The purpose of this study was to understand 1) perceptions about transition services of special education teachers who work with students with intellectual disabilities (ID) and 2) dilemmas these teachers have encountered when implementing these services in Korea. I used Qualitative in-depth interviews for providing insight into the Korean special school teachers' perceptions of transition services, dilemmas they encountered in practice, and strategies for solving these dilemmas to improve their performance level for implementing transition services. As a results of this study, I found many challenges or barriers that keep special education teachers for students with ID from effectively implementing transition services. I have used the four dilemmas framework theorized by Windschitl (2010) to further examine why the implementation of transition services is lacking. In place of being critical of educators, it is important to provide them with an environment that allows them to work effectively. Active participation and cooperation by school administrators, parents, government organizations for people with disabilities, and legal services would be most helpful in providing an atmosphere in which special educators could ensure successful transition services for their students. This study also found that teachers had encountered other dilemmas that had not been categorized into the four dilemmas framework. In place of critiquing teachers' low levels of transition implementation, it would be more effective to provide professional development training for these educators and to prepare the educational and social infrastructure to enhance their implementation of transition services for students with ID.

This study examined the conceptual framework of ethical reasoning of public elementary school assistant principals during decision-making. An ethical framework not only provides a descriptive way of thinking during ethical decision-making, but also provides a rationale for decisions. The purpose of this study was to determine which ethical reasoning framework, including the ethics of justice, critique, care, and the profession, elementary school assistant principals' use during decision-making. Additionally, the study determined other resources assistant principals' consult during decision-making. This study incorporated descriptive survey research through purposeful sampling with specific participant criteria. A researcher-developed survey of hypothetical dilemmas was deployed electronically to public elementary school assistant principals. Thirty-seven participants responded to four hypothetical scenarios, involving either staff or students, through a Likert scale and open response questions. Each hypothetical scenario included one of the ethical frameworks of justice, critique, care, or the profession embedded in one of four potential solutions. The findings suggest that elementary school assistant principals use an ethical framework during decision-making, whether they refer to the framework specifically by name or not. The data suggest the assistant principals in this study most frequently selected the ethic of care framework for their decision-making. Lastly, the evidence in this study suggests the most frequently consulted resource during decision-making by the assistant principals in this study was that of their principal. There is much research on ethics, teachers, and school leaders, but there are few studies on ethics and the assistant principal. Additionally, there are few studies on the assistant principal and ethical decision-making. The literature suggested that the assistant principalship is a stepping-stone to the principalship. If the assistant principalship is truly a stepping-stone for future principals, assistant principals need to have developed their personal and professional code of ethics, as well as, have an understanding of the ethical reasoning frameworks for implementation during ethical decision-making.

<p>I omvårdnaden av dementa uppstår ofta etiska överväganden där hänsyn skall tas till den demenssjuke, närstående, medboende samt lagar och riktlinjer. Sjuksköterskan ställs ofta inför svåra etiska situationer där beslut ska tas om eventuella tvångsåtgärder oberoende av vilket sorts stöd, moraliskt och/eller juridiskt, sjuksköterskan eventuellt har i sina beslut. Syftet med studien var att belysa sjuksköterskors upplevelser av etiska dilemman i demensvården i samband med olika tvångsåtgärder. Data samlades in via fokusgruppsintervjuer med sjuksköterskor (n=12) som ansvarade för personer med demenssjukdom inom särskilda boenden i en kommun i Norrland. En fallbeskrivning utgjorde grunden i fokusgruppsintervjuerna. Materialet analyserades via en kvalitativ manifest innehållsanalys. I resultatet framkom fyra kategorier. Etiska dilemman, etiskt förhållningssätt, rättsnormer och verklighet samt behov av stöd.  Sjuksköterskorna upplevde att de är ensamma i beslutsfattandet och behövde stöd i de svåra besluten kring åtgärder i olika etiska dilemman . Sjuksköterskorna upplevde närståendes delaktighet i vården av de dementa som ett bra och viktigt stöd och dialogen med närstående betonades. Det beskrevs också en känsla av stress då sjuksköterskan kommer i kläm mellan vårdpersonalens och de närståendes motstridiga krav som kan kännas svåra att tillmötesgå. En medvetenhet om de olika lagarna beskrevs men sjuksköterskorna upplevde det inte som ett etiskt dilemma att ibland behöva kringgå dem för att skydda den demente från skada eller lidande. Det skulle dock kännas bättre om de hade möjlighet att få stöd i lagen i sitt handlande. Den slutsats som vi drar är att sjuksköterskorna inte upplever några svårigheter att besluta om en tvångsåtgärd men behovet av stöd och handledning är stort.</p> / <p>Within the care of people with dementia ethical considerations often occurs and considerations has to be taken to the person with dementia, relatives, cohabitants and to laws and guidelines. Ethical dilemmas often occurs when the registered nurses (RNs) have to decide  whether or not to use constraints in the care, regardless of what kind of support these actions have in a moral or legal sense. The aim of this study was to describe the RNs experience of ethical dilemmas in relation to constraints in care of people with dementia. Data were collected in focus groups, with RNs (n=12) who worked in a municipal residential care for people with dementia in the north of Sweden. A case report initiated the interviews. Data were analyzed with qualitative content analysis. Four categories emerged. Ethical dilemmas, ethical approach, legal norms and reality, the need of support.  The RNs experienced loneliness in their decision making of interventions in different ethical difficult care situations and felt the need of support. They experienced that relatives are an important and a fine support in the care and the dialogue are pointed out as important. The RNs described feelings of stress when they were caught between conflicting demands from nursing staff and relatives. The RNs were aware of the laws related to health care, but they didn`t think of it as an ethical dilemma if they had to take sidestep from the law to protect the person with dementia from harm or misery. However they would feel better if they were supported by the law. <strong><em>Conclusion</em></strong><em>: </em>The RNs didn´t feel any difficulties if they had to decide to use constraints in the care of a person with dementia, but they are in need of support and coaching.</p>

<p>The meaning that Justice has after a conflict in a society might vary regarding the political development and cultural and shared values of a certain society.</p><p>Rawls, in his Theory of Justice gives his idea of what justice is and presents two principles of justice that he argues are required to live in a good society: a first principle that secures equal rights and liberties for all individuals and a second egalitarian principle that restrains the consequences of economic inequalities within societies. He also introduces the concept of “overlapping consensus” which I will use regarding the idea of Reconciliation, at the end of this paper.</p><p>In the cases presented in this paper (i.e. Argentina and South Africa), essential human rights were violated, therefore wrongdoers made the society unjust.</p><p>The aim of this thesis is to elucidate the conditions that are necessary to re-establish justice when a society goes through a conflict. I will introduce some ideas concerning that issue: ideas of retribution, reparation and reconciliation. These are seen as different paths for several countries when trying to tackle to the matter of achieving justice.</p><p>In my view, this question can be answered appealing first to an intuitive conception of moral justice that may exist at an individual and collective level, as well.</p><p>The ethical dilemmas both levels have are in relation to the harm done, punishments and how to balance them, limiting, for instance, the punishment in order to accomplish a just and a better society. I will also present how shared values can result from a process of reconciliation, which is considered as the ideal alternative to achieve justice.</p><p>However, when the equilibrium between members of a community is broken, some people claim that punishment can restore that lost equilibrium that existed before in the community.</p><p>Nevertheless, peace, reconciliation and justice cannot be constructed under the basis of silence. One way to keep memory alive is to let survivors, for instance, narrate what they have lived through; telling stories also creates a new space to share with others their experiences, revealing their fears and emotions. Regarding this theme, I will present the NUNCA MAS (Never Again) report, which is fundamental as it gives some testimonies, facts and proposals that will help to reach a consensus and therefore, future reconciliations.</p><p>Why is important to achieve justice? Because then members of a certain community will be able to interact in the present with common shared values and thus, deal with the past.</p><p>Not to consider reconciliation as one important step to achieve justice, and only think in terms of punishment, instead of giving way to peace and justice, could perhaps promote the possibility of further conflicts. To consider both punishment and reconciliation might just be one possible blueprint in the long and difficult way of searching for a just society.</p>

<p>The aim of the present literature study was to describe the significant factors contributing to the development of moral distress and the consequences of moral distress can lead to in the nurse profession. A literature search was performed in the databases Medline through PubMed and Academic Search Elite on the basis of in advanced defined criterions. A total of 19 articles was reviewed and included in the study. The main result revealed that nurses experience moral distress and that it is frequent within the nurse profession. The findings revealed that there seem to be several significant factors in the development of moral distress, such as providing life-sustaining care, competing loyalties, conflicts with the physician, communication barriers, emotional barriers, cultural barriers, regulation and rules and working environment that gives the nurse difficult or unsolved ethical dilemmas. The consequences of moral distress can contribute to health problems both physical symptoms and mentally, such as headache, neck and muscle pain, stomach problems, depression, anger and guilt. Moral distress affects the nurse professionally, and contributes to distancing from patients, relatives and colleagues, a resistance against going to work and to perform work tasks. The conclusion is that the consequences of moral distress don’t just affect nurses but undeniably also patients, relatives and other instances in within the healthcare system.</p> / <p>Syftet med denna litteraturstudie var att beskriva de faktorer som har betydelse för utvecklingen av moral distress, och vilka konsekvenser moral distress kan leda till i sjuksköterskans yrkesutövning. En litteratursökning genomfördes i databaserna Medline via PubMed och Academic Search Elite utifrån i förväg uppsatta kriterier. Totalt 19 artiklar granskades och inkluderades i studien. Huvudresultatet visade att moral distress existerar och är frekvent inom vården och sjuksköterskeyrket. Av författarnas resultat framkommer att det tycks finnas flera faktorer av betydelse för utvecklingen av moral distress, som livsuppehållande vård, konkurrerande lojaliteter, konflikt med läkaren, kommunikationshinder, emotionella hinder, kulturella hinder, föreskrifter och regler och arbetsmiljöfaktorer ger sjuksköterskan svårlösta eller olösta etiska och moraliska dilemman. Konsekvenserna av detta kan bidra till långvariga stressrelaterade hälsoproblem, så som huvudvärk, smärta i nacke, muskler och mage, nedstämdhet, ilska, skuld och depression. Moral distress får även konsekvenser för professionen så som avståndstagande till patienter, anhöriga och arbetskamrater, motstånd att gå till jobbet och att utföra sina arbetsuppgifter. Författarna drar slutsatsen att följderna av moral distress inte bara drabbar sjuksköterskan utan onekligen även patienter, anhöriga och övriga i vårdkedjan.</p>

<p>The aim of this thesis emanated from a discussion whether voluntary associations have a choice or not regarding their democratic development. Robert Michels (1911/1983), one of the classic sociological thinkers, says no. The path towards oligarchy is inevitable. Nevertheless, maybe there are certain points, where the organizations face a certain democratic “dilemma” (Merton, 1966), forcing them more or less easily towards the oligarchic path? Seven counterarguments deriving from modern perspectives on participatory democracy (Pateman 1985; 1989) where used to find a way to avoid the oligarchic path and by that develop democracy in organizations. Since democracy also requires equality, the dissertation explored the question of power and influence in democratic organisations by studying the use of (spoken) language. Inspired by sociolinguistic theory (Milles, 2004) the aim was to identify dominance of the conversation: Who are taking part of the conversation? Are there differences between women and men in democratic organisations?</p><p>The main part of the study consists of group interviews. Members of the boards of six relatively small voluntary associations where chosen as units of analysis. Information around founding an association gathered from 75 homepages on Internet served as background data. The language as each one of the 27 board members where studied both separately and as conversation.</p><p>The conclusion is that formal structures build in hierarchal levels already when voluntary organisations take form. The dilemmas seem to revolve around the two fundamental criteria of democratic government, namely effectiveness and responsiveness are more or less explicitly stated. Awareness of dilemmas seems to be a possible way to avoid the determinism of oligarchy. The need for reinterpretation of the goals now and then could make it easier to find alternative actions. The associations have to strike a balance between effectiveness in relation to their goals and effectiveness in a democratic sense, a balance not always held. By clarifying the work and development processes of the voluntary organisations it is possible to identify (the lack of) democratic work within the organisations – a useful instrument in practice. The elite that runs the organisations is almost exclusively male and is preventing the members, especially women, from voicing their opinion. Democracy obstructs by structures demanded by society, socialised gender structures and the need of efficiency. The representatives are not always carrying out their task as elected representatives; self-interest puts before the common good.</p>

The aim of this thesis emanated from a discussion whether voluntary associations have a choice or not regarding their democratic development. Robert Michels (1911/1983), one of the classic sociological thinkers, says no. The path towards oligarchy is inevitable. Nevertheless, maybe there are certain points, where the organizations face a certain democratic “dilemma” (Merton, 1966), forcing them more or less easily towards the oligarchic path? Seven counterarguments deriving from modern perspectives on participatory democracy (Pateman 1985; 1989) where used to find a way to avoid the oligarchic path and by that develop democracy in organizations. Since democracy also requires equality, the dissertation explored the question of power and influence in democratic organisations by studying the use of (spoken) language. Inspired by sociolinguistic theory (Milles, 2004) the aim was to identify dominance of the conversation: Who are taking part of the conversation? Are there differences between women and men in democratic organisations? The main part of the study consists of group interviews. Members of the boards of six relatively small voluntary associations where chosen as units of analysis. Information around founding an association gathered from 75 homepages on Internet served as background data. The language as each one of the 27 board members where studied both separately and as conversation. The conclusion is that formal structures build in hierarchal levels already when voluntary organisations take form. The dilemmas seem to revolve around the two fundamental criteria of democratic government, namely effectiveness and responsiveness are more or less explicitly stated. Awareness of dilemmas seems to be a possible way to avoid the determinism of oligarchy. The need for reinterpretation of the goals now and then could make it easier to find alternative actions. The associations have to strike a balance between effectiveness in relation to their goals and effectiveness in a democratic sense, a balance not always held. By clarifying the work and development processes of the voluntary organisations it is possible to identify (the lack of) democratic work within the organisations – a useful instrument in practice. The elite that runs the organisations is almost exclusively male and is preventing the members, especially women, from voicing their opinion. Democracy obstructs by structures demanded by society, socialised gender structures and the need of efficiency. The representatives are not always carrying out their task as elected representatives; self-interest puts before the common good.

The aim of the present literature study was to describe the significant factors contributing to the development of moral distress and the consequences of moral distress can lead to in the nurse profession. A literature search was performed in the databases Medline through PubMed and Academic Search Elite on the basis of in advanced defined criterions. A total of 19 articles was reviewed and included in the study. The main result revealed that nurses experience moral distress and that it is frequent within the nurse profession. The findings revealed that there seem to be several significant factors in the development of moral distress, such as providing life-sustaining care, competing loyalties, conflicts with the physician, communication barriers, emotional barriers, cultural barriers, regulation and rules and working environment that gives the nurse difficult or unsolved ethical dilemmas. The consequences of moral distress can contribute to health problems both physical symptoms and mentally, such as headache, neck and muscle pain, stomach problems, depression, anger and guilt. Moral distress affects the nurse professionally, and contributes to distancing from patients, relatives and colleagues, a resistance against going to work and to perform work tasks. The conclusion is that the consequences of moral distress don’t just affect nurses but undeniably also patients, relatives and other instances in within the healthcare system. / Syftet med denna litteraturstudie var att beskriva de faktorer som har betydelse för utvecklingen av moral distress, och vilka konsekvenser moral distress kan leda till i sjuksköterskans yrkesutövning. En litteratursökning genomfördes i databaserna Medline via PubMed och Academic Search Elite utifrån i förväg uppsatta kriterier. Totalt 19 artiklar granskades och inkluderades i studien. Huvudresultatet visade att moral distress existerar och är frekvent inom vården och sjuksköterskeyrket. Av författarnas resultat framkommer att det tycks finnas flera faktorer av betydelse för utvecklingen av moral distress, som livsuppehållande vård, konkurrerande lojaliteter, konflikt med läkaren, kommunikationshinder, emotionella hinder, kulturella hinder, föreskrifter och regler och arbetsmiljöfaktorer ger sjuksköterskan svårlösta eller olösta etiska och moraliska dilemman. Konsekvenserna av detta kan bidra till långvariga stressrelaterade hälsoproblem, så som huvudvärk, smärta i nacke, muskler och mage, nedstämdhet, ilska, skuld och depression. Moral distress får även konsekvenser för professionen så som avståndstagande till patienter, anhöriga och arbetskamrater, motstånd att gå till jobbet och att utföra sina arbetsuppgifter. Författarna drar slutsatsen att följderna av moral distress inte bara drabbar sjuksköterskan utan onekligen även patienter, anhöriga och övriga i vårdkedjan.

I omvårdnaden av dementa uppstår ofta etiska överväganden där hänsyn skall tas till den demenssjuke, närstående, medboende samt lagar och riktlinjer. Sjuksköterskan ställs ofta inför svåra etiska situationer där beslut ska tas om eventuella tvångsåtgärder oberoende av vilket sorts stöd, moraliskt och/eller juridiskt, sjuksköterskan eventuellt har i sina beslut. Syftet med studien var att belysa sjuksköterskors upplevelser av etiska dilemman i demensvården i samband med olika tvångsåtgärder. Data samlades in via fokusgruppsintervjuer med sjuksköterskor (n=12) som ansvarade för personer med demenssjukdom inom särskilda boenden i en kommun i Norrland. En fallbeskrivning utgjorde grunden i fokusgruppsintervjuerna. Materialet analyserades via en kvalitativ manifest innehållsanalys. I resultatet framkom fyra kategorier. Etiska dilemman, etiskt förhållningssätt, rättsnormer och verklighet samt behov av stöd.  Sjuksköterskorna upplevde att de är ensamma i beslutsfattandet och behövde stöd i de svåra besluten kring åtgärder i olika etiska dilemman . Sjuksköterskorna upplevde närståendes delaktighet i vården av de dementa som ett bra och viktigt stöd och dialogen med närstående betonades. Det beskrevs också en känsla av stress då sjuksköterskan kommer i kläm mellan vårdpersonalens och de närståendes motstridiga krav som kan kännas svåra att tillmötesgå. En medvetenhet om de olika lagarna beskrevs men sjuksköterskorna upplevde det inte som ett etiskt dilemma att ibland behöva kringgå dem för att skydda den demente från skada eller lidande. Det skulle dock kännas bättre om de hade möjlighet att få stöd i lagen i sitt handlande. Den slutsats som vi drar är att sjuksköterskorna inte upplever några svårigheter att besluta om en tvångsåtgärd men behovet av stöd och handledning är stort. / Within the care of people with dementia ethical considerations often occurs and considerations has to be taken to the person with dementia, relatives, cohabitants and to laws and guidelines. Ethical dilemmas often occurs when the registered nurses (RNs) have to decide  whether or not to use constraints in the care, regardless of what kind of support these actions have in a moral or legal sense. The aim of this study was to describe the RNs experience of ethical dilemmas in relation to constraints in care of people with dementia. Data were collected in focus groups, with RNs (n=12) who worked in a municipal residential care for people with dementia in the north of Sweden. A case report initiated the interviews. Data were analyzed with qualitative content analysis. Four categories emerged. Ethical dilemmas, ethical approach, legal norms and reality, the need of support.  The RNs experienced loneliness in their decision making of interventions in different ethical difficult care situations and felt the need of support. They experienced that relatives are an important and a fine support in the care and the dialogue are pointed out as important. The RNs described feelings of stress when they were caught between conflicting demands from nursing staff and relatives. The RNs were aware of the laws related to health care, but they didn`t think of it as an ethical dilemma if they had to take sidestep from the law to protect the person with dementia from harm or misery. However they would feel better if they were supported by the law. Conclusion: The RNs didn´t feel any difficulties if they had to decide to use constraints in the care of a person with dementia, but they are in need of support and coaching.

The meaning that Justice has after a conflict in a society might vary regarding the political development and cultural and shared values of a certain society. Rawls, in his Theory of Justice gives his idea of what justice is and presents two principles of justice that he argues are required to live in a good society: a first principle that secures equal rights and liberties for all individuals and a second egalitarian principle that restrains the consequences of economic inequalities within societies. He also introduces the concept of “overlapping consensus” which I will use regarding the idea of Reconciliation, at the end of this paper. In the cases presented in this paper (i.e. Argentina and South Africa), essential human rights were violated, therefore wrongdoers made the society unjust. The aim of this thesis is to elucidate the conditions that are necessary to re-establish justice when a society goes through a conflict. I will introduce some ideas concerning that issue: ideas of retribution, reparation and reconciliation. These are seen as different paths for several countries when trying to tackle to the matter of achieving justice. In my view, this question can be answered appealing first to an intuitive conception of moral justice that may exist at an individual and collective level, as well. The ethical dilemmas both levels have are in relation to the harm done, punishments and how to balance them, limiting, for instance, the punishment in order to accomplish a just and a better society. I will also present how shared values can result from a process of reconciliation, which is considered as the ideal alternative to achieve justice. However, when the equilibrium between members of a community is broken, some people claim that punishment can restore that lost equilibrium that existed before in the community. Nevertheless, peace, reconciliation and justice cannot be constructed under the basis of silence. One way to keep memory alive is to let survivors, for instance, narrate what they have lived through; telling stories also creates a new space to share with others their experiences, revealing their fears and emotions. Regarding this theme, I will present the NUNCA MAS (Never Again) report, which is fundamental as it gives some testimonies, facts and proposals that will help to reach a consensus and therefore, future reconciliations. Why is important to achieve justice? Because then members of a certain community will be able to interact in the present with common shared values and thus, deal with the past. Not to consider reconciliation as one important step to achieve justice, and only think in terms of punishment, instead of giving way to peace and justice, could perhaps promote the possibility of further conflicts. To consider both punishment and reconciliation might just be one possible blueprint in the long and difficult way of searching for a just society.