publication of "Medical Ethics" by Thomas Percival, yet essential ethical guidelines remain the same. Similarly, ethical codes published in Poland in 19 century can still be an inspiration to modem physicians.

Code of ethics: principles for ethical leadership

The code of ethics for a professional association incorporates values, principles, and professional standards. A review and comparative analysis of a 1934 pledge and codes of ethics from 1957, 1977, 1988, 1998, 2004, and 2011 for a health information management association was conducted. Highlights of some changes in the healthcare delivery system are identified as a general context for the codes of ethics. The codes of ethics are examined in terms of professional values and changes in the language used to express the principles of the various codes.

[Hippocratic Oath: professional or ethic code?]

In order to study the historical relationship of early medical professional codex and contemporary demands and challenges, which are currently being placed before physicians, the first such text, known as Hippocratic Oath has been re-translated. According to the source, it is clear that this is a Code of professional conduct, primarily for the welfare of patients, and in order to maintain and preserve medical authority. All parts of the Oath have been discussed and presented, as well as the historical data from which one can see how the system in ancient Greece and Rome worked. The study includes historical data from that time on two controversial issues: the liability of medical awards, and addressing medical services. These are mistakenly considered to belong to the text of the Oath. Examples of the amount of medical awards are stated, as well as the examples of selflessness and dedication of the physicians in that time. A physician was obliged to help by law, only in the case of accidents and injuries. It is obvious that "medical doctrine" existed also in this time. Requirements set to a doctor were realistic, modest and appropriate to the call, with the main purpose of protecting the reputation and dignity of the profession. Despite the historical distance, classical text of the Oath is still up to date. In this context, ambiguities and errors result from not being familiar with the both, the basic text, and the circumstances prevailing at the time and society, in which the Oath was made.

Toward an horizon in design ethics

This paper suggests that design ethics can be enriched by considering ethics beyond the traditional approaches of deontology, teleology, and virtue ethics. Design practice and design ethics literature tend to frame ethics in design according to these approaches. The paper argues that a fundamental and concrete ethical understanding of design ethics can also be found in Sartrean Existentialism, a philosophy centered on the individual and his/her absolute freedom. Through the analysis of four core concepts of Sartrean Existentialism that define a specific ethics, the paper illustrates why such philosophical approach is relevant to design ethics. The paper also shows how Sartrean Existentialism and its ethics apply to critical issues of professional practice in design such as professional engagement and design decision-making. The paper finally argues that Sartre's philosophy and ethics is a perspective that offers the designer in design practice a solid ground to engage his/her ethical dilemma.

The science of ethics: Deception, the resilient self, and the APA code of ethics, 1966-1973

This paper has two aims. The first is to shed light on a remarkable archival source, namely survey responses from thousands of American psychologists during the 1960s in which they described their contemporary research practices and discussed whether the practices were "ethical." The second aim is to examine the process through which the American Psychological Association (APA) used these survey responses to create principles on how psychologists should treat human subjects. The paper focuses on debates over whether "deception" research was acceptable. It documents how members of the committee that wrote the principles refereed what was, in fact, a disagreement between two contemporary research orientations. The paper argues that the ethics committee ultimately built the model of "the resilient self" into the APA's 1973 ethics code. At the broadest level, the paper explores how prevailing understandings of human nature are written into seemingly universal and timeless codes of ethics.

The ethical foundations of professionalism: a sociologic history

The purpose of this article is to trace the development of medical professionalism in medicine from its origins to the present. Codes of professional conduct are the tangible expressions of professionalism. I use them as a window into contemporary circumstances of medical practice. The medieval guilds are my framework for examining the relationship of the medical profession in relation to society. The craft guilds of postmedieval Europe wielded considerable power. They controlled entry into a craft, training, and standards of quality. By controlling the volume of production, they controlled price. The craft guilds flourished until their monopoly powers began to hinder the forces of capitalism, which influenced the state to limit the powers of the guild. The professions are the offspring of the medieval craft guilds. Since the early 19th century, the medical profession in the United States has sought guild powers. The triangular relationship between state, capitalism, and the medical profession explains the rise of the profession during the 19th century and its decline since the mid-20th century. I argue that the codes of conduct of the profession reflect what it needs to maintain its guild powers against the forces of capitalism and the state. The Charter on Medical Professionalism calls on physicians to take into account both the individual patient's needs and those of society. I believe this important clause reflects the conflict of the profession with the state and capitalism over the aggregate costs of medical care.

Nurses and the sterilization experiments of Auschwitz: a postmodernist perspective

The medical experiments conducted on non-consenting prisoners of Nazi concentration camps during World War II necessitated the codification of principles to protect human subjects of research. Auschwitz was the largest and one of the most infamous of the camps and the site of numerous 'medical' experiments. This historical study uses primary source documents obtained from archives in England and Germany to describe one type of experiment carried out at Auschwitz - the sterilization experiments. The purpose of these experiments was to perfect a technique in which non-Aryans could be prevented from reproducing while still being able to work as slave laborers. These narratives regarding the sterilization experiments at Auschwitz are remarkable in that they contain previously undocumented information regarding the voluntary and involuntary involvement of nurses. Following these narratives, a discussion of ethics in relation to the Holocaust is presented with a specific focus on the work of Agamben. Implications of the Auschwitz narratives for the application of codes of ethical principles and contemporary nursing are discussed from a postmodernist perspective.

[The oath of Amatus Lusitanus and the town of Salonique]

In the XVIth century, Thessaloniki experienced the health problems of a large international metropolis. With Byzantine medicine surviving only in the nearby monastic centre of Mount Athos, the city found it easy to accept the medical practice introduced by the Sephardic Jews, newly arrived from Iberia. Excelling among the newcomers was Amatus Lusitanus, who wrote his major work Curationum Medicinalium Centuriae Septem in Thessaloniki. In the town's multicultural ambience, the Hippocratic Oath was universally acknowledged as the basis of medical ethics, with various traditions providing their own interpretations. In the framework of Byzantine science, this respected text had been interpreted from a Christian viewpoint, while on their side the Ottomans recognised the numerous Islamic efforts to regulate the conduct of doctors. The Sephardic community added their own thoughts, some old, some new, while Western Europe adopted standards for the specific needs of schools of medicine. The Oath of Amatus, published in 1561, was a product both of the varied medical traditions of Antiquity and of the Middle Ages. It owed much to the special conditions existing in Thessaloniki, where a new scientific perspective was added to the ethical foundations of medicine.

Soviet medical ethics (1917-1991)

Russian medical ethics bears a heavy mark of seven decades of the communist regime. In 1918 the Health Care Commissariat (ministry) was formed. It was headed by Nikolai Semashko (1874-1949) who claimed that "the ethics of the Soviet physician is an ethics of our socialist motherland, an ethics of a builder of communist society; it is equal to communist moral". "Medical ethics" had been avoided until the late 1930s when it was replaced by "medical (or surgical) deontology". This "deontological" period started with "Problems of surgical deontology" written by N. Petrov, a surgeon, and lasted for almost half a century until "medical deontology" was abandoned in favor of "bioethics" in post-communist Russia. There have been five All-Union conferences on medical deontology since 1969. The story of the emergence of "The Oath of a Soviet Physician" is briefly described. The text of this Oath was approved by a special decree of the Soviet Parliament in 1971. Each graduate of medical school in USSR was obliged to take this Oath when receiving his or her medical diploma. It is concluded that such ideas of zemstvo medicine as universal access to health care and condemnation of private practice were put into practice under the communist regime.

Embodiment and ethics: constructing medicine's two bodies

The first 'modern' presentation of medical ethics is generally acknowledged to be Percival's text of 1803. The main theme of this influential pamphlet was the way in which medical practitioners should relate to one another. Two centuries later, clinical practice has very different moral underpinnings: bioethics, which first emerged in the middle of the 20(th) century, is not concerned with how doctors should interact with each other but with the responsibilities of medical practitioners to their patients. The shift from an ethics based on the relationship between practitioners to one based on the relationship with their patients is viewed as a major advance brought about by a more enlightened society engaging with the consequences of new technologies. But rather than addressing the changing picture of medical ethics in its own terms (which over the last few decades has been from the perspective of bioethics) I examine the history of medical ethics in its close relationship to the form and nature of the medical profession. Further, in a parallel thread I describe contemporary developments in public health and explore the similarities and connections between the two.

The new Glasgow medical and dental graduation declaration

The medical and dental graduation ceremony at the University of Glasgow in July 2003 marked not only the 300th anniversary of the first Glasgow medical graduation, but also the first major revision of the graduation oath. This paper records the process, and explains the reasons, behind the revision of the oath and the introduction of a new graduation declaration. The new declaration provides continuity with the past, while addressing current and future challenges for professionalism in medicine.

Profesionalismo médico: aspectos históricos y religiosos

The essence of the medical profession resides in the medical act, whereupon a sick human being meets another with the power to heal him or her. The source of this power has evolved from the divinity itself through magic to science or acquired knowledge. This power implies acknowledgement of values that are inherent to the profession as well as responsibility toward one's own conscience and toward society, elements considered constitutive of what we now call professionalism. From antiquity these principles have evolved into behavioral codes containing variable components according to the different ages and cultures, but also permenent core values such as respect for life, altruism, and honesty, among others. Scientific and technological advances have magnified medical power but at the same time they have required that the philosophical and ethical principles that ought to inform professional practice be made explicit. This happens at a time when certitudes are questioned or abandoned, relativism and secularism pervade culture, and traditional medical values are challenged. Therefore, consensus attainment appears for some as the only legitimation of the ethics of professional medical acts, while for others the ancestral principles and values of medicine have permanent validity as objective goods based on the dignity of the human person.

Beyond the physician charter: reflections on medical professionalism

The numerous challenges now facing the profession of medicine have led to an intense focus on professionalism by individual physicians and by their professional and academic organizations. In 2002, a distinguished group of leaders in internal medicine created the Physician Charter, which calls on physicians to reaffirm medical professionalism through commitment to three principles and 10 responsibilities. The Charter reflects a duty-based ethic that is chiefly concerned with physician competence. This article offers a critical analysis of the Physician Charter from the perspective of the traditional values of medicine as articulated in medical oaths and championed by leaders of past generations, exemplified by William Osler. The authors argue that medical professionalism should reflect the values of a virtue-based ethic that stresses compassion and beneficence, rather than the values of a duty-based ethic. The challenges that now confront the practice of medicine can be addressed successfully only to the extent that physicians promote virtue-ethics, act collectively in the public interest, and render service that clearly transcends their own self-interests.