I argue that there has been inadequate attention to and questioning of the dominance and normativity of whiteness in the cultural construction of bioethics in the United States. Therefore we risk reproducing white privilege and white supremacy in its theory, method, and practices. To make my argument, I define whiteness and trace its broader social and legal history in the United States. I then begin to mark whiteness in U.S. bioethics, recasting Renee Fox's sociological marking of its American-ness as an (...) important initial marking of its whiteness/WASP ethos. Furthermore, I consider the attempts of social scientists to highlight sociocultural diversity as a corrective in U.S. bioethics. I argue that because they fail to problematize white dominance and normativity and the white-other dualism when they describe the standpoints of African-American, Asian-American, and Native-American others, their work merely inoculates difference and creates or maintains minoritized spaces. Accordingly, the dominant white center of mainstream U.S. bioethics must be problematized and displaced for diversity research to make a difference. In conclusion, I give several examples of how we might advance the recommended endeavor of exploring our own ethnicity, class, and other social positioning and norms operating in U.S. bioethics, briefly highlighting "white talk" as one challenge. (shrink)

This study analyses the types and frequencies of ethical dilemmas and the rationale of ethical decision making in student nurses; it also evaluates their decision making. One hundred senior student nurses who were enrolled in a two-credit course in nursing ethics were asked to provide an informal description of a dilemma that they had experienced during their clinical practice. The results were as follows. The ethical dilemmas identified fell into four categories and were of 27 types. Those most frequently experienced (...) were ‘family giving up on a patient because he or she could not be cured’, and ‘not telling the truth to the patient’. The Korean Nurses’ Code of Ethics was applied, in particular the preamble, and the third, fourth, seventh and tenth clauses. The most common rule of ethics and principle applied in these nurses’ ethical decision making were veracity and nonmaleficence. With regard to the moral reasoning process, the primary concern was the welfare of the patients. These students were equipped with the ability to exercise critical and reflective thought when they experienced ethical dilemmas. (shrink)

A brief review of the social and educational context of Hong Kong shows that the publication of the General guidelines on moral education in schools in 1981, by the Hong Kong Education Department, marked a milestone in the development of moral education. The Guidelines explicitly asserted moral education as one function of schooling, whilst also formally recognizing the home and the community as two main influences. This paper narrates how three moral sources of influence – namely Confucian‐parental, Christian‐religious and liberal‐civic (...) – have shaped the development of moral education in Hong Kong from 1973 to 2003. It then examines in more detail: parental influence at home – the Confucian moral source in Chinese family; schooling influenced by religious sources – taking Christian schools as an example; and the Independent Commission Against Corruption as an official agency for moral education – a liberal source calling for civic morality. In conclusion, the post‐colonial emergence of nationalistic influence in the recently constituted Chinese Special Administrative Region, advocating national identity as the new core value, is traced and the implications for future moral education in Hong Kong are considered. (shrink)

This Korean study replicated a previously published American study. The conceptual framework and method combined ethical enquiry and phenomenology. The research questions were: (1) What is nursing students’ experience of ethical problems involving nursing practice? and, (2) What is nursing students’ experience of using an ethical decision-making model? The participants were 97 senior baccalaureate nursing students, each of whom described one ethical problem and chose to use one of five ethical decision-making models. From 97 ethical problems, five content categories emerged, (...) the largest being health professionals (69%). The basic nature of the ethical problems was the students’ experience of conflict, resolution and rationale. Using an ethical decision-making model helped 94% of the students. A comparison of the Korean and American results yields important implications for nursing ethics education, practice and research. (shrink)

: Since the late 1970s, American appraisals of Chinese medical ethics and Chinese responses to American bioethics range from frank criticism to warm appreciation, from refutation to acceptance. Yet in the United States as well as in China, American bioethics and Chinese medical ethics have been seen, respectively, as individualistic and communitarian. In this widely-accepted general comparison, the great variation in the two medical moralities, especially the diversity of Chinese experiences, has been unfortunately minimized, if not totally ignored. Neither American (...) bioethics nor Chinese medical ethics is a field with only one dominant way of thinking. Medical moralities in America and China--traditional and modern--have always been plural and diverse. For example, American and Chinese cultures and medical moralities both exhibit individualistic and communitarian traditions. For this reason, bioethics in general and cross-cultural bioethics in particular must be fundamentally interpretive. Interpretive cross-cultural bioethics appreciates the plurality of medical morality within any culture. It can serve as a vital means of social and cultural criticism through engaged interpretations. (shrink)

Ancient Chinese ideas of moral education could be said to have five main dimensions – philosophical foundations, content, principles, methods and evaluation – which are described in this paper. An analysis of the fundamental features of Confucian thinking on moral education shows that it took the idea that human beings have a good and kind nature as its logical starting point. It built a system of ethical norms, based on the idea that an individual's feelings come from the inner mind, (...) combined with external rites. Its methods of moral education are diverse, with an emphasis on learning from exemplars, environmental conditions and practice, as well as the cultivation of moral responsibility and social commitment. Its quintessential ideas were ‘virtue lies in practice’ and ‘life is moral education’. The paper concludes by arguing that Confucian thinking on moral education has ongoing value for research and practice in contemporary moral education. (shrink)

Extensive historical sleuthing reveals that the word "bioethics" and the field of study it names experienced, in 1970/1971, a "bilocated birth" in Madison, Wisconsin, and in Washington, D.C. Van Rensselaer Potter, at the University of Wisconsin first coined the term; and André Hellegers, at Georgetown University, at the very least, latched onto the already-existing word "bioethics" and first used it in an institutional way to designate the focused area of inquiry that became an academic field of learning and a movement (...) regarding public policy and the life sciences. A further comparison of the Potter and the Hellegers/Georgetown understandings of bioethics and the relative acceptance of the two views will appear in the March 1995 issue of this journal. (shrink)

This article is based on an empirical study regarding ethical challenges in intercultural nursing. The focus is on autonomy and disclosure. Autonomy is a human capacity that has become an important ethical principle in nursing. Although the relationship between autonomy and patients’ possibly harmful choices is discussed, the focus is on ‘forced’ autonomy. Nurses seem to equate respect with autonomy; it seems to be hard to cope with the fact that there are patients who voluntarily undergo treatment but who actively (...) participate neither in the treatment offered nor in making choices regarding that treatment. Nurses’ demand for patients to be autonomous may in some cases jeopardize the respect, integrity and human worth that the ethical principle of autonomy is meant to ensure. Even though respect for a person’s autonomy is also respect for the person, one’s respect for the person in question should not depend on his or her capacity or aptitude to act autonomously. Is autonomy necessarily a universal ethical principle? This article negates this question and, through the issues of culture, individualism versus collectivism, first- and second- order autonomy, communication and the use of family interpreters, and respect, an attempt is made to explain why. (shrink)

Since the late 1970s, American appraisals of Chinese medical ethics and Chinese responses to American bioethics range from frank criticism to warm appreciation, from refutation to acceptance. Yet in the United States as well as in China, American bioethics and Chinese medical ethics have been seen, respectively, as individualistic and communitarian. In this widely-accepted general comparison, the great variation in the two medical moralities, especially the diversity of Chinese experiences, has been unfortunately minimized, if not totally ignored. Neither American bioethics (...) nor Chinese medical ethics is a field with only one dominant way of thinking. Medical moralities in America and China--traditional and modern--have always been plural and diverse. For example, American and Chinese cultures and medical moralities both exhibit individualistic and communitarian traditions. For this reason, bioethics in general and cross-cultural bioethics in particular must be fundamentally interpretive. Interpretive cross-cultural bioethics appreciates the plurality of medical morality within any culture. It can serve as a vital means of social and cultural criticism through engaged interpretations. (shrink)

Ethical issues in international nursing research are identified and the perspectives of the International Centre for Nursing Ethics are offered in an effort to develop an international consensus of ethical behaviour in research. First, theoretical issues are reviewed, then initial conditions for ethical conduct are defined, and protocol design and procedure considerations are examined. A concerted effort is made to identify and avoid a western bias. Broad guiding principles for designing and reviewing research are offered: (1) respect for persons; (2) (...) beneficence; (3) justice; (4) respect for community; and (5) contextual caring. A collaborative model of the researcher-participant relationship is suggested and discussed. (shrink)

This longitudinal study examined the development of moral judgement in 37 nursing students attending a university in Suwon, Korea. The participants completed the Korean version of the Defining Issues Test to allow analysis of their level of moral judgement. The development of moral judgement was quantified using ‘the moral development score’ at each stage (i.e. the six stages detailed by Kohlberg) and the ‘P(%) score’ (a measure of the overall moral judgement level). The results were as follows: (1) the moral (...) development score for stage 5A was consistently the highest across the four years of the students’ course, showing significant differences in some sociodemographic factors including home, birth order and monthly income; and (2) the P(%) score was higher in fourth-year (47.47 ± 11.21) than in first-year (46.13±9.73) students. There was no significant difference in the P(%) score according to sociodemographic factors. Further studies will examine in detail the correlation between curriculum and moral judgement development. We suggest that courses in ethics education should be made more relevant. (shrink)

SETTING: Medical ethics education has become common, and the integrated ethics curriculum has been recommended in Western countries. It should be questioned whether there is one, universal method of teaching ethics applicable worldwide to medical schools, especially those in non-Western developing countries. OBJECTIVE: To characterise the medical ethics curricula at Asian medical schools. DESIGN: Mailed survey of 206 medical schools in China, Hong Kong, Taiwan, Korea, Mongolia, Philippines, Thailand, Malaysia, Singapore, Indonesia, Sri Lanka, Australia and New Zealand. PARTICIPANTS: A total (...) of 100 medical schools responded, a response rate of 49%, ranging from 23%-100% by country. MAIN OUTCOME MEASURES: The degree of integration of the ethics programme into the formal medical curriculum was measured by lecture time; whether compulsory or elective; whether separate courses or unit of other courses; number of courses; schedule; total length, and diversity of teachers' specialties. RESULTS: A total of 89 medical schools (89%) reported offering some courses in which ethical topics were taught. Separate medical ethics courses were mostly offered in all countries, and the structure of vertical integration was divided into four patterns. Most deans reported that physicians' obligations and patients' rights were the most important topics for their students. However, the evaluation was diverse for more concrete topics. CONCLUSION: Offering formal medical ethics education is a widespread feature of medical curricula throughout the study area. However, the kinds of programmes, especially with regard to integration into clinical teaching, were greatly diverse. (shrink)