This diploma thesis deals with practical ethical issues in specialized mobile palliative care. First of all the terms necessary for understanding the context are explained. Than brief introduction to the legal order and the principles of palliative care in the Czech Republic follows. Diploma thesis summarizes the phases of coping with the disease and the loss of a close person. This is both from adult's and a child's point of view. Next section deals with spiritual and pastoral care of dying, four principles of medical ethics and informed consent. Based on an interview with MUDr. Irena Závadová, supported by specialized literature, the ethical issues and theire possible solutions are mentioned too. This thesis deals with ethical issues as follows: awareness of diagnosis education system in palliative care development of palliative care in hospital facilities opiatophobia antibiotics in palliative and hospice care proxy decision making in a patient with dementia alternative forms of nutrition palliative sedation transfusion in palliative/hospice care Keywords Home hospic, dying, death, specialized mobile palliative care, ethical dilemmas.

This diploma thesis deals with practical ethical issues in specialized mobile palliative care. First of all the terms necessary for understanding the context are explained. History of palliative care. Than introduction to the legal order and the principles of palliative care in the Czech Republic follows. Diploma thesis summarizes the phases of coping with the disease and the loss of a close person. This is both from adult's and a child's point of view. Next section deals with spiritual and pastoral care of dying, four principles of medical ethics and informed consent. Based on an interview with MUDr. Irena Závadová, supported by specialized literature, the ethical issues and theire possible solutions are mentioned too. This thesis deals with ethical issues as follows: education system in palliative care controversial interpretation of the law n. 372/2011 opiatophobia antibiotics in palliative and hospice care nutrition in palliative care palliative sedation transfusion in palliative/hospice care autonomy patient with dementia Keywords Home hospic, dying, death, specialized mobile palliative care, ethical dilemmas.

The purpose of the study was to evaluate the didactic potential, and applicability of fiction in religious education. The subject I wanted to examine was J.R.R. Tolkiens The Fellowship of the Ring and whether it could be enriching for religious studies in upper secondary school, focusing on normative ethics.The study used a qualitative research method and the empirical material consisted of J.R.R. Tolkiens The Fellowship of the Ring. The book was read several times and sorted and reduced using focused coding searching for ethical dilemmas and different thematic units. The result was analyzed with the help of the high school’s curriculum, previous research, and selected theoretical concepts, normative ethics and didactic potential.The results showed that the book contained a large number of ethical dilemmas and several thematic units wich could help realize its didactic potential. The book’s usefullnes and didactic potential, focusing on normative ethics in religious studies, could then be proven on the basis of the upper secondary school’s and religious studies curriculum, as well as using previous research. The ethical dilemmas and thematic units found throughout the book make it highly usefull for discussing issues of normative ethics in the classroom.

Sammanfattning Bakgrund: Varje år insjuknar omkring 10 miljoner personer i världen i en demenssjukdom. Dessa personer behöver ibland vårdas på sjukhus på grund av olika akuta försämringar. Sjuksköterskor behöver arbeta utifrån ett personcentrerat förhållningssätt för att kunna tillgodose alla de behov en person med demenssjukdom har.     Syfte: Att beskriva vårdpersonals upplevelser i vården av personer med demenssjukdom på sjukhus. Metod: Kvalitativ litteraturöversikt med induktiv ansats. Analys av elva vetenskapliga artiklar genomfördes utifrån Fribergs beskrivning av fem-stegsanalys.    Resultat: Analysen resulterade i två teman och sju subteman. Under temat “Omvårdnadsaspekter av betydelse” presenteras subteman bemötande, kommunikationshinder, etiska dilemman och anhörigas inflytande. Under temat “Organisatoriska aspekter av betydelse” presenteras subteman vårdmiljö, tidsbrist samt utbildning och kunskap. Slutsats: Vårdpersonal har en viktig roll i främjandet av en god vård för alla parter i omvårdnaden av personer med demenssjukdom på sjukhus. Ett flertal omvårdnadsaspekter och organisatoriska aspekter begränsar vårdpersonalen i deras omvårdnadsarbete och behöver ses över. För att uppnå en säker vård av kvalitét för personer med demenssjukdom på sjukhus behövs förslagsvis ökad kunskap och utbildning. En anpassad vårdmiljö samt ett bra samarbete inom det interprofessionella teamet och med anhöriga är även stor betydelse. / Summary Background: Around 10 million people worldwide get dementia every year. These people sometimes need to be cared for in hospital due to various acute deteriorations. Nurses need to work in a person-centered approach in order to meet all the needs of a person with dementia. Aim: To describe nursing staffs’ experience in the care of people with dementia in hospitals. Method: A qualitative literature review with an inductive approach. Analysis of eleven scientific articles was carried out based on Friberg's description of five-step analysis. Result: The analysis resulted in two themes and seven subthemes. The theme “Aspects of importance in nursing” presents the subthemes personal treatment, communication barriers, ethical dilemmas and the influence of relatives. The theme “Organizational aspects of importance” presents the subthemes healthcare enviroment, lack of time, and education and knowledge.  Conclusion: Nursing staff play an important role in promoting good care for all parties in the care of people with dementia in hospitals. A number of nursing aspect and organizational aspects limit the nursing staff in their work and need to be considered. In order to achieve safe, quality care for people with dementia in hospitals, increased knowledge and education are suggested. An adapted healthcare environment and a good collaboration within the interprofessional team and with relatives is also of great importance.

This Master's thesis analyzes the subject of moral distress of Czech primary school teachers. It is divided into two parts. The first theoretical part clarifies key concepts and terms of ethics in education. Aside from more general terms like ethics, morals, and stress, it also covers crucial terms like moral distress and critical events. The second, practical part analyzes a qualitative dataset to describe and categorize different forms of moral distress. It records a variety of ways of solving critical situations and their potential influence on the psyche and professional development of educators. The aim of this work is to serve as a base for additional research or as a material for creating strategies to overcome similar situations. KEYWORDS Moral values, ethics, social influences, critical situations, dilemmas, moral distress, stress

Production has relocated to the Eastern world, whilst consumption is dominating the Western world. Taking into consideration the cultural differences between East and West sanctions a problem, as it is identified that corporate social responsibility (CSR) practices require adaptation to the different cultural contexts. For this reason, it is of interest to study how the values in a middle-income country influence the attitudes that are formed towards CSR to further contextualise the need for adaptation of CSR. To accomplish the aim to the fullest extent, and to adequately form an understanding of how the values influence the attitudes towards CSR in a middle-income country, this study takes place in Colombo, Sri Lanka. As Sri Lanka is a country that has a prevalent textile industry, along with a strong focus on CSR activities and ethical production, augments the choice for the enactment of this study. In the essence of this, the encompassing purpose of this study is as follows: To illustrate how cultural values influence attitudes regarding CSR practices from a future managerial perspective in the setting of Sri Lanka, and if the cultural factors play an important role in the formation of values that inhere to CSR. The methodology of the research consists of focus groups that implicate a vignette technique that builds on the theoretical chapter. Five focus groups were performed, which comprised of fifteen students in total, all current fashion students within textiles, design and marketing at the University of Academy of Design (AOD) located in Colombo, Sri Lanka. By using the vignette technique enables the authors to compose ten scenarios, building on the concepts of CSR in where Carroll’s pyramid is of significance, along with cultural dimensions that are represented by Hofstede and Schwartz. Through these scenarios, the authors explore the attitudes of future managers, namely students, in their attempt to act upon ethical dilemmas. Thereafter, thematic analysis was used to extract four themes from the participants’ insights. These themes add up to the Sri Lankan Business Mindset, Hierarchy, Level of Recognition and Who is Responsible. The findings of this study suggest that in an attempt to approach CSR in a manner which strives to shape the values towards ethical reasoning, it is essential to take into consideration the four actors that are identified as responsible – namely the government, society, company, and individual.

Föreliggande studies syfte var att undersöka yrkesverksamma psykologers erfarenheter och hantering av yrkesetiska dilemman kopplat till sociala medier. Studien utgjordes av en kvalitativ ansats och baserades på sex semistrukturerade intervjuer. Datamaterialet analyserades genom induktiv tematisk analys, som mynnade ut i tre huvudteman: Psykologen på sociala medier- föreställningar och förväntningar, Gränser samt Vägledning. Två huvudteman bestod i sin tur av två underteman vardera. Resultatet visade att psykologers erfarenheter av yrkesetiska dilemman bestod av både konkreta erfarenheter och en generell medvetenhet inför potentiella dilemman på sociala medier. De yrkesetiska dilemman som framkom i relation till sociala medier berörde i huvudsak interaktion med patienter, hantering av information om patienter samt självutlämnande information om psykologen. En central aspekt av yrkesetiska dilemman berörde samspelet och gränsdragningen mellan rollen som privatperson och rollen som psykolog på sociala medier. Hanteringen av yrkesetiska dilemman bestod av förebyggande åtgärder och strategier som syftade till att tydliggöra och dra gränser mellan de olika rollerna, där yrkesetiska principer och stöd från arbetsplatsen fungerade vägledande. Studiens resultat kan bidra till att skapa en dialog på arbetsplatser och utbildningar kring etiska dilemman. Därtill belyser studien värdet av en medveten reflektion kring ämnet, vilket kan vara till nytta för den enskilde psykologen i arbetet med patienter. Den kunskap som studien bidrar med kan även vara relevant vid en eventuell uppdatering av Psykologförbundets yrkesetiska principer. / The aim of the present study was to explore psychologists' experiences of ethical dilemmas related to social media, and how these ethical dilemmas are managed. This was explored using a qualitative approach and was based on six semi-structured interviews. The data was analyzed through inductive thematic analysis, which resulted in three main themes: The psychologist on social media - perceptions and expectations, Boundaries and Guidance. Two of the main themes consisted of two sub-themes each. The results showed that psychologists' experiences of ethical dilemmas consisted of concrete experiences and a general awareness of potential dilemmas on social media. The ethical dilemmas that emerged in relation to social media concerned interaction with patients, managing information about patients and self-disclosing information about the psychologist. A central aspect of ethical dilemmas concerned the interplay and demarcation between the private role and the role as a psychologist on social media. The management of ethical dilemmas consisted of preventive measures and strategies aimed at clarifying and establishing boundaries between the various roles, where ethical principles and support from the workplace acted as a guide. The results of the study can contribute to creating a dialogue in workplaces and educational systems about ethical dilemmas. In addition, the study highlights the value of awareness about the subject, which can be useful for the individual psychologist in working with patients. The study may also act as a basis in an eventual update of the Swedish Psychological Association's professional ethical principles.

Compulsory care of a child is one of the most intrusive interventions that can be made in a child's life, but a protective task that social services have been obliged to carry out. In the case of compulsory care of a child, the social secretary is faced with a number of different difficulties and dilemmas that can be linked to coercion in LVU legislation and consideration of the child's best interests. The aim of this qualitative study is to investigate social workers, in social services' child and family investigation, experience of how the child's best interests are taken into account in LVU processes och what thoughts and ethical dilemmas arise for social workers in connection to the LVU process in the meetings with children and parents, and also how can this be understood in relation to their professional role. By using an interview based qualitative method, this study strives to reach a deeper understanding of social workers' experience of the subject matter. The results of this study shows that the experience of the child's best interests is a concept that social workers must constantly define and describe as situational, based on the child's situation. A common description of the child's best interests is that it is a concept that needs a definition and frame of reference, as the lack of a definition makes it more difficult for social workers to consider what is in the child's best interests. This study reaches the conclusion that social workers experience the LVU process to be harmful to the relationship between both children and parents, and parents and social services. Based on this, the social workers felt that it was a huge ethical dilemma to use LVU, as the implementation of the LVU law was both emotionally stressful and comes with its limitations. This despite knowing that LVU should function as a protection for the child and its best interests.

Background: Ethical dilemmas are present in all areas of healthcare and arise particularly when working with patients. When a nurse has to act in contrast to what they consider to be morally correct they risk developing moral distress. Moral distress can lead to mental health problems, burnout or even a career change. The element of compassion is at the core of nursing and is present during ethical challenges and patient suffering. Aim: The aim of this study was to investigate what causes moral distress in nurses.Method: A qualitative literature-review based on 19 articles. Results: The result consists of one overall theme with three main categories and ten subcategories. The overall theme was patient suffering. Main categories were: Organizational causes, internal causes and relational causes. Conclusion: Moral distress in the nursing profession is a complex multi-factored problem. Both organizational and individual-focused solutions need to be implemented to reduce moral distress and there by reduce burnout and mental health problems in nurses. Future research in this area should focus on nurses and how they can better manage and cope with moral stress. / Bakgrund: Etiska dilemman uppkommer inom alla områden inom hälso- och sjukvård, i synnerhet vid patientarbete. När sjuksköterskan måste agera mot sina egna moraliska värderingar riskerar hen att drabbas av moralisk stress. Moralisk stress kan leda till psykisk ohälsa, utmattningssyndrom och karriärbyte. Medkänsla är en grundpelare inom omvårdnad och är närvarande vid etiska utmaningar och vid lindrande av patientens lidande.Syfte: Syftet med studien var att undersöka orsaker till moralisk stress hos sjuksköterskor. Metod: En litteraturstudie med kvalitativ ansats utfördes. Studien baseras på 19 artiklar. Resultat: I resultatet framkom ett övergripande tema samt tre huvudkategorier med tio tillhörande underkategorier. Det övergripande temat var patientens lidande. Huvudkategorierna var: Organisatoriska orsaker, inre orsaker och relationella orsaker. Slutsats: Moralisk stress inom sjuksköterskeyrket är ett komplext och mångfacetterat problem. För att lösa problemet måste både organisatoriska och individbaserade lösningar implementeras, för att därigenom minska utbrändhet och psykisk ohälsa bland sjuksköterskor. Framtida forskning bör fokusera på sjuksköterskan och hur denne bättre kan hantera moralisk stress.

Abstrakt Introduktion: Intensivvårdssjuksköterskor möter i sin yrkesroll många individer och en vård som bedrivs i enlighet med vetenskap och beprövad erfarenhet skall erbjudas till såväl patienter som anhöriga. Upplevelsen av vården bygger på intensivvårdssjuksköterskans förmåga att utveckla en trygg och pålitlig relation. Studier visar att när intensivvårdssjuksköterskor konfronteras med etiska dilemman, leder de inre konflikterna till osäkerhet i hur situationen ska hanteras vilket i sin tur påverkar vården och upplevelsen av mötet med patienter och anhöriga. Syfte: Att beskriva intensivvårdssjuksköterskors upplevelser av att vårda eller möta patienter eller anhöriga som de har en relation till. Metod: Studien genomfördes med kvalitativ metod. Ändamålsenligt urval användes där inklusionskriterierna var sjuksköterskor med en specialistutbildning inom intensivvård, att de i sin roll som intensivvårdssjuksköterskor mött eller vårdat en patient eller anhörig som de hade en relation till samt att de hade en nuvarande anställning på en intensivvårdsavdelning. Datainsamlingen genomfördes med ostrukturerade intervjuer, dessa transkriberades och analyserades genom kvalitativ innehållsanalys med induktiv ansats. Resultat: Resultatet presenteras med fem huvudkategorier och elva subkategorier. Resultatet visar att intensivvårdssjuksköterskorna vill undvika att vårda någon de har en relation till, men under vissa omständigheter kan de känna sig tvungna att vårda även fast de inte vill. Intensivvårdssjuksköterskorna poängterar vikten av att värna om patientens integritet i vården och mötet. Att möta eller vårda någon de har en relation till skapar starka känslor oavsett hur nära relationen är, ett bra stöd på arbetsplatsen underlättar i dessa situationer. Intensivvårdssjuksköterskorna beskriver att de upplever press för att vården ska bli bra och anstränger sig därför mer i situationer som involverar någon de har en relation till. Det kan vara en positiv upplevelse för anhöriga att den som vårdar är någon de har en relation till, då de upplever mer tillit och trygghet i situationen. Intensivvårdssjuksköterskorna upplever också en inre konflikt mellan att vara vän eller personal och de beskriver ett behov av att distansera sig fysiskt och känslomässigt för att klara av situationen. Slutsats: Intensivvårdssjuksköterskorna upplever det svårt och påfrestande att vårda eller möta någon de har en relation till men relationens karaktär påverkar upplevelsen. Det finns en stark oro och ovilja över att behöva ställas emot detta, men när det inträffar så underlättas situationen av ett bra stöd på arbetsplatsen. Det är därför viktigt med bra och utförliga rutiner för hanteringen av dessa situationer.