Abstract:In this paper, we examine critically the notion of “Triple Bottom Line” accounting. We begin by asking just what it is that supporters of the Triple Bottom Line idea advocate, and attempt to distil specific, assessable claims from the vague, diverse, and sometimes contradictory uses of the Triple Bottom Line rhetoric. We then use these claims as a basis upon which to argue (a) that what is sound about the idea of a Triple Bottom Line is not novel, and (b) that what is novel about the idea is not sound. We argue on both conceptual and practical grounds that the Triple Bottom Line is an unhelpful addition to current discussions of corporate social responsibility. Finally, we argue that the Triple Bottom Line paradigm cannot be rescued simply by attenuating its claims: the rhetoric is badly misleading, and may in fact provide a smokescreen behind which firms can avoid truly effective social and environmental reporting and performance.

International government guidance recommends patient and public involvement (PPI) to improve the relevance and quality of research.  PPI is defined as research being carried out ‘with’ or ‘by’ patients and members of the public rather than ‘to’, ‘about’ or ‘for’ them ( http://www.invo.org.uk/). Patient involvement is different from collecting data from patients as participants.  Ethical considerations also differ.  PPI is about patients actively contributing through discussion to decisions about research design, acceptability, relevance, conduct and governance from study conception to dissemination.  Occasionally patients lead or do research.  The research methods of PPI range from informal discussions to partnership research approaches such as action research, co-production and co-learning. This article discusses how researchers can involve patients when they are applying for research funding and considers some opportunities and pitfalls.  It reviews research funder requirements, draws on the literature and our collective experiences as clinicians, patients, academics and members of UK funding panels.

This article seeks an improved understanding of nurse autonomy by looking at nursing through the lens of what recent feminist scholars have called 'relational' autonomy. A relational understanding of autonomy means a shift away from older views focused on individuals achieving independence, towards a view that seeks meaningful self-direction within a context of interdependency. The main claim made here is that nurse autonomy is, indeed, relational. The article begins with an explanation of the notion of relational autonomy. It then explains both the collective and the individual application of the term 'professional autonomy'. Finally, it argues that both senses of professional autonomy are best understood as relational, and suggests some implications of this conclusion.

Many nurses grieve when patients die; however, nurses’ grief is not often acknowledged or discussed. Also, little attention is given to preparing nurses for this experience in schools of nursing and in orientations to health care organizations. The purpose of this research was to explore obstetrical and neonatal nurses’ experiences of grieving when caring for families who experience loss after perinatal death. A visual arts-informed research method through the medium of digital video was used, informed by human science nursing, grief concepts, and interpretive phenomenology. Five obstetrical nurses and one neonatal intensive care nurse who cared for bereaved families voluntarily participated in this study. Nurses shared their experiences of grieving during in-depth interviews that were professionally audio- and videotaped. Data were analyzed using an iterative process of analysis-synthesis to identify themes and patterns that were then used to guide the editing of the documentary. Thematic patterns identified throughout the data were growth and transformation amid the anguish of grief, professional and personal impact, and giving–receiving meaningful help. The thematic pattern of giving–receiving meaningful help was made up of three thematic threads: support from colleagues; providing authentic, compassionate, quality care; and education and mentorship. Nurses’ grief is significant. Nurses who grieve require acknowledgment, support, and education. Supporting staff through their grief may ultimately have a positive impact on quality of work life and home life for nurses and quality of care for bereaved families.

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This study focuses on examining the thematic landscape of the history of scholarly publication in business ethics. We analyze the titles, abstracts, full texts, and citation information of all research papers published in the field's leading journal, the Journal of Business Ethics, from its inaugural issue in February 1982 until December 2016-a dataset that comprises 6308 articles and 42 million words. Our key method is a computational algorithm known as probabilistic topic modeling, which we use to examine objectively the field's latent thematic landscape based on the vast volume of scholarly texts. This "big-data" approach allows us not only to provide time-specific snapshots of various research topics, but also to track the dynamic evolution of each topic over time. We further examine the pattern of individual papers' topic diversity and the influence of individual papers' topic diversity on their impact over time. We conclude this study with our recommendation for future studies in business ethics research.

Key Words: eth ics, treat ment re sis tance, pa tient auton omy, eat ing dis or ders, clini cal de cision mak ingA no rexia ner vosa (AN) is a mul ti fac tor ial psy chi at ric disor der (Note 1) char ac ter ized by sig nifi cantly di min ished body weight and dis torted body im age that is of ten ac com panied by de nial and gen eral cog ni tive im pair ment. More than 90% of cases oc cur in girls and women, and it is thought to affect 0.5% to 1.0% of fe males in late ado les cence and early adult hood (1). Long-term mor tal ity for AN is over 10%, with death most of ten re sult ing from star va tion, sui cide, or elec trolyte im bal ance (1).Treat ment pro grams for AN gen er ally com bine nu tri tional ther apy aimed at in creas ing body weight and re stor ing electro lyte lev els with psy chi at ric ther apy or fam ily ther apy, or both, aimed at reme dy ing un der ly ing sources of the prob lem (which are still not well un der stood). Pa tients suf fer ing from AN, how ever, do not want to gain weight. In deed, they typically mani fest an in tense fear of weight gain, even when they are bor der ing on physi cal col lapse from mal nu tri tion. They thus typi cally re sist treat ment, in one way or an other. Such • Ethi cal is sues are per va sive in clini cal set tings, and even daily, none mer gent ethi cal is sues deserve our care ful ethi cal con sid era tion.• Psy chi at ric prac tice pro vides fer tile ter ri tory for ex am in ing ethi cal chal lenges faced in all clinical set tings. Limi ta tions• The con sid era tions pre sented here are pre limi nary; the eth ics of deal ing with treat ment re sistance has re ceived in suf fi cient at ten tion in the bio eth ics and eat ing dis or der lit era t ure.• More criti cal at ten tion needs to be fo cused on the less ob vi ous ways in which pa tient autonomy is lim ited in clini cal set tings.• This dis cus sion draws upon the lit era ture on eat ing dis or ders and bio eth ics. Its scope could be broad ened through an ex ami na tion of treat ment re sis tance in other psy chi at ric ill nesses.Clini cal ef forts to treat ano rexia ner vosa (AN) are con stantly re sisted by pa tients. Al though the pri macy of pa tient auton omy is a cor ner stone of mod ern medi cal eth ics, cli ni cians will none the less of ten be jus ti fied in pur su ing par ticu lar in ter ven tions de spite such re sis tance, given the re duced com pe tency of pa tients suf fer ing from this mul ti fac tor ial psy chi at ric illness. While a lit era ture ex ists on the ethi cal jus ti fi ca tion for im pos ing treat ment, that lit erature has fo cused ex clu sively on situa tions in which pa tients ref use treat ment out right. When pa tients re sist rather than ref use treat ment, cli ni cians are faced with the ethi cal challenge of de cid ing whether par ticu lar in ter ven tions con sti tute jus ti fied in fringe ments upon pa tient auton omy. Given the fact that treat ment re sis tance is en demic to AN, we see that ethi cal de ci sion mak ing must also be a con tin ual part of t...

The purpose of this research was to uncover the structure of the lived experience of living with changing expectations from the perspectives of women with high-risk pregnancies. The researchers' nursing theoretical perspective is the humanbecoming theory and the Parse research method was used. For the participants, living with changing expectations is foreboding disquietude arising with arduous restrictions, while envisioning the yearned-for with mitigating nurturing engagements. Findings enhance the theory of humanbecoming as well as enhance understanding of the experience of living with changing expectations. Recommendations for future research and practice are discussed.