Ethical decision-making regarding infant viability: A discussion

© The Author(s) 2016. Background: There are no universally agreed rules of healthcare ethics. Ethical decisions and standards tend to be linked to professional codes of practice when dealing with complex issues. Objectives: This paper aims to explore the ethical complexities on who should decide to give infants born on the borderline of viability lifesaving treatment, parents or the healthcare professionals. Method: The paper is a discussion using the principles of ethics, professional codes of practice from the UK, Nursing Midwifery Council and UK legal case law and statute. Healthcare professionals' experiences that influence parental decision are also considered. Findings & Discussion: There are considerable barriers to an effective discussion taking place in an environment where clinical decisions have to be made quickly once the baby is born. This is compounded by the need and respect for parental autonomy and the difficulties they face when making a best interest's decision knowing that this could cause more harm than good for their infant child and balancing any decision they make with quality of life. Conclusion: On deciding whether to give lifesaving treatment born at the borderline of viability, it should be a joint decision between the parents and the neonatal team

‘One big wheel’: young people’s participation in service, design, development and delivery (Sharing our experience, Practitioner-led research 2008-2009; PLR0809/080)

How do professionals and agencies seek the views of young people moving from participation to the implementation of service design and delivery? The research involved six white British young people from the Camborne, Pool and Redruth (CPR) area of Cornwall who, with the support of a senior social worker within the Schools Multi-Agency Resource Team (SMART) and other members of the team, became researchers themselves. The young people were involved in the process of designing questions and conducting semi-structured interviews with agencies such as Children’s Social Care, the police and the fire service to ask how young people are involved in service design and delivery. In addition to the semi-structured interviews, creative and solution focused methods were employed to identify a young person’s perception of services. The research process highlighted some surprising examples of service delivery for young people from agencies other than those set up to deliver ‘youth services’. Why has this developed and what recommendations can be made for further service design and delivery on front-line and strategic levels to achieve a true model of integrated practice, ensuring young people have a voice and are heard? Natasha Jame

Ethical approaches to family planning in Africa

Africa has historically provided the geographical flashpoint of ethical issues relating to family planning programs. Until recently in Sub-Saharan Africa, advocacy of family planning by non-Africans was unacceptable and by Africans politically inadvisable. This has changed in the 1980s. The health rationale for family planning is backed by strong evidence, especially in Africa, where infant and maternal mortality and morbidity rates are high. Population growth in many African countries impedes development, which cannot keep up with needs. Earlier attempts to offer family planning aid were often politically inept and endangered the needed partnership between donor and developing countries. Theoretical arguments and abstract demographic projections are less persuasive than carefully designed programs geared to the health and well-being of communitities that help plan them. Increased cooperation between donor and developing countries has helped resolve some of the ethical difficulties that beset family planning programs. This report summarizes many of the practical, ethical and cultural considerations in making family planning aid acceptable.Health Monitoring&Evaluation,Adolescent Health,Agricultural Knowledge&Information Systems,Gender and Health,Early Child and Children's Health

Profit and purpose: the case for sustainable luxury fashion

The development of the fashion industry into a large-scale multinational operation and the resulting potential for damage to planet and people has attracted the attention of environmental and social activists since at least the 1960s, but consumers on the whole remain broadly ignorant of how their personal fashion purchases and widespread industry practices contribute to negative environmental and social impact (Connell and Kozar, 2014). The luxury sector, in particular, has much to lose in terms of reputation by revelations of exploitation and irresponsible environmental actions along the supply chain, given that much of its premium-pricing is based on notions of authenticity and quality production (Kapferer and Bastien, 2012). Previously, a focus on eco or sustainable fashion was seen as marginal or niche, but more recently consumers demonstrate a desire for greener products creating potential for businesses to work for profit and purpose (Ottman, 2011). This change has resulted in a new hybrid business model- the social enterprise- which adds value by meeting market needs and wants through responsible business and employment practices (Radclyffe-Thomas and Roncha, 2016). Tengri, a London-based luxury knitwear label is one such social enterprise business and this paper explores social enterprise in the luxury sector through a case study of Tengri’s business model that combines social and environmental awareness with luxury product development to create a virtuous cycle of ethical fashion production and consumption. Founder Nancy Johnston was inspired by her experiences travelling with Mongolia’s yak herders where she was confronted with the harshness of the nomadic way of life and threats to its continuing existence from land degradation and exploitative business practices. She was driven to action when she juxtaposed these conditions with the promoted glamour of the luxury fashion industry, which relies on supplies of ingredients from just such workers in supply chains that stretch across the globe. Informed by primary research with Tengri and industry experts supplemented with analysis of Tengri’s business, product development and marketing materials, this paper investigates how Tengri works to balance environmental and social engagement with launching a start-up luxury business aimed at engaging the new global sustainable luxury consumers, a group described by Caroline Holme Director of Globescan as the ‘Aspirational’ consumer – a segment that combines a desire to be ethical with a love of style, design and shopping, particularly prevalent in emerging markets. Keywords: sustainability, luxury, fashion, social-enterprise, innovatio

The Pope John Center: Labor, Delivery and the First Decade

Roll 26. Lodger's Caroling / Fr. Klubertanz. Image 1 of 7. (18 December, 1952; 22 December, 1952) [PHO 1.26.6]The Boleslaus Lukaszewski (Father Luke) Photographs contain more than 28,000 images of Saint Louis University people, activities, and events between 1951 and 1970. The photographs were taken by Boleslaus Lukaszewski (Father Luke), a Jesuit priest and member of the University's Philosophy Department faculty

The Role of External Auditors and International Accounting Bodies in Financial Regulation and Supervision

The emergence of powerful financial conglomerates operating at a global level has led to unified supervision of financial services in the UK and Germany. These changes in regulatory structures have a higher potential of better utilisation through the involvement of external auditors. The crucial role played by external auditors in banking regulation and supervision has been highlighted in bank collapses like BCCI and Barings. According to the Basel Core Principles for effective Banking Supervision 1997, an effective banking supervisory system should consist of both “on-site” and “off-site” supervision. Off-site supervision involves the regulator making use of external auditors. On-site work is usually done by the examination staff of the bank supervisory agency or commissioned by supervisors but may be undertaken by external auditors. Following Enron's collapse, debates focussed around why the UK had avoided its Enron. Many argued that it was because the US approach to accounting regulation was rules-based in comparison to the principles based system of the UK . In addition to adopting an independent standard setting, the International Accounting Standards Board's second principle is aimed at principles as opposed to rules based standards. All public trading companies in the European Union would have to apply new international standards from 2005 in consolidated financial statements ( EC Regulation 1606/2002) and huge efforts are now being made towards global convergenc

Impact of violence against women on severe acute maternal morbidity in the intensive care unit, including neonatal outcomes: a case–control study protocol in a tertiary healthcare facility in Lima, Peru

Introduction Preventing and reducing violence against women (VAW) and maternal mortality are Sustainable Development Goals. Worldwide, the maternal mortality ratio has fallen about 44% in the last 25 years, and for one maternal death there are many women affected by severe acute maternal morbidity (SAMM) requiring management in the intensive care unit (ICU). These women represent the most critically ill obstetric patients of the maternal morbidity spectrum and should be studied to complement the review of maternal mortality. VAW has been associated with all-cause maternal deaths, and since many women (30%) endure violence usually exerted by their intimate partners and this abuse can be severe during pregnancy, it is important to determine whether it impacts SAMM. Thus, this study aims to investigate the impact of VAW on SAMM in the ICU. Methods and analysis This will be a prospective case-control study undertaken in a tertiary healthcare facility in Lima-Peru, with a sample size of 109 cases (obstetric patients admitted to the ICU) and 109 controls (obstetric patients not admitted to the ICU selected by systematic random sampling). Data on social determinants, medical and obstetric characteristics, VAW, pregnancy and neonatal outcome will be collected through interviews and by extracting information from the medical records using a pretested form. Main outcome will be VAW rate and neonatal mortality rate between cases and controls. VAW will be assessed by using the WHO instrument. Binary logistic followed by stepwise multivariate regression and goodness of fit test will assess any association between VAW and SAMM. Ethics and dissemination Ethical approval has been granted by the La Trobe University, Melbourne-Australia and the tertiary healthcare facility in Lima-Peru. This research follows the WHO ethical and safety recommendations for research on VAW. Findings will be presented at conferences and published in peer-reviewed journals