Informed consent is a central topic in contemporary biomedical ethics. Yet attempts to set defensible and feasible standards for consenting have led to persistent difficulties. In Rethinking Informed Consent in Bioethics Neil Manson and Onora O'Neill set debates about informed consent in medicine and research in a fresh light. They show why informed consent cannot be fully specific or fully explicit, and why more specific consent is not always ethically better. They argue that consent needs distinctive communicative transactions, by which (...) other obligations, prohibitions, and rights can be waived or set aside in controlled and specific ways. Their book offers a coherent, wide-ranging and practical account of the role of consent in biomedicine which will be valuable to readers working in a range of areas in bioethics, medicine and law. (shrink)

Every year in this country, some 10,000 college and university courses are taught in applied ethics. And many professional organizations now have their own codes of ethics. Yet social science has had little impact upon applied ethics. This book promises to change that trend by illustrating how social science can make a contribution to applied ethics. The text reports psychological studies relevant to applied ethics for many professionals, including accountants, college students and teachers, counselors, dentists, doctors, journalists, nurses, school teachers, (...) athletes, and veterinarians. Each chapter begins with the research base of the cognitive-developmental approach--especially linked to Kohlberg and Rest's Defining Issues Test. Finally, the book summarizes recent research on the following issues: * moral judgment scores within and between professions, * pre- and post-test evaluations of ethics education programs, * moral judgment and moral behavior, * models of professional ethicseducation, and * models for developing new assessment tools. Researchers in different professional fields investigate different questions, develop different research strategies, and report different findings. Typically researchers of one professional field are not aware of research in other fields. An important aim of the present book is to bring this diverse research together so that cross-fertilization can occur and ideas from one field can transfer to another. (shrink)

Patient counseling is a cornerstone of ethical pharmacy practice and high quality pharmaceutical care. Counseling promotes patient compliance with prescription regimens and prevents dangerous drug interactions and medication errors. Counseling also promotes informed consent and protects pharmacists against legal risks. However, economic, social, and technological changes in pharmacy practice often force community pharmacists to choose between their professional obligations to counsel patients and business objectives. State and federal legislatures have enacted laws that require pharmacists to counsel patients, but these laws (...) have had mixed results. This essay argues that community pharmacy's patient counseling conundrum can be solved through additional moral education and moral persuasion, not through additional legal mandates. (shrink)

There is a great deal of support for the contention that the ethical cognition of health care professionals are of consequence to the level of patient care provided. The present study examines the ethical cognition of what has traditionally been deemed a profession of incomplete or marginal status: the retail, or community, pharmacy setting. An empirical examination of ethical cognition compares a systematic random sample of retail pharmacists with pharmacy students. Additional comparisons are made with a baseline of ethical cognition (...) abilities of other health care professionals, such as physicians and nurses.Based on cognitive-developmental theory and using a well-known measure of ethical reasoning, two hypotheses are explored regarding the ethical reasoning skills of retail pharmacy practitioners and pharmacy students. Results indicate that, contrary to cognitive moral development theory, students possess greater ethical reasoning skills than do their practitioner counterparts. In addition, baseline comparisons with other health professional groups reflect unfavorably on the retail pharmacists. It is suggested that the selection-socialization processes inherent in the retail pharmacy setting may result in one or more of the following outcomes: 1) the selection of lower ethical reasoners to the community pharmacy setting, 2) the exodus to other pharmacy settings of higher reasoners, and 3) a possible retrogression in the ethical cognition of community practitioners. Implications for retail practice and limitations are discussed. (shrink)

Objective: To explore the relationship between pharmacists'' tenure in the community setting and their moral reasoning abilities. Design: Systematic random sample design. Setting: A large southeastern city in the United States. Participants:450 independent and chain community pharmacists identified from the state board of pharmacy list of licenced community pharmacists. Interventions: A mailed questionnaire that included a well-known moral reasoning instrument and collected demographic information. Main Outcome Measures: Moral Reasoning abilities and tenure of community pharmacists. Results: As a group, community pharmacists (...) with greater years of tenure in community practice scored significantly lower on moral reasoning than those pharmacists with fewer years of tenure (p = 0.016). Conclusion: Four plausible explanations for the results are given including: a) a selection of lower ethical reasoners and/or an exodus of higher ethical reasoners from the community setting; b) a retrogression in the moral reasoning skills as community pharmacists obtain tenure in this setting; c) differences between the low and high moral reasoning groups may be due to a cohort effect; and d) the obtained practitioner sample may not have been representative of the population of community pharmacists. (shrink)

The primary purpose of this cross sectional study was to empirically test the notion that retail pharmacists' moral reasoning scores (using Rest's Defining Issues Test) relate to their patient care performance scores (using the Behavioral Pharmaceutical Care Scale). Presently, retail pharmacy organizations are experiencing a paradigm shift from a prescription dispensing emphasis to a patient-centered one. The present investigation examined the influence of moral reasoning, within the situational context of workload pressures and perceived normative beliefs of significant others, on retail (...) pharmacists' self-report patient care performance scores.A secondary goal was to explore the relationship between moral reasoning and retail pharmacists' propensity to exaggerate depictions of their true behavior (using a short-form Marlowe-Crowne Social Desirability Scale). (shrink)

McDowell offers an unusually frank discussion of the ethical principles that should govern decisions and analyzes the pressures that drive some professionals to sell unnecessary or excessive services.