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The alleviation of suffering lies at the core of compassionate end-of-life care, yet little is known about the lived experience of suffering. Motivated by a series of reports on poor care of older people in hospital, this study addresses suffering in older people at the end of life in an acute hospital ward in the United Kingdom. Methods were developed from a synthesis of ethnographic fieldwork and phenomenological interpretation. Data were collected using participant observation on an acute care ward for older people in a hospital in Northern England, over 186 hours between June and August 2015. Data included field notes, documents, photographs and informal interviewing. Staff and patient participants were identified using theoretical sampling. Data were analysed using a hermeneutic approach involving a continuous process of analysis, further data collection, posing of problems and questions, and interpretation. This cyclical approach to the data enabled the development of interpretive perspectives which could then be further explored in the field. Findings suggested that care for older people was shaped by competing ideologies of care and organisational regulatory processes. Particularly when there was ambiguity regarding prognosis, there was a tendency for care to default to a ‘rescuing’ acute care model. Through exploring the experiences of individual patients and placing these in the context of cultures of care, I suggest that iatrogenic suffering was a significant concern that often went unrecognised. Patient-centred goals must be more focused upon avoidance of iatrogenic suffering. Recommendations include innovations in clinical education and multiprofessional working.

No description available.

Introduction: Ethical decision-making is an important component of occupational therapy practice in Canada. Research is needed to understand ethical decision-making and how to build occupational therapists’ competency to make ethical decisions. Purpose: The aim of this thesis was to study ethical decision-making in occupational therapy practice in order to contribute to epistemological development regarding ethics in occupational therapy and to support continuing competency in ethical decision-making. Method: Three studies comprise this thesis. A constructivist grounded theory study was conducted involving in-depth semi-structured interviews with 18 occupational therapists from a range of practice settings to explore the process of ethical decision-making. An interpretive description study using secondary analysis of grounded theory data was conducted to explore gaps related to continuing competency in ethical decision-making from the participants’ perspective and to generate recommendations for future directions to support continuing competency. Finally, a non-randomized, single-group, pre- and post-test study (n=33) was conducted to evaluate an on-line education module developed to support competency for clinician-educators. Findings: The grounded theory study led to development of an ethical decision-making prism capturing three processes: Considering the Fundamental Checklist, Consulting Others, and Doing What’s Right. The interpretive description study highlighted two gaps related to continuing competency in ethical decision-making: lack of knowledge and lack of supports. Education, tool development, and ethics mentorship were identified directions for development. The third evaluation study found that an on-line education module led to improvements in ethics knowledge and intent to change practice but not to actual practice change. Implications: This thesis advances a theoretical understanding of ethical decision-making in occupational therapy practice and an applied understanding of occupational therapists’ needs related to competent ethical decision-making. Findings also provide preliminary data regarding on-line ethics education to advance knowledge and skills of clinician-educators who are involved in cultivating ethical decision-making among student occupational therapists. / Thesis / Doctor of Philosophy (PhD) / “Doing what’s right”, or ethical decision-making, is an important part of being an occupational therapist in Canada. To help occupational therapists build knowledge and skills it is important to understand how they make ethical decisions in day-to-day practice. This PhD describes three studies that look at three different aspects of ethical decision-making. The first study presents a theoretical explanation of how occupational therapists decide what’s right to do. The second study uses the same data to look at supports that occupational therapists feel they need to build knowledge and skills about ethical decision-making. The third study measures the value of an on-line education course in helping occupational therapy educators teach students about ethical decision-making. Results of these studies can be used to support occupational therapists in doing what’s right. Results also highlight areas for additional study to further support ethical occupational therapy practice in Canada.

Text in English / Health Studies / M.A. (Nursing Science)

Thesis (MBA (Business Management))--Stellenbosch University, 2008. / ENGLISH ABSTRACT: Ethical decision making in business, the manifestation of business ethics in the individual, is influenced and shaped by various factors, including the external environment, organisational factors and society. In China business ethics, and consequently ethical decision making has emerged and developed mainly as a response to the economic reforms in response to globalisation. Globalisation, a product of the interaction of political and predominantly economic liberalisation, largely brought about by technological change, has become a household word since the last decade of the twentieth century. It is hailed by its advocates as a way to spread cosmopolitan values as well as better employment conditions and standards of living. Its critics, however, see it as a new wave of colonialism imposed by developed countries and multinational companies on poor countries, a synonym to exploitation and impoverishment of both people and nature. A contested issue on globalisation is concerned with its consequences as to the convergence of societies toward a uniform pattern of economic, political, and even cultural organisation, and thus to the formation of a global ethic. A change in approach towards intellectual property and the trends observed in patent applications indicate to what degree various countries have embraced the opportunities presented by globalisation. China is a prime example of a country that embraced the opportunities, and also made the required changes in policies and behaviour. Globalisation has changed the environment in which everyone is competing forever. International institutions play a significant role, and being part of treaties is paramount if countries want to play in the global market. Thus, globalisation changed the external environment that has an important influence on ethical decision making by individuals. These changes are followed by changes in countries' legal environments. As a result the rules by which companies have to play are also influenced, changing the way management should and eventually do behave, which will ultimately change the work experience gained by an individual. A change in individual factors will eventually change the ethical philosophy and the decision ideal of an individual, which also have an impact on ethical decision making. The end result is that globalisation has a profound influence on every factor that influence an individual making ethical decisions. However, these changes can take very long to start to manifest, a fact seen in the lag between policy changes and observing tangible changes in approach to intellectual property rights, as observed in China. / AFRIKAANSE OPSOMMING: Etiese besluitneming deur die individu word beinvloed deur 'n wye verskeidenheid faktore, waaronder die eksterne omgewing, die organisasie waarvoor die individu werk, en ook die kultuur gemeenskap. Sake etiek in China, en dus ook etiese besluitneming het ontwikkel as die resultaat van ekonomiese beleidsveranderinge wat teweeg gebring is deur globalisering. Globalisering is die produk van die grootskaalse liberalisering van ekonomiee, aangehelp deur tegnologiese vooruitgang. Voorstanders van globalisering glo dat dit die verspreiding en groei van kosmopolitaanse waardes tot gevolg het, en uiteindelik lei tot beter werksomstandighede en lewensstandaarde vir almal. Die kritici meen egter dat dit 'n nuwe vorm van kolonialisme is waardeur ontwikkelde lande en internasionale besighede die ontwikkelende lande uitbuit. Die mate waarin globalisering lei tot die konvergensie van gemeenskappe na 'n uniforme ekonomiese, politiese en kulturele entiteit, word egter betwis. Gevolglik word daar ook gevra of globalisering lei tot die totstandkoming van 'n globale etiese kode. Lande benader die geleenthede wat globalisering bied op verskillende maniere. Hierdie verskille is duidelik sigbaar in die benadering wat gevolg word met intellektuele eiendom. Die tendense oor die afgelope paar jaar in die aantal aansoeke om patente te registreer, verskil dramaties van land tot land. China is 'n goeie voorbeeld van 'n land wat die geleentheid met beide hande aangegryp het. Nie net is beleid aangepas om voordeel uit die geleentheid te trek nie, maar mense se houding het ook dienooreenkomstig verander. Globalisering het die omgewing vir kompetisie dramaties verander. Internasionale organisasies speel 'n belangrike rol, en die ondertekening van verskeie ooreenkomste is ononderhandelbaar om ten volle deel te wees van die globale ekonomie. Globalisering het die eksterne omgewing sodanig verander dat dit nie anders kan as om 'n impak te hê op die besluitneming van individue nie. Die veranderende eksterne omgewing het noodgedwonge gelei tot veranderinge in die wette van verskeie lande. Die reels waaraan besighede moet voldoen is dus ook beinvloed, en so ook die manier waarop bestuur moet optree. Uiteindelik sal hierdie ook die ervaring van werknemers verander, en dus 'n impak hê op etiese besluitneming. Die uiteinde is dat globalisering elke faktor wat 'n impak het op etiese besluitneming beinvloed. Hierdie veranderinge kan egter 'n lang tyd neem om gestalte te vind in die optrede van organisasies en indivdue. 'n Goeie voorbeeld word gevind in China. Dit het 'n geruime tyd geneem vanaf beleid ten opsigte van intellektuele eiendom ingestel is totdat organsiasies en individue 'n verandering in gedrag en optrede begin toon het deur patente ernstig te beskou.

Submitted by JOSIANE SANTOS DE OLIVEIRA (josianeso) on 2017-10-16T15:41:16Z No. of bitstreams: 1 Manuela Gomes de Oliveira dos Santos_.pdf: 2211763 bytes, checksum: 4980fcede35738a7f430bb9745d2b321 (MD5) / Made available in DSpace on 2017-10-16T15:41:16Z (GMT). No. of bitstreams: 1 Manuela Gomes de Oliveira dos Santos_.pdf: 2211763 bytes, checksum: 4980fcede35738a7f430bb9745d2b321 (MD5) Previous issue date: 2017-06-09 / Nenhuma / É frequente a divulgação de atos de corrupção, suborno e fraudes envolvendo políticos e governo. Entretanto, os atos de desonestidade também estão presentes no dia a dia das relações entre empresas privadas com funcionários que estão em cargos que possuem o poder de tomada de decisão. Dificilmente uma pessoa não tenha conhecido um colega de trabalho que já tenha alterado relatórios, ocultado informações no seu trabalho ou inflado despesas de viagem e tenha se considerado extremamente moral. Com o intuito de investigar o comportamento antiético, este trabalho focou na relação entre o agente de compras e fornecedor organizacional, por entender que o agente de compras possui em sua rotina de trabalho oportunidade de ter um benefício financeiro pessoal em detrimento a empresa. Essa dissertação testou a influência do ambiente transgressor na tomada de decisão de ética, o emprego do priming ético como um estímulo capaz de engajar a tomada de decisão ética e o padrão moral do indivíduo como forma de influenciar o efeito do priming ético. Foram desenvolvidos três estudos experimentais em laboratório. O resultado prova que o ambiente transgressor influência sobre a tomada de decisão ética e que o priming ético estimula o indivíduo a tomar decisões éticas. O resultado desse trabalho contribui fortemente para área de Comportamento Ético e Comportamento Operacional, encorajando as organizações ao uso do priming Ético, além de códigos de éticas e sanções. / The disclosure of acts of corruption, bribery and fraud involving politicians and the government has become frequent. However, acts of dishonesty are also present in day-to-day relations among private companies with employees who hold positions having decision-making power. Hardly ever would one find a person who has not known coworkers who had already altered reports, hidden information at work or inflated travel expenses and even so considered themselves extremely moral. Aiming at investigating unethical behavior, this study focused on the relationship between organizational buyer and supplier, given the fact it understands that the organizational buyer has an opportunity in his/her work routine to have personal financial benefit to the detriment of the company. This dissertation tested the influence of the transgressive environment on ethical decision-making, the use of ethical priming as a stimulus capable of engaging ethical decision-making, and the individual moral standards as a way of influencing the ethical priming effect. Three experimental studies were developed. Result proves that a transgressive environment influences ethical decision-making and that ethical priming encourages the individual to make ethical decisions. Our findings strongly contribute to the areas of Ethical Behavior and Operational Behavior, encouraging organizations to use ethical priming, as well as codes of ethics and sanctions.

In view of the latest corporate collapses globally, the purpose of this thesis is an attempt to investigate and to theorise how managers make decisions when faced with an ethical dilemma.Philosophers over the years have proposed different moral theories. For example, Kantian’s Categorical Imperative (O’Neil 2001, Peters, 1971) suggests that there are laws that should apply universally. However, its principles are too abstract to guide action, in that it does not provide a detailed set of instructions for following them. Others such as Baier, (2001) suggest that people behave to satisfy their own self-interest. The literature review shows that there is no consensus to define what constitutes ethical behaviour. Kohlberg (1981) divides childhood moral development into six stages. He theorises that greater moral development will be related to the highest social responsibility of an individual. Lagon (2000), Seabright and Moberg (1998), Logsdon and Yuthas (1997) extrapolate Kohlberg’s model to incorporate into organisational and individual moral development.Based on the literature review, research questions were developed. The research methodology is qualitative, based on the realism paradigm using a case research design (Yin 1994). Face to face interviews were conducted with fourteen participants using critical incidents and the findings were triangulated using a semi-structured focus group.The research data analysis is based on grounded theory proposed by Glaser and Strauss (1967). The findings confirm that there is no single theory or approach to business ethics. The findings indicate that a person’s ethical behaviour changes when his/her self-interest is affected. Whilst participants believed that business and ethics can be reconciled, most agreed that they can only be reconciled if the individual’s interest or business profit is not affected. Based on the findings, a new model is proposed in an attempt to theorise an individual’s business ethical behaviour and his/her ethical decision making process.This research also identifies important areas that require further research. These are:• Conflicts between personal values and business values• Should ethics be taught? And if so how?• Should an ethical programme be developed and incorporated in a company’s strategic plan?

Business ethics is a fragmented and well covered scientific field. This Master thesis study concerns two type of organizations, namely family businesses (FB’s) and venture capital firms (VCF’s), in relation to the ethical decision-making process, which is a relatively undiscovered field. The study is conducted in the way it sheds a light on the influences on a manager when taking decisions concerning ethical considerations. Important scholars such as Colby and Kohlberg (1987) and Rest et al. (1999) framed the field of moral development of individuals, and what makes managers unaware of their unethical decisions (Bazerman, 2008). However, a manager’s possibility to take decisions is also influenced by organizational factors and actors. The type of management and ownership structure, and the expectations these actors have with regard to profits, as well as situational factors such as business strategy, maturity of the company, human and financial resources and market position are shaping the environment and possibility for managers to pursue ethical behavior because they affect the decision-making process.The purpose of this study is to understand how managers in FB’s and VCF’s manage ethical considerations. The creating of the conceptual framework was used as a foundation to visualize how ethical behavior is constructed, while the focus laid on the influences and possibility to take decisions including ethical considerations and content. While performing this research, we have conducted eight semi-structured interviews with managers in three VCF’s and two FB’s in Sweden. The respondent companies and interviewees remain anonymous. We did that to increase the chance of honest and unbiased answers since we saw a risk to receive adjusted and image improving responses.The empirical findings show that the VCF’s do not pay attention to ethical considerations in the same extent as FB’s do. Discovered reasons were lack of time and know-how, financial and human resources, business maturity and the fact that they were to generate a high ROI to the venture capitalist. Such a relationship makes the managers focus on profit maximization and short term objectives rather than ethical considerations. The two FB’s did have an ethical code of conduct with the employees and was constructed in order to fulfill acceptance, integration and efficiency with this management tool. The ethical codes of conduct were created with the goal to steer behavior and ensure ethical commitment in certain areas of interest. The major finding is that situational factors either suffocate or give room for ethical considerations in companies when taking decisions.In particular, this research contributes to the field of business ethics and VCF’s in general, but also with regard to FB’s. The results of this thesis are constructed in the decision-making model which is different than the ethical decision-making model we constructed based on the theoretical research. However, reality did not allow us to recognize the fragmented patterns we interpreted from the theory. We therefore created a new top-down model which takes the need for a decision in companies into account, the actors and factors in the organization, the situational factors that influence the happenings in the organization and the outcome of the decision, which possibly contains ethical considerations and content. With the improved model we visualize the decision-making process while taking influences towards ethical decision-making into consideration and visualize organizational reality as we discovered it.Key words: business ethics, ethical considerations, ethical code of conduct, moral awareness, ethical decision-making, ethical behavior, family business, venture capital firm, profit maximization, shareholder preferences.

How does authentic leadership influence subordinate outcomes? It depends on whom you ask. Using Walumbwa, Avolio, Gardner, Wernsing, and Peterson’s (2008) theory-based measure of authentic leadership, this dissertation research advances the authentic leadership literature by: 1) examining relations between managers’ self-reported and subordinates’ ratings of authentic leadership and subordinate outcomes; 2) testing the theoretical proposition that more authentic leaders are inherently more ethical both in the values they subscribe to and in their behavior when compared to less authentic leaders; and 3) examining the mediating mechanisms that account for relations between authentic leadership and subordinate outcomes. Using a field sample of 188 managers and 75 subordinates, results revealed that subordinates and their managers do not see eye to eye in their perceptions of managers’ authentic leadership as the correlation between their ratings was only marginally significant. General support was found for the notion that more authentic leaders subscribe more to self-transcendent values and less to self-enhancement values when compared to less authentic leaders; they also engage in more ethical decision making. Furthermore, results showed that authentic leadership is associated with a broad range of subordinate outcomes, including leader-member exchange, affective organizational commitment, organizational citizenship behavior, and job performance. However, these relations were found only within source. Mediation analyses revealed that subordinates’ trust in their manager partially mediated the relation between subordinate-rated authentic leadership and subordinates’ perceptions of the quality of their relationship with their manager (LMX). Mediation analyses also revealed that subordinates’ trust in their manager and their sense of psychological empowerment each mediated relations between subordinate-rated authentic leadership and subordinates’ affective organizational commitment. In addition, managers’ self-reported empowering leader behavior mediated the relation between managers’ self-rated authentic leadership and their ratings of their subordinates’ organizational citizenship behavior. Implications for research and practice are discussed.