Decision-making capacity: the core of self-neglect

Self-neglect in the elderly is a pervasive public health issue that affects 1.2 million elderly each year. In working with self-neglect cases, ethical issues are often raised that challenge all professionals. Professional and family's wishes to remove obstacles to the wellbeing of an elderly may be directly in opposition to the individual's wishes. The core of many ethical dilemmas resides in the question of the individual decision-making capacity. Issues surrounding decision-making capacity are complex with many confounding factors. Through case-discussion, fundamental ethical issues of decision-making capacity relating to self-neglect will be explored and strategies will be offered to resolve these dilemmas.     

Dealing with the Dilemmas: Integration at the Street‐level in Norway

In Norway, as elsewhere in Europe, the debates about immigration, increasing cultural diversity and the need for integration, are heated and polarised. For welfare state workers and institutions, the perceived task and challenge of integration has to a large extent been to both provide space for cultural diversity and to promote social equality through participation in the labour market, education, and civil society. Amidst all this ongoing debate, a large number of people deal with these issues as a part of their daily work. This paper focuses on the dilemmas such street‐level bureaucrats, or diversity workers, encounter in their work with refugees, immigrants and their children. Most of all, it explores the strategies they have developed to handle such situations. Street‐level bureaucrats have a range of strategies to get around integration dilemmas, which are presented here as five distinct response repertoires. The analytical construction of these repertoires is useful because it provides us with a tool to describe and understand what is going on when policies are translated into institutional practices. It shows how public sector employees are handling the everyday dilemmas that policy does not provide the solutions for. Finally, this analysis of repertoires can also be useful in thinking normatively about what kinds of strategies particular institutions ought to nurture and how they can achieve this.     

Public Research, Private Concerns: ethical issues in the use of open-ended interviews with people who have learning difficulties

This paper is an exploration of the ethical dilemmas in open-ended interview research with people with learning difficulties. We address the possibility that research which gives voice to the experience of abuse, from the viewpoint of the victim, can itself be abusive. Such research is justified in terms of empowering, illuminating and disseminating the meaning that participants give to their lives. Yet every stage of the process raises complex ethical issues when research participants are drawn from vulnerable and powerless groups in society, and the focus for investigation can be deemed private. As a vehicle for our exploration, we reflect on our ethical dilemmas in researching the story of a young woman who has learning difficulties and has been the victim of various forms of abuse. We argue that ethical dilemmas cannot be overcome solely by Ethical Codes or even predetermined 'good practice'. They are integral to the whole research process and necessitate continuous explicit examination of decision making processes within research.     

Studying Postmodern Families: A Feminist Analysis of Ethical Tensions in Work and Family Research

Through dialogue and reflexivity, feminist researchers aim to create knowledge that is emergent from people in relationship with one another. Reflexivity is a process whereby researchers place themselves and their practices under scrutiny, acknowledging the ethical dilemmas that permeate the research process and impinge on the creation of knowledge. Guided by these tenets, we analyzed the relations among our research practices, our participants, and ourselves to understand and reduce the ethical tensions we encountered in a multimethod research project designed to investigate work and family processes. Our reflective efforts underscore both the active nature of research participants and the importance of the sociopolitical contexts within and around the research process. We make suggestions for more ethical research.     

Navigating the ethical maze in disability research: ethical contestations in an African context

Despite changes in how disability is viewed, ethical requirements for disability research have hardly changed. Some ethical clearance procedures, processes and practices still consider persons with disabilities as not able, creating unease among researchers and research participants with disabilities themselves. This paper considers five ethical contestations arising from research in the area of disability in an African context: positionality, vulnerability, signed consent, anonymity, and research committee composition. We argue that ethical requirements in practice are still largely based on a medical model of disability and propose that culturally sensitive social and human rights models should influence disability research ethics.     

Studying-Up and Studying-Across: At-Home Research of Governmental Violence Organizations

Studying the military and other security organizations is challenging for both methodological and ethical reasons. Studying these domains “at home,” literally in the researcher’s own country, complicates things even further. This article discusses these intricacies by proposing a dynamic conceptualization of the subject-object relationship in the study of the military and security in Israel. This conceptualization illuminates the effects of the dynamic positioning of the researcher in four social fields: the academic, the military-security, gender, and the ethno-national. The actual influence of these fields and their interrelations changes throughout the phases of research. We argue that when researchers and their respondents have similar ethno-national affiliation and military experiences, the dichotomous relations between them break down and give way to a dense web of expectations. This brings the researcher to maneuver between two, ostensibly contradictory, research strategies: studying-up and studying-across. The paper unpacks the complexities encapsulated in these strategies by discussing methodological and ethical dilemmas in two field studies on the Israeli-Palestinian conflict conducted by the authors.     

Ethical dilemmas in social problems research: A theoretical framework

Interest in ethical issues in social science has increased greatly in recent years. However, no comprehensive framework for the prediction and elimination of ethical dilemmas has been presented in the literature. This paper first analyzes reasons for increased interest in ethical issues, and then presents a broad framework for prediction and analysis of ethical problems. This framework is based on exchange theory, and shows the interdependencies between five “publics” in the research process: sponsors, researchers, subjects, the media, and the general public. The model also utilizes the sociological concepts of role of each public, the configuration of ascribed and achieved status, and norm abeyance. The primary exchange concepts used are cost, benefit, and trust. The model is illustrated with four actual research projects where ethical dilemmas occurred, and is found to be predictive of ethical problems if there are great disparities in cost/benefit ratios between subjects and researchers or sponsors, if there is great discrepancy between the status of the subjects and the researchers or sponsors, and if the researchers engage in norm abeyance. the author ofMethods of Social Research and numerous articles on research methods. Bailey also is interested in theory and ecology. This research was partially funded by UCLA Senate Research Committee Grant #2884.     

Methodological problems and policy implications in Vietnamese refugee research

This article is written with 2 objectives: 1) to describe some of the critical methodological problems encountered in research with Vietnamese refugees in San Diego, California, about whom few studies have been conducted previous to their arrival in 1975; and 2) to discuss the policy implications of research beset with these difficulties, some of which are unique to studies of refugee populations per se, while others are common to research on small ethnic minorities in general. This article focuses on 4 major issues: 1) the quality of refugee studies, 2) the purpose and functions of such research, 3) the ethical dilemmas of studying refugees, and 4) public policy implications of refugee research. Recommendations are offered to resolve some of these issues which would call for policy changes both in the ways that refugee research is conducted and in the training of researchers themselves.     

Ethical Dilemmas of Practicing Social Workers Around Psychiatric Medication

Abstract

It is acknowledged that social workers in mental health and other settings routinely experience client-related ethical dilemmas. Further, there is wide recognition of the potential impact of ethical dilemmas on social work practice with clients who use psychotropic medication. Little is know empirically, however, about the experiences of practitioners with these dilemmas. This article describes the results of a national survey of practicing social workers regarding the nature of ethical dilemmas they face related to their work with clients on medication issues. The results make it clear that social workers regularly confront a variety of ethical dilemmas in this type of practice. Many of these dilemmas are related to ambiguities around the knowledge base of practice, appropriate roles of providers, and basic personal and professional values. The authors present implications of these findings for social work practice and further research.     

Organization Formation as Epistemic Practice: The Early Epistemological Function of the American Medical Association

This research explores how social actors adjudicate knowledge claims within intellectual environments where epistemic standards are contested. Through the case study of 19th century debates over cholera in the United States, I examine the strategies deployed by orthodox and homeopathic physicians in the struggle over medical knowledge during this “epistemic contest.” The 1832 cholera epidemic ushered in a crisis for orthodox medicine, as epistemological standards for adjudicating medical knowledge claims became challenged and ill-defined. Failing to muster an effective cultural response to homeopathy, orthodoxy adopted an organizational strategy, forming the American Medical Association and offering professional membership as a proxy indicator of legitimate knowledge. The AMA created an organizational/intellectual space insulated from homeopathy, which translated into a concerted campaign to exclude homeopaths from government institutions and affected the nature of orthodox knowledge on cholera. This case reveals that epistemic contests are not waged by cultural means only; organizational practices form an integral part of actors’ repertoires in adjudicating epistemological claims in practice.     

Muslim Women,Moral Visions: Globalization and Gender Controversies in Indonesia

Since 1998, Indonesia’s democratization has produced contentious public debates, many of which revolve around issues of gender and sexual morality. Yet such controversies not only often focus on women, but also involve women as participants. This article examines how Muslim women activists in two organizations adapt global discourses to participate in important public sphere debates about pornography and polygamy. Indonesia’s moral debates demonstrate an important way in which global discourses are negotiated in national settings. In the debates, some pious women use discourses of feminism and liberal Islam to argue for women’s equality, while others use Islam to call for greater moral regulation of society. My research demonstrates that global discourses of feminism and Islamic revivalism are mediated through national organizations which shape women’s political activism and channel it in different directions. Women’s political subjectivities are thus shaped through their involvement in national organizations that structure the ways they engage with global discourses. The Indonesian case shows not only that the national should not be conflated with the local, but also demonstrates the significance of national contexts and histories for understanding global processes.     

Beyond solidarity and losses in aid: strategic approaches towards adversity

Natural adversity elicits public policy reactions in accordance with its negative impact; aid actions are expectedly seen as altruistically driven. This article is based on interviews with experts from NGOs and public emergency response agencies. It debates the paradoxical potentialities that may arise in post‐disaster situations. Topics discussed include: factors surpassing altruism, mass media as a solidarity regulator tool, conflicts between what is understood internationally and what may, in fact, be adopted at the local level, and strategies to internalise resources. Conclusions recognise potentialities as concrete assets for policy makers, but suggest we do not yet possess the ability to strategically identify them as unique and positive opportunities.     

Ready Rhetorics: Political Homophobia and Activist Discourses in Malawi,Nigeria, and Uganda

Since the late 1990s political leaders in several African countries have pursued legislation to expand criminal penalties for same-sex sex. Yet, much of the research on efforts to expand criminalization of same-sex sexualities in Africa has focused on individual country cases, neglecting the role of national and transnational sociopolitical contexts and economic flows. Focusing on discourses present in news media data from 2000 to 2014 in three African countries pursuing regressive policies targeting homosexuality—Malawi, Nigeria, and Uganda—we examine: 1) the different antihomosexual discourses and constellations of actors that emerge over time; 2) the linkages among antihomosexual discourses and other social or cultural logics that allow individuals and collective actors to make sense of antihomosexual discourses in a particular historical moment; and 3) the relationships among discourses vying for power in a given discursive field. In these data we observe episodic public debates around homosexuality that engage different arguments and constellations of actors over time. The intensity of public debates has increased since the mid-2000s in each country, and debates reflect strong linkages among transnational and national actors. Ultimately, we contend that the particular debates occurring around the regulation of same-sex sex in Malawi, Nigeria, and Uganda reflect larger conflicts over social change, political power, and global status hierarchies. We conclude with implications for the study of homophobia and LGBT movements in sub-Saharan Africa.     

Taxonomic Chaos in the Confused Canadian Bioethics Industry: Apres Moi la Deluge

Abstract

This paper presents a conceptual analysis of a decade-old movement in Canada to purportedly raise ethical standards in research with human subjects, even though no systematic evidence has ever been presented either that there are serious ethical problems (especially in psychological research), or that the solutions imposed by the movement would improve the ethical situation, and not harm research's fundamental epistemological enterprise. The movement began with the activities of a committee from Canada's three major government research councils, the Tri-Council Committee (TCC). Like all ideological enterprises, it provided taxonomic chaos by, for example, confusing ethics with epistemology and feelings of discomfort concerning an area of investigation with intellectual expertise about that area. It also went beyond its American counterparts by calling its proposals a code of conduct rather than guidelines, and proposing that if a so-called research participant (i.e., a subject) did not like the investigator's hypotheses, she or he could withdraw “her” or “his” data. Even after the TCC and its various bureaucratic progeny retreated (though ambiguously) from these absurd positions, there has been a maintenance of such positions as the right and responsibility of IRBs to advise not only on the ethical issue of the treatment of subjects, but also on epistemological issues of research design. These issues require not only expertise in the requisite disciplines, but also an intimate familiarity with highly specialized sub-areas. In practical terms senior researchers may be able deal with the burgeoning North American bioethics industry and ignore the anti-epistemological and implicit principles according to which the industry operates. Younger researchers, who have no memory of how research used to be conducted, will succumb, and, in an epistemological sense, be “corrupted”. As the last phrase of my title suggests, senior researchers are currently acting like France's Louis XV.     

Public Sociology: Working at the Interstices

The article examines recent debates surrounding public sociology in the context of a UK based Department of Applied Social Sciences. Three areas of work within the department form the focus of the article: violence against women and children; community-based oral history projects and health ethics teaching. The article draws on Micheal Burawoy’s typology comprising public, policy, professional and critical sociology, and argues that much of the work described in the case studies more often lies somewhere in between, in the interstices, rather than within one or other of the four types. The result is not without its tensions and dilemmas, some of which are identified and explored, notably those arising from attempts to appeal to diverse audiences and meet the sometimes conflicting expectations of each.     

The coloniality of the gaze on sexual violence: a stalled attempt at a South Africa - Rwanda dialogue?

ABSTRACT

In South Africa and Rwanda, the issue of sexual violence has been catapulted into the public sphere in politically charged post-conflict contexts. This article chronicles some of the theoretical, practical and ethical dilemmas that the writer has faced while contemplating research on rape law formation and reform in Rwanda, with an acute awareness of being a Black feminist from a country known to many as one of the rape capitals of the world. Feminist discourses around sexual violence may be grounded in political convictions that this historically invisible aspect of women’s oppression should be spotlighted and included in agendas for criminal and social justice. The writer contends that while feminist scholarship in its plurality is to be commended for stressing the importance of power relations in research, scholars are still not always sensitive to how inter- and intra-group power disparities may adversely affect the interaction between the researchers and researched and the nature of the research itself. Inter-group power disparities may also adversely affect the interaction between researchers themselves. Decolonial thought may provide lenses to make these power disparities even more visible, but it is difficult to say whether decolonial approaches can establish the terms for a more equitable engagement between all the parties concerned.     

Ethical challenges in conducting research with hard to reach families

This paper reflects on some of the ethical challenges encountered by the authors whilst undertaking sensitive qualitative research with parents and children who are traditionally hard to reach. The research aimed to provide more holistic and in‐depth accounts of parenting on a low income in diverse social circumstances than already exist. The nature of the sample and the subject matter that was covered inevitably raised many familiar ethical dilemmas and some that are less often encountered in practice, particularly in relation to child protection. In this article we discuss our approach to ethics, some of the ethical challenges we encountered undertaking work with families and discuss the complexity of decision‐making around risk of harm to children. We conclude that a clear framework to avoid harm should be developed at the outset and a transparent approach to child protection issues should be used. Additional time and resources need to be incorporated at the planning stage of similar projects in order to develop appropriate methods, ensure effective decision‐making and support researchers. Copyright © 2008 John Wiley & Sons, Ltd.     

Technology assessment and the 'ethical matrix'

This paper explores the usefulness of the 'ethical matrix', proposed by Ben Mepham, as a tool in technology assessment, specifically in food ethics. We consider what the matrix is, how it might be useful as a tool in ethical decision-making, and what drawbacks might be associated with it. We suggest that it is helpful for fact-finding in ethical debates relating to food ethics; but that it is much less helpful in terms of weighing the different ethical problems that it uncovers. Despite this drawback, we maintain that, with some modifications, the ethical matrix can be a useful tool in debates in food ethics. We argue that useful modifications might be to include future generations amongst the stakeholders in the matrix, and to substitute the principle of solidarity for the principle of justice. Electronic Publication     

‘Yes,but ... ’: When Separation Creates an Identity Vacuum

This paper explores the ethical and therapeutic dilemmas of working with clients who come in session after session with an intense need to rehearse and re-rehearse their own view, following a separation. This is a particularly difficult client group with which to work. Individuals may be suicidal, want help, and yet are much more aware of their own words than anyone else's. Four such clients are discussed. I will speculate why three out of four are male, look at the ethics of continuing to work with them, suggest possible strategies, and raise implications for therapist training. The ‘Yes, but ...’ is both the clients’ and mine.     

ETHICAL DILEMMAS IN FAMILY THERAPY

A review of the literature in the area of ethical dilemmas facing family therapists revealed that there were a number of issues facing family therapists which are not included in the Principles for Family Therapists (1984) of the American Association for Marriage and Family Therapy. Seventy-five family therapists from across the nation responded to a questionnaire which asked what ethical dilemmas they face and how helpful the ethical guidelines are with these dilemmas. Results indicate that family therapists are encountering dilemmas which are not included in the Principles, significantly more often than those that are included. The ethical principles were found to be helpful for those ethical dilemmas attended to by the Principles.