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Nurses are regularly confronted with moral questions and ethical dilemmas in their practice, for example where a patient's decisions about their treatment conflict with the nurse's own views. While the standards contained in the Nursing and Midwifery Council The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates provide nurses with an overarching framework to guide practice, it is important that nurses understand the four main principles that underpin ethical care - autonomy, beneficence, non-maleficence and justice. This article examines these four principles and how they relate to nurses' ethical decision-making. The author also explores how nurses' ethics were tested by the coronavirus disease 2019 (COVID-19) pandemic. Having an awareness of ethical decision-making can enhance nurses' practice by providing them with a theoretical framework for treating patients with dignity and respect.

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This project explored what constitutes "ethical practice of mathematics". Thematic analysis of ethical practice standards from mathematics-adjacent disciplines (statistics and computing), were combined with two organizational codes of conduct and community input resulting in over 100 items. These analyses identified 29 of the 52 items in the 2018 American Statistical Association Ethical Guidelines for Statistical Practice, and 15 of the 24 additional (unique) items from the 2018 Association of Computing Machinery Code of Ethics for inclusion. Three of the 29 items synthesized from the 2019 American Mathematical Society Code of Ethics, and zero of the Mathematical Association of America Code of Ethics, were identified as reflective of "ethical mathematical practice" beyond items already identified from the other two codes. The community contributed six unique items. Item stems were standardized to, "The ethical mathematics practitioner…". Invitations to complete the 30-min online survey were shared nationally (US) via Mathematics organization listservs and other widespread emails and announcements. We received 142 individual responses to the national survey, 75% of whom endorsed 41/52 items, with 90-100% endorsing 20/52 items on the survey. Items from different sources were endorsed at both high and low rates. A final thematic analysis yielded 44 items, grouped into "General" (12 items), "Profession" (10 items) and "Scholarship" (11 items). Moreover, for the practitioner in a leader/mentor/supervisor/instructor role, there are an additional 11 items (4 General/7 Professional). These results suggest that the community perceives a much wider range of behaviors by mathematicians to be subject to ethical practice standards than had been previously included in professional organization codes. The results provide evidence against the argument that mathematics practitioners engaged in "pure" or "theoretical" work have minimal, small, or no ethical obligations.

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Background: Conducting oral treatment early in the disease course, is encouraged for better health outcomes. Obtaining informed consent is an essential part of medical practice, protecting the legal rights of patients and guiding the ethical practice of medicine. In practice, consent means different things in different contexts. Silver Diamine Fluoride (SDF) and Silver Fluoride (SF) is becoming popular and cost effective methods to manage carious lesions, however, cause black discolouration of lesions treated. Obtaining informed consent and assent is crucial for any dental treatment-and has specific relevance with SDF/ SF treatments. Methods: The aim of this paper is to describe informed consent regulations for dental care in a selection of countries, focusing on children and patients with special health care needs. An online survey was shared with a convenience sample of dental professionals from 13 countries. The information was explored and the processes of consent were compared. Results: Findings suggest that there are variations in terms of informed consent for medical practice. In Tanzania, South Africa, India, Kenya, Malaysia and Brazil age is the determining factor for competence and the ability to give self-consent. In other countries, other factors are considered alongside age. For example, in Singapore, the United Kingdom, and the United States the principle of Gillick Competence is applied. Many countries' laws and regulations do not specify when a dentist may overrule general consent to act in the "best interest" of the patient. Conclusion: It is recommended that it is clarified globally when a dentist may act in the "best interest" of the patient, and that guidance is produced to indicate what constitutes a dental emergency. The insights gathered provide insights on international practice of obtaining informed consent and to identify areas for change, to more efficient and ethical treatment for children and patients with special needs. A larger follow up study is recommended to include more or all countries.

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People living with dementia can become vulnerable when experiencing symptoms such as memory loss and disorientation, as well as stigma attached to the condition. The care of people with dementia is fraught with ethical dilemmas and challenges regarding how nurses should respond to situations that put patients at risk of distress. For example, if a person with dementia asks to see a deceased relative, a nurse may have to decide whether to tell the truth, or a 'white lie' to avoid distress. This article examines the debates around the use of such 'therapeutic lying' when caring for people with dementia and provides guidance on how nurses could use this technique while protecting the individual's best interests.

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BACKGROUND: There is increasing research interest in the relationship between ethical leadership and deviant workplace behaviour. Ethical leadership encompasses altruism, courage, ethical orientation, integrity and fairness. Examples of deviant workplace behaviours include theft, fraud, sabotage, assault, abuse, manipulation and bullying. It appears that when leaders are fair and emphasise ethical conduct, followers are less inclined to engage in deviant workplace behaviour. AIM: To investigate the relationship between nurses' self-rated levels of deviant workplace behaviour and perceived levels of ethical leadership in managers. METHOD: For this descriptive correlational study, 355 nurses from one university hospital in Egypt responded to an online questionnaire comprising the Ethical Leadership Scale and the Workplace Deviance Behavior Scale. Descriptive and inferential statistics were used to explore results and examine the relationships between study variables. RESULTS: There was a statistically significant negative relationship between respondents' self-rated levels of deviant workplace behaviour and their perceptions of levels of ethical leadership in managers. The results appeared to confirm previous research. Nurses who feel that they are treated fairly by their managers tend to have positive attitudes towards work, colleagues and management. CONCLUSION: Ethical leadership on the part of managers is a significant determinant of nurses' behaviour in the workplace and should therefore be fostered by healthcare organisations.

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OBJECTIVE: To identify the issues raised by the unsuccessful Voice referendum and propose removal of barriers to reporting and prevention of family violence in remote communities as the most ambitious measure of success in hearing First Nations voices. CONCLUSIONS: The Voice referendum was partly justified to improve the mental health of First Nations Australians, despite concern the process and its outcome might worsen both. Aboriginal and Torres Strait Islander leaders revealed the tensions that arise between individual and communal interests when marginalised groups fight for self-determination. While a unified First Nation Voice is likely to amplify prominent messengers, we should also be interested in hearing diverse, dissenting voices. As the most marginalised group within a marginalised community, the ability to hear the voices of women and children subject to family violence in rural/remote Australian communities may be the best measure of success in overcoming the barriers that was the motivation for the referendum.

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Responsible Research involves setting moral examples before fellow academicians and the society as a whole. The concept of Responsible Research applies appropriately to ethical sourcing and handling of human tissues. The present study was undertaken to analyze present situation regarding implementation of attributes of Relevant Research in relation to body donors in anatomical research. A literature search of relevant, peer-reviewed, published articles was undertaken from indexed databases (Medline & PubMed, Scopus, Embase, CINAHL Plus, Web of Science and Google Scholar) for this study. The following attributes of Responsible Research were identified for possible intervention: the fact that research was conducted on human tissues from body donors and details regarding ethical handling thereof may be explicitly mentioned in method section; expression of gratitude towards body donors by authors may be included in acknowledgement section; editor's and publisher's note in support of adoption of attributes of Responsible Research may be included in published research. Adherence to best practices in terms of ethical guidelines requires anatomists to embrace a responsible approach in research from an inclusive perspective. Accordingly, practice of acknowledging the body donors may be nurtured and augmented to include the anonymised dead (human tissues from unclaimed bodies and unknown source) provided the research protocol received clearance from authorities concerned with ethical scrutiny. Moreover, adoption of the practice in review articles will enhance the boundaries of Responsible Research in anatomical science. Thus, few recommendations are proposed as epilogue for effectual implementation of the notion floated in present study.

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AIM: There is a lack of clarity about therapeutic lying in the context of everyday dementia care. This study provides conceptual clarity on how the term is used and considers the concept in relation to person-centred care. METHODS: Rodgers' (1989) evolutionary framework of concept analysis was employed. A systematic multiple database search was conducted and supplemented with snowballing techniques. Data were analysed thematically through an iterative process of constant comparison. RESULTS: This study highlighted that therapeutic lying is intended to be used in the person's best interests for the purpose of doing good. However, its potential for doing harm is also evident. Its use in the literature has increased with the general trend towards becoming more accepted in the discourse. A continuum emerged depending on the degree to which a lie departs from the truth. Emerging guidelines were also evident as to when a lie could or could not be justified. CONCLUSION: The term therapeutic lying, was contrasted with aspects of person-centred care and was found to be problematic. We conclude that there may be more pragmatic ways of constructing language around the care of people with dementia which could be less stigmatising.

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Antipsychotic medicines are often prescribed 'as required' to manage behavioural and psychological symptoms of dementia, despite evidence that these medicines have little benefit for people with dementia and have numerous adverse side effects, including sedation. It is the nurse's role to decide if and when to administer antipsychotic medicines that have been prescribed on an as required basis. This decision-making is underpinned by complex ethical considerations such as mental capacity, chemical restraint, quality of life and autonomy. Adopting a person-centred approach and considering the ethics, guidelines and legislation related to such decisions can support nurses to act in patients' best interests. This article uses two ethical frameworks - the four principles of biomedical ethics and the 'four quadrants' approach - to examine this complex issue and to demonstrate their use in the context of ethical decision-making in nursing practice.

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BACKGROUND: During a disaster, nurses face complex ethical challenges because of risky situations. It is necessary to identify trends and ethical issues of nurses in disasters to improve the quality of care and impact for nurses. METHOD: This systematic review enrolled in the international registration with PROSPERO: CRD42022350765. We searched the following databases: PubMed, EBSCO MEDLINE, SCOPUS, ProQuest, ScienceDirect, and Sage Pub. The inclusion criteria were developed according to PICO and D; are Population (F): involving nurses; intervention/Exposure (I): disaster, Comparison (C): none; outcome (O): ethical practice. And Design (D): qualitative, quantitative, and mixed methods. Years of publication were 2012-2022, with full text in English. The quality of study assessment used was The Joanna Briggs Institute (JBI) Critical Appraisal tool and Mixed Methods Appraisal Tool (MMAT) version 2018. Analysis used PICO synthesis. RESULTS: There were 15 studies reviewed from 2093 results, including cross-sectional (4/15, 26.6%), qualitative (9/15, 60%), and mixed methods (2/15, 13.3%) studies. The types of disasters were: COVID-19 (7/15, 46.6%), infectious (4/15, 26.6%), and all disaster events (4/15, 26.6%). The main themes were: (1) ethical issues in disasters have the potential to address ethical dilemmas, (2) factors applying nursing ethics to support ethical decision-making in disasters, (3) strategies for applying ethics and dealing with ethical issues in disasters, and (4) the impact of applying ethics in disasters. CONCLUSION: Applying ethics nursing in a disaster is influenced by various factors. This framework for ethical nursing in disasters aims to help nurses, educational institutions, and policymakers develop schemes or scenarios to enhance responsible ethical decisions in disasters.

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Food and nutrition are popular topics in the media and on social media. The ubiquity of social media has created new opportunities for qualified or credentialed experts in the scientific community to connect with clients and the public. It has also created challenges. Health and wellness gurus, or self-proclaimed experts, utilize social media platforms to garner attention through compelling narratives, build audience followings, and influence public opinion by sharing (often) misleading information about food and nutrition. The consequence of this can be the perpetuation of misinformation, which not only undermines a well-functioning democracy but also diminishes support for policies that are science or evidence based. Nutrition practitioners, clinician scientists, researchers, communicators, educators, and food experts need to encourage and model critical thinking (CT) to participate in our world of mass information and mitigate misinformation. These experts can play a vital role in the evaluation of information about food and nutrition against the body of evidence. This article explores the role of CT and ethics of practice in the context of misinformation and disinformation by providing a framework for engaging with clients and offering a checklist for ethical practice.

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In the 1980s Contact Precautions were introduced as a precautionary measure to control the emerging threat of antimicrobial resistance in hospitals, particularly methicillin resistant Staphylococcus aureus (MRSA). Today, antimicrobial resistance remains a concerning global public health threat, and a focus for hospital patient safety priorities. In late 2019 a novel respiratory virus described as SARS-CoV-2, was reported. Just as MRSA had prompted control measures developed in the context of limited information and understanding of the pathogen, public health control measures against SARS-CoV-2 were promptly and strictly implemented. Whilst SARS-CoV-2 control measures were successful at containing the virus, numerous detrimental socio-economic and health impacts have led to a rebalancing of harms versus benefits and loosening of restrictions. Conversely, evidence collated over the past 50 years, suggests that Contact Precautions are not superior to well-applied standard infection prevention and control precautions in controlling MRSA acquisition in hospitals. Several harms associated with Contact Precautions, affecting patient safety, financial costs, and organisational culture, are described. However, rebalancing of hospital MRSA control policies has been slow to materialise. This commentary invites infection prevention and control policy makers to reflect and revise policies for the control of MRSA in hospitals so that harms do not outweigh benefits.

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There is anecdotal evidence of informal telemedicine activity in KwaZulu-Natal (KZ-N), South Africa. AIM: To determine the current extent of telemedicine in district hospitals in KZ-N; the range of clinical activities and technologies used; additional services needed; current knowledge and practice regarding legal, ethical, and regulatory issues; and the need to formalise telemedicine activities. METHOD: A cross-sectional survey of telemedicine use by 143 doctors working at 22 District hospitals in KZ-N. RESULTS: Most doctors (96%) participated in some form of telemedicine across a spectrum of disciplines, but more than half did not consider their activities to constitute telemedicine. To meet their needs, doctors have started their own informal services with colleagues, using mostly instant messaging and chat groups (WhatsApp). Some doctors indicated the need to formalise these services and establish additional services. Few doctors were aware of the national telemedicine guidelines and the required written informed consent for telemedicine was seldom obtained. This could have serious legal, regulatory, and ethical implications. CONCLUSIONS: Practical clinical and technical guidelines and standard operating procedures need to be developed with the active participation of the clinical workforce. These should encourage innovation and greater use of telemedicine, including the use of instant messaging apps.

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Chemical restraint research is growing with multiple healthcare disciplines increasing focused on understanding uses, harms of restraint and restraint reduction in inpatient mental health settings. Despite increased restraint research relatively little is known about nurses' experiences of administering chemical restraint. The research question guiding this study was: what are mental health nurses' experiences of using chemical restraint interventions in times of behavioural emergency on adult inpatient acute mental health units? The purpose of the research was to understand direct care nurses' first-hand experiences in use of chemical restraint interventions. Eight adult acute inpatient mental health nurses were interviewed using hermeneutic phenomenological method. The aim of this paper to discuss three themes that emerged in the research which clearly highlight the complex ethical issues and education needs of mental health nurses who use chemical restraint: working within constraints, making medication choices, and transitioning from novice to expert. Research findings indicated a need for further focus on medication best practice, policy development and nurse education. These exploratory research findings can be used to both inform and challenge dominant inpatient mental health practice to guide nurses, health care leaders, and policy makers by increasing understanding of the complex ethical decision-making required for use of chemical restraint interventions. Education strategies can be developed from the findings which highlight integral ways that nurses make meaning in their administering of chemical restraint, and their accompanied insights into the complex clinical and ethical decision-making aspects involved in nursing care.

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Midwives and nurses play a critical role in safeguarding the lives of women in resource-constrained African countries. Working within the context of scarce resources may undermine their moral agency and hinder their ability to care. The purpose of this paper is to understand the influence of resource scarcity on midwifery and nursing care and practice. A critical ethnography was conducted in the obstetric department of three tertiary-level facilities in Ghana. Purposive sampling was used to recruit 30 midwives and nurses and semistructured interviews, field notes and documentary materials were used to generate in-depth understanding. Ethical approval was granted from Canada and Ghana and written, and ongoing informed consent was obtained from the participants. Five conceptual themes depicting the impact of scarce resources on midwifery and nursing care were discovered: compromised care, constrained care, dehumanized care, missed care and disengaged care. Improving the maternal health of women and averting avoidable maternal morbidity and mortality require governments and institutions to invest in health infrastructure that will support the delivery of ethical and safe midwifery care for women in their most vulnerable period.

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PURPOSE: Comprehensive and efficient home safety assessments are needed to provide quality interventions for community living. This study explores early career and experienced home evaluator perspectives on content and usability of HESTIA, a home safety assessment app. METHOD: Four early career and five experienced practitioners rated the HESTIA app using the uMARS usability evaluation and then participated in focus groups. Data were analysed using a key concept analytic approach. RESULTS: Results include "how to do" home safety evaluations and how prompts and training help practitioners "get it right." Early practitioner participants viewed the step-wise processes of the app as necessary whereas the experienced evaluators relied on own knowledge and experiences. CONCLUSIONS: Gobet and Chassy's TempT theory provides insight into the development of expertise in practice for rehabilitation professionals. The procedural complexities of assessment and ethical responsibility to provide competent, quality service to clients with disabilities are integrated into discussion of the development of professional intuition and ethical practice as guided by HESTIA.IMPLICATIONS FOR REHABILITATIONHome safety evaluations and home modifications are essential in helping persons with disabilities to live at home.Mobile applications such as HESTIA can serve as beneficial supports in facilitating effective decision making processes for rehabilitation practitioners conducting home safety evaluations.Technology driven assessments through mobile applications (apps) can help improve proper decision making and client outcomes, as well as aid in the development of intuition in students and early-career practitioners.Decision making support systems can help practitioners uphold their ethical responsibility to provide competent and quality rehabilitative services.

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Ongoing discussions about the problems of white supremacy and colonialism in archaeology are useful but have not, thus far, fully considered the exacerbated effects of these issues on small islands. In this opinion piece, we, two white women academics from the Global North with extensive experience working in the Dutch Caribbean and the Hawaiian Islands, observe these exacerbated effects in governance, academic hegemony, and community relations, and call for more consideration of the effects of our discipline in small island contexts. Ultimately, in line with the observations of local, descendant, and Indigenous scholars, we argue that archaeologists must invest in de-colonial, antiracist, and social justice efforts in heritage fields and industries by foregrounding the wishes and needs of island communities. This may involve modifying or altogether abandoning current motivations and practices to build a discipline that can be a positive rather than a negative in island worlds.

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Present day scenario regarding epistemological methods in anatomy is in sharp contrast to the situation during ancient period. This study aimed to explore the evolution of epistemological methodologies in anatomy across centuries. In ancient times Egyptian embalmers acquired anatomical knowledge from handling human bodies and likewise anatomical studies in India involved human dissection. Ancient Greeks used theological principles-based methods, animal dissection and human dissection in practice of anatomy. Human dissection was also practiced in ancient China for gaining anatomical knowledge. Prohibition of human dissection led to use of animal dissection in ancient Rome and the trend continued in Europe through Middle Ages. Epistemological methods used by Muslim scholars during Middle Ages are not clearly chronicled. Human dissection returned as primary epistemological method in Renaissance Europe and empirical methods were reinstated after ancient period in human dissection during 16th century. The situation further improved with introduction of pragmatic experiment based approach during 17th century and autopsy-based methods during 18th century. Advances in anatomical knowledge continued with advent of microscope-based methods and emergence of anatomical sections in practice of human dissection in 19th century. Introduction of human observational studies, medical imaging, and molecular methods presented more options in terms of epistemological methods for investigating the human body during 20th century. Onset of 21st century has witnessed dominance of technology-based methods in anatomy. Limited emphasis on ethics in epistemological methodologies since antiquity is a dark aspect of otherwise an eventful evolutionary journey but recent developments are in positive direction.

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Consent to treatment is a common, albeit complex, aspect of nursing practice. Over the past few years, laws have been strengthened to provide increased recognition of patient autonomy. This has meant that there is a greater onus placed on nurses to understand how consent is obtained from patients, the elements required to ensure any consent is valid, and how to proceed when it has been determined that a patient does not have the mental capacity to consent to treatment. This article explores some of the legal considerations that nurses should keep in mind when seeking consent from a patient.

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Moral injury may be experienced when a person perpetrates, witnesses or fails to prevent an act that conflicts with their moral values and beliefs. The concept of moral injury has its origins in the context of military personnel encountering ethically challenging decisions during armed conflict. The term has been applied to healthcare and moral injury is increasingly acknowledged to be a challenge for healthcare professionals. Nurses across all specialties and settings are frequently required to make or witness ethically challenging decisions about patient care. The coronavirus disease 2019 (COVID-19) pandemic has increased nurses' risk of sustaining moral injury. This article discusses the manifestations of moral injury and its associated risk factors, including the effects of the COVID-19 pandemic. It also outlines various strategies that can be used to mitigate and/or prevent moral injury in nurses.

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