Este estudo teve como objetivos revelar os dilemas éticos do cotidiano de enfermeiros de instituições de medicina diagnóstica, e o que consideram na tomada de decisão frente a esses dilemas. Para compreender o vivencial desses enfermeiros nesse contexto, optei pela abordagem qualitativa, vertente fenomenológica, segundo a modalidade “estrutura do fenômeno situado". Foram realizadas nove entrevistas com duas questões norteadoras: “Em seu cotidiano, você identifica situações que envolvam dilemas éticos? Fale sobre a sua vivência." e “Frente a um dilema ético, o que você leva em consideração para a tomada de decisão?". Após a descrição dos discursos, foi realizada a análise ideográfica, a partir da qual surgiram sete temas: “(Não) Reconhecimento da existência de dilemas éticos"; “Falta de autonomia profissional"; “(Des) Valorização profissional"; “Fatores envolvidos na tomada de decisão"; “Humanização no relacionamento com a equipe e com o cliente"; “Postura ética" e “Valorização da dimensão técnica". Com a análise nomotética realizada posteriormente, buscou-se revelar as convergências e divergências das unidades de significado interpretadas, com o intuito de perceber a estrutura geral do fenômeno. Com as proposições foi possível desvelar que em Medicina Diagnóstica, os dilemas éticos são percebidos como situações desencadeadas pelo cliente, família, profissionais e instituição. As enfermeiras tomam decisões através da participação de todos os envolvidos na situação, ponderando o custo-benefício de uma ação para o cliente, agindo de forma humanizada, através de suas crenças, respeitando a hierarquia institucional e procurando respaldo médico quando sentem insegurança. A decisão para mudar uma rotina só é tomada quando existem recursos no trabalho. Cumprir normas e condutas da empresa, ser imparcial e humana com a equipe de enfermagem e cliente e ver o que é certo e errado para tomar a posição correta diante de uma situação ética, também são fatores considerados na tomada de decisão. / This study tried to reveal the ethical dilemmas in wich nurses from institutions of medicine diagnostic live every day, and what they consider when they make a decision. To understand the nurse’s experience in this context, I chose the qualitative analysis, according to phenomenological orientation in which there is the modality “structure of the phenomenon situated". Nine interviews were realized with two guiding questions: “In your ordinary day, do you identify situations involving ethical dilemmas? Speak about your experience." and “In front of an ethical dilemma, what do you take into consideration for making a decision?" After describing the speeches, there was an ideographic analysis in which apperead seven themes: “(No) Acknowledgement of the existence of ethical dilemmas"; “Lack of professional autonomy"; “Professional (de) valuation"; “Factors involved in making decision"; “Humanization in the relationship with the team and the customer"; “Ethical attitude" and “Valuation of the tecnique dimension". The nomothetic analysis was in order to show the convergences and divergences of the units of meaning interpreted, with the purpose of understanting the general structure of the phenomenon. With the propositions it was possible to unveil that the ethical dilemmas in Medicine Diagnostic are perceived like situations created by costumer, family professionals and institution. The nurses make a decisions by regarding the participation of people involved in the situation, analyse the cost-benefit of an action for the customer, humanize their actions, in their beliefs, respect the institucional hierarchy and look for a medical opinion when they feel insecurity. The only decide to change a routine when there are resources at work. Other factors are also considered for making a decision: execute rules and behaviours inside the company, be impartial and humane with the nursing team and the customer and identify what is right and wrong to know how to make a correct decision in an ethic situation.

Research and interventions concerning anti-social behaviour have neglected the bad behaviour of “good” people or those who typically behave pro-socially. Additionally, past and current research and practice in this area have often neglected how factors in one’s current environment influence behaviour. Instead, the focus has been on how individual characteristics—borne of the interplay of genetic composition and environmental influences over time—result in anti-social behaviour. However, evidence suggests immediate contexts can foster even atypical behaviour, behavior not correlated with genetic and long-term environmental influences. The thesis is presented in four parts. Part One introduces the idea that immediate group context can have a significant effect on anti-social behaviour, particularly that of “good” people. Part Two reviews research on the impact of social dynamics on behaviour. Part Three presents the empirical study on the role of a particular group dynamic, social dilemmas, in relation to a specific type of anti-social behaviour, bullying. Finally, Part Four considers the implications of the thesis for future research and practice. Social dilemmas are situations in which individual motives are at odds with the best interests of the group and help to explain why individuals sometimes make anti-social decisions. The study at the core of this thesis tested two hypotheses: 1) both individual and group factors are associated with behaviour in bullying situations; and 2) attitudes, group norms, and social dilemmas each have a unique contribution to predicting behaviour in bullying situations. Participants were 292 middle school students at a residential school in the U.S., and data were analysed using multi-level modelling. The primary findings were, in general, consistent with the two hypotheses. The research suggests that social dilemma dynamics might be an important group factor in predicting behaviour in bullying situations.

Although there is extensive literature on supervision in the human services, there is limited research specific to the stories from supervisors in child welfare, in particular in Canada. This inquiry sought to understand how child welfare supervisors navigated through ethical dilemmas in their practice and how their approach influenced decision making. In addition, specific attention was paid on whether these practitioners used critical reflection in their approach to decision making. Findings indicated that these child welfare supervisors relied primarily on their personal moral framework. They encountered frequent dilemmas in highly complex work environments. Further, they endured ethical tensions as a result of not being able to enact their ethics amid work place barriers. These ongoing tensions often resulted in leaving these supervisors depleted emotionally and physically. Critical reflection in action was used in some cases when examining the context of the family in the process of ethical decision making. As with recent studies, this inquiry found that child welfare supervisors often stepped away from reflection in action for self-preservation and relied more heavily on reflection on action. Implications for future studies and recommendations for child welfare practice are discussed. / Graduate

Submitted by Silvana Teresinha Dornelles Studzinski (sstudzinski) on 2016-08-25T12:44:53Z No. of bitstreams: 1 Bianca Andrade_.pdf: 330379 bytes, checksum: d2155ed8ff3610cb77571fa1cada60bd (MD5) / Made available in DSpace on 2016-08-25T12:44:53Z (GMT). No. of bitstreams: 1 Bianca Andrade_.pdf: 330379 bytes, checksum: d2155ed8ff3610cb77571fa1cada60bd (MD5) Previous issue date: 2016-06-14 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Esta é uma dissertação sobre os dilemas bioéticos. O objetivo deste trabalho é determinar quais são os dilemas, quais são os dilemas em bioética, quais são os assuntos comuns a todos os dilemas e classificar dilemas em bioética dividindo-os em categorias para diminuir a incerteza em torno destas discussões políticas. Eu pretendo construir um sistema que poderia ajudar-nos especialistas em ética, eticistas, reconhecer o que questões que estamos lidando e que, provavelmente, seria um primeiro passo para a resolução de dilemas em bioética. / This is a dissertation about bioethical dilemmas. The aim of this work is to determine what are dilemmas, what are dilemmas in bioethics, what are the subjects common to all dilemmas and classify dilemmas in bioethics dividing them into categories to diminish the fuzziness around these polemical discussions. I plan to build a system that could help us, ethicists, recognize what issues we are dealing with and that would probably would be a first step towards the resolution of dilemmas in bioethics. The scope of the work will be: this introduction, a chapter about dilemmas divided into simplified dilemmas, amplified dilemmas and moral mathematics and bioethical dilemmas: why solve them, a chapter about problems involving all dilemmas: the matter of time and well-being and suffering, a chapter on a proposal on bioethical dilemmas: identity dilemmas, self-consciousness dilemmas, future suffering dilemmas and freedom dilemmas and the conclusion.

<p> </p><p>The number of hidden refugees in Sweden is estimated to be at least 15,000. The law, which only allows this group a very limited access to health care, can be considered to clash with the human rights and the ethical codes related to the health care professionals.</p><p>The aim of the study was to examine how the personnel in public health care may experience treating hidden refugees and which ethical conflicts that may be connected to this. The study, which is of a qualitative descriptive design, is based on eight semi-structured interviews. The interviewees were trained nurses and mid-wives in an emergency room, a maternity ward and a health care centre for asylum seekers.</p><p>The experience of treating hidden refugees amongst the informants was limited. The study proved that the knowledge of laws and guidelines regarding hidden refugees amongst the interviewed health care personnel was poor. The interviewees presumed that it would be mentally trying if the law impeded them from giving a patient the care needed.</p><p>The lack of knowledge of laws and guidelines that appeared from the interviews, may lead to an insecurity for the patient, as well as for the personnel. An increasing knowledge and accurate guidelines at the work place would improve the treatment of hidden refugees.</p> / <p> </p><p>I Sverige uppskattas att det finns minst 15000 gömda flyktingar. Lagstiftningen, som endast tillåter en begränsad vård för den gruppen, kan anses stå i konflikt med de mänskliga rättigheterna och sjukvårdspersonalens yrkesetiska koder.</p><p>Syftet med studien var att undersöka hur sjukvårdspersonal som arbetar inom landstinget kan uppleva vård av gömda flyktingar och vilka etiska konflikter som kan vara kopplade till detta. Studien, som är en intervjustudie med kvalitativ deskriptiv design, baseras på åtta semistrukturerade intervjuer. Informanterna utgjordes av sjuksköterskor och barnmorskor på akutmottagning, BB-avdelning och en vårdcentral för flyktingar.</p><p>Informanternas erfarenhet av att vårda gömda flyktingar var begränsad. Det framkom av studien att kunskapen om lagar och riktlinjer gällande vård av gömda flyktingar hos den intervjuade sjukvårdspersonalen var bristfällig. Informanterna förutsatte att det skulle vara psykiskt påfrestande om lagen hindrade dem att ge vård till en patient.</p><p>Den brist på kunskap om lagar och riktlinjer som framkom av intervjuerna, leder till en osäkerhet för både patienten och personalen. Ökad kunskap om lagar och ordentliga riktlinjer på arbetsplatsen skulle underlätta vården av gömda flyktingar.</p><p> </p>

The number of hidden refugees in Sweden is estimated to be at least 15,000. The law, which only allows this group a very limited access to health care, can be considered to clash with the human rights and the ethical codes related to the health care professionals. The aim of the study was to examine how the personnel in public health care may experience treating hidden refugees and which ethical conflicts that may be connected to this. The study, which is of a qualitative descriptive design, is based on eight semi-structured interviews. The interviewees were trained nurses and mid-wives in an emergency room, a maternity ward and a health care centre for asylum seekers. The experience of treating hidden refugees amongst the informants was limited. The study proved that the knowledge of laws and guidelines regarding hidden refugees amongst the interviewed health care personnel was poor. The interviewees presumed that it would be mentally trying if the law impeded them from giving a patient the care needed. The lack of knowledge of laws and guidelines that appeared from the interviews, may lead to an insecurity for the patient, as well as for the personnel. An increasing knowledge and accurate guidelines at the work place would improve the treatment of hidden refugees. / I Sverige uppskattas att det finns minst 15000 gömda flyktingar. Lagstiftningen, som endast tillåter en begränsad vård för den gruppen, kan anses stå i konflikt med de mänskliga rättigheterna och sjukvårdspersonalens yrkesetiska koder. Syftet med studien var att undersöka hur sjukvårdspersonal som arbetar inom landstinget kan uppleva vård av gömda flyktingar och vilka etiska konflikter som kan vara kopplade till detta. Studien, som är en intervjustudie med kvalitativ deskriptiv design, baseras på åtta semistrukturerade intervjuer. Informanterna utgjordes av sjuksköterskor och barnmorskor på akutmottagning, BB-avdelning och en vårdcentral för flyktingar. Informanternas erfarenhet av att vårda gömda flyktingar var begränsad. Det framkom av studien att kunskapen om lagar och riktlinjer gällande vård av gömda flyktingar hos den intervjuade sjukvårdspersonalen var bristfällig. Informanterna förutsatte att det skulle vara psykiskt påfrestande om lagen hindrade dem att ge vård till en patient. Den brist på kunskap om lagar och riktlinjer som framkom av intervjuerna, leder till en osäkerhet för både patienten och personalen. Ökad kunskap om lagar och ordentliga riktlinjer på arbetsplatsen skulle underlätta vården av gömda flyktingar.

abstract: As the world's resources face increasing pressure from a growing population, it is critical that psychologists understand the motivational processes that lead to cooperation or defection in the context of social dilemmas. Research has uncovered several key strategies for encouraging maintenance of these resources, however, one area that remains understudied is the effect various emotions may have on cooperation. Furthermore, it is important to consider the specific type of desired behavior: reduction of consumption of a shared resource, or increased contribution to a shared resource. The current study takes a step in this direction, examining the effects of two self-conscious emotions, guilt and pride, on behavior in two different kinds of social dilemmas. Guilt, a prosocial emotion that has been described as a "behavioral interrupt mechanism," is predicted to increase cooperation in both a social trap game and a public goods dilemma game. However, its effects should be strongest in the social trap game, in which the desired behavior is reduced consumption. Pride, an emotion that is conceptually related to the constructs of status and power, is predicted to motivate action in both domains, by increasing both consumption in the social trap game and contribution in the public goods dilemma game. Results partially support these predictions: Whereas guilt and pride both had the predicted effects on consumption in the social trap game, neither had a significant effect on contribution in the public goods dilemma game. Individual differences are examined, as are the results of a Game Feedback Sheet, which yielded insight as to how participants understood the rules of the games, and why they chose the strategies they did. Results support the idea that emotions represent a potentially fruitful avenue of research in social dilemma cooperation, and possible future directions for this research are discussed. / Dissertation/Thesis / Ph.D. Psychology 2012

Este estudo teve como objetivos revelar os dilemas éticos do cotidiano de enfermeiros de instituições de medicina diagnóstica, e o que consideram na tomada de decisão frente a esses dilemas. Para compreender o vivencial desses enfermeiros nesse contexto, optei pela abordagem qualitativa, vertente fenomenológica, segundo a modalidade “estrutura do fenômeno situado”. Foram realizadas nove entrevistas com duas questões norteadoras: “Em seu cotidiano, você identifica situações que envolvam dilemas éticos? Fale sobre a sua vivência.” e “Frente a um dilema ético, o que você leva em consideração para a tomada de decisão?”. Após a descrição dos discursos, foi realizada a análise ideográfica, a partir da qual surgiram sete temas: “(Não) Reconhecimento da existência de dilemas éticos”; “Falta de autonomia profissional”; “(Des) Valorização profissional”; “Fatores envolvidos na tomada de decisão”; “Humanização no relacionamento com a equipe e com o cliente”; “Postura ética” e “Valorização da dimensão técnica”. Com a análise nomotética realizada posteriormente, buscou-se revelar as convergências e divergências das unidades de significado interpretadas, com o intuito de perceber a estrutura geral do fenômeno. Com as proposições foi possível desvelar que em Medicina Diagnóstica, os dilemas éticos são percebidos como situações desencadeadas pelo cliente, família, profissionais e instituição. As enfermeiras tomam decisões através da participação de todos os envolvidos na situação, ponderando o custo-benefício de uma ação para o cliente, agindo de forma humanizada, através de suas crenças, respeitando a hierarquia institucional e procurando respaldo médico quando sentem insegurança. A decisão para mudar uma rotina só é tomada quando existem recursos no trabalho. Cumprir normas e condutas da empresa, ser imparcial e humana com a equipe de enfermagem e cliente e ver o que é certo e errado para tomar a posição correta diante de uma situação ética, também são fatores considerados na tomada de decisão. / This study tried to reveal the ethical dilemmas in wich nurses from institutions of medicine diagnostic live every day, and what they consider when they make a decision. To understand the nurse’s experience in this context, I chose the qualitative analysis, according to phenomenological orientation in which there is the modality “structure of the phenomenon situated”. Nine interviews were realized with two guiding questions: “In your ordinary day, do you identify situations involving ethical dilemmas? Speak about your experience.” and “In front of an ethical dilemma, what do you take into consideration for making a decision?” After describing the speeches, there was an ideographic analysis in which apperead seven themes: “(No) Acknowledgement of the existence of ethical dilemmas”; “Lack of professional autonomy”; “Professional (de) valuation”; “Factors involved in making decision”; “Humanization in the relationship with the team and the customer”; “Ethical attitude” and “Valuation of the tecnique dimension”. The nomothetic analysis was in order to show the convergences and divergences of the units of meaning interpreted, with the purpose of understanting the general structure of the phenomenon. With the propositions it was possible to unveil that the ethical dilemmas in Medicine Diagnostic are perceived like situations created by costumer, family professionals and institution. The nurses make a decisions by regarding the participation of people involved in the situation, analyse the cost-benefit of an action for the customer, humanize their actions, in their beliefs, respect the institucional hierarchy and look for a medical opinion when they feel insecurity. The only decide to change a routine when there are resources at work. Other factors are also considered for making a decision: execute rules and behaviours inside the company, be impartial and humane with the nursing team and the customer and identify what is right and wrong to know how to make a correct decision in an ethic situation.

This thesis takes a discursive-rhetorical approach to becoming vegetarian and vegan. Previous studies have pointed to complexity and variety in definitions, types and criteria of vegetarianism, making `objective' studies difficult. Meat is also one of the most highly prized but ambivalently valued foodstuffs. The cultural and social meanings of diet in terms of `identities' are well established but the rhetorical approach taken here explores identity as accomplished through social practices of accounting. Rather than seeing variation and disagreement as problematic, analytic focus is on the complex and varied construction of social categories/identities in accounts and the practices of justification and criticism. Cultural ambivalences are recast as dilemmas of identity and account-giving. Diary and serial interview `case-material' was collected from 23 new and aspiring vegetarians and vegans. Participants' accounts are shown to handle a number of dilemmatic aspects of vegetarian/vegan identity; notably, a dilemma of moral superiority and a dilemma of abstinence. These dilemmas are discussed in terms of stereotype-avoidance, commitment, and the co-construction of self and Other. Such identity-management is argued to fundamentally involve relationships. Seen as contexts, texts and resources for account-giving, relationships highlight both local and biographical elements in self-construction, the inter-dependence of selfnarratives/ identities and the need for managing them, especially when identities are changed. A number of other rhetorical resources and practices used in the management of identity are also drawn out, including the discourses of lapsing, desire and temptation and accounts of suppression and repression. The management of dilemmas of accounting through presenting the self as ambivalent, conflicted and divided is underlined. Following recent work by Billig (e. g., 1999a), ambivalence and repression are further considered as discursive activities as well as claims. This leads to a discussion of identity, contradiction and repression in terms of prohibition, desire and transgression. It is suggested that becoming vegetarian or vegan may be characterised as a matter of narrating autobiographical change and the continued negotiation of various dilemmas of identity. Social psychological theories of identity and identity change are criticised and the importance of argumentation, ambivalence and commitment are emphasised. The value of a more `populated' case-study perspective within discursive psychology is also stressed and the study of discursive avoidance and repression is illustrated and recommended.

This PhD by published work consists of: • two single authored articles in refereed journals; • four jointly authored articles in refereed journals; • one jointly authored editorial; • one jointly authored book, including four single authored chapters; They were published in the period 2003-2013. Philip Gilligan submitted the jointly written publications as part of his submission for the award of Degree of Doctor of Philosophy by Published Work in 2013. This thesis identifies substantive findings, theoretical insights, new questions and practice/policy implications arising from the published work. The body of work has and continues to stimulate debate about the need to recognise and appreciate the significance and relevance of religion and related belief in the lives of people accessing health and social care services in the UK. It outlines the general relevance and impact of religion and related belief and explores questions and research concerned with the extent to which social work takes these matters into account in its practices, polices and professional training. It prompts practitioners to reflect on their own and others’ religious beliefs by providing a framework of nine related principles to assist them in their professional practice. One key finding is the need for service providers and policy makers to develop new services that are more responsive to the diverse needs of people living in the UK today by recognising and adopting some of the diverse helping strategies employed and imported by different communities.