Patient consent has been formulated in terms of radical individualism rather than shared benefits. Medical education relies on the provision of patient consent to provide medical students with the training and experience to become competent doctors. Pelvic examination represents an extreme case in which patients may legitimately seek to avoid contact with inexperienced medical students particularly where these are male. However, using this extreme case, this paper will examine practices of framing and obtaining consent as perceived by medical students. This (...) paper reports findings of an exploratory qualitative study of medical students and junior doctors. Participants described a number of barriers to obtaining informed consent. These related to misunderstandings concerning student roles and experiences and insufficient information on the nature of the examination. Participants reported perceptions of the negative framing of decisions on consent by nursing staff where the student was male. Potentially coercive practices of framing of the decision by senior doctors were also reported. Participants outlined strategies they adopted to circumvent patients’ reasons for refusal. Practices of framing the information used by students, nurses and senior doctors to enable patients to decide about consent are discussed in the context of good ethical practice. In the absence of a clear ethical model, coercion appears likely. We argue for an expanded model of autonomy in which the potential tension between respecting patients’ autonomy and ensuring the societal benefit of well-trained doctors is recognised. Practical recommendations are made concerning information provision and clear delineations of student and patient roles and expectations. (shrink)

Perceptions of psychological empowerment play a vital role in the way an individual perceives things at the workplace. In spite of this, there is scant research on the antecedents and consequences of psychological empowerment. This study is an attempt to fill this gap by analyzing the mediating role of psychological empowerment on the relationship between its antecedents (leader–member exchange) and its consequences (work engagement and psychological withdrawal behavior). Data were collected from 454 employees working in the Research and Development (R&D) (...) departments of the information technology (IT) and pharmaceutical sectors operating in India. Results suggest that employees who have a high-quality relationship with their leader have high psychological empowerment, they are highly engaged at work, and their psychological withdrawal behavior is also low. In addition to this, high levels of psychological empowerment have a positive impact on their engagement toward work, which further leads to a low psychological withdrawal behavior. The theoretical and practical implications of these results are discussed. (shrink)

Drawing on the theoretical frameworks of antiblackness and intersectionality and the concept of viral visibility, this essay attends to the considerable archive of research about endemic Kaposi’s sarcoma in sub-Saharan Africa accrued during the mid-20th century. This body of data was inexplicably overlooked in Western research into KS during the first decade of the AIDS epidemic, during which period European and Mediterranean KS cases were most often cited as precedents despite the volume of African data available. This paper returns to (...) the research on KS conducted in Africa during the colonial and postcolonial period to consider visibility, racial erasure, and discourses of global epidemiology, suggesting that the dynamics of medical research on HIV/AIDS have proceeded according to a tacit paradigm of antiblackness manifest in multiple exclusions of Africa from global health agendas—most recently the exclusion of the region from antiretroviral drug therapy during the first decades of the treatment’s availability. During that decade KS all but disappeared among people with access to ARV therapy while KS became even more prevalent in sub-Saharan Africa, escalating along with HIV. (shrink)

Inventory prediction and management is a key issue in a retail store. There are a number of inventory prediction techniques. However, it is difficult to identify a time series prediction model for inventory forecasting that provides uniformly good results for all the products in a store. This paper uses data from a small retail store to demonstrate the variability of results for different modeling techniques and different products. We demonstrate inadequacy of a generic inventory model. Stability and seasonality analysis of (...) the time series is used to identify groups of products exhibiting similar sales patterns. Different clustering techniques are applied to determine reasonable local groups. With the help of Mean absolute percentage error, the effectiveness of dataset partitioning for better inventory management is demonstrated. Appropriate inventory management strategies are proposed based on the stability and seasonality analysis. (shrink)

The term ‘Bakhtin Circle’ is used to refer to a group of Russian thinkers centred around Mikhail Bakhtin in the years following the 1917 Revolution. The group's prime concern was with the importance of questions of language-use in social life, and with the way in which language-use registered conflicts between social groups and classes. Prominent members, as well as Bakhtin himself, included P.N. Medvedev and V.N. Voloshinov. Between 1929, when a number of members were arrested, and his death in 1975, (...) Bakhtin continued to work on the issues which had occupied the group. (shrink)

Animalism, according to its strongest proponents, is the view that human beings are ‘essentially or most fundamentally animals’. Specifically, ‘we are essentially animals if we couldn’t possibly exist without being animals’ (Olson 2008). Although contemporary animalism offers an account superior to its Lockean competitors, Olson’s ‘biological approach’ has certain limitations, particularly in its denial of any psychological continuity whatsoever as either necessary or sufficient for individual persistence through time. I propose a number of amendments towards a Thomistic variety of animalism (...) that avoids these difficulties. Although prone to misinterpretation, animalism understood properly is compatible with Aquinas’s theory of subsistent intellect. Against recent challenges, I defend the view that Thomistic animalism not only is intelligible, but is indeed crucial for understanding Aquinas’s view of human nature and rationality. (shrink)

This essay argues that religion is a distinctive form of human activity, and offers a philosophical account of what religion fundamentally is (and what it is not), within the context of the Free Exercise Clause. §I promotes religion as an action-theoretic concept. §II presents the claim that atheism can be regarded as a religion: this claim is rejected on the basis that religion cannot be defined as a set of propositional beliefs concerning metaphysics and morality. §III defends a paradigmatic account (...) of religion as a kind of activity ordered to a concept of transcendence or superior nature, and argues that morally excellent human actions can be identified as religious, but only in a secondary or derivative way. §IV contends with the problem of including act-omissions as instantiations of religious exercise, and proposes a solution with reference to recent arguments implicating two-way powers. (shrink)

This thesis develops a disjunctivist approach to action as an alternative to the standard causal theory, or 'causalism'. The standard theory promotes a concept of action as constituted by a bodily event joined to certain mental conditions by a bond of causation. A disjunctivist approach, in contrast, claims that action must be distinguished by more than merely its etiology: action and mere movement are fundamentally different kinds. Recent objections to the causal theory of action are first surveyed, and the common (...) causalist assumption claiming Aristotle as the progenitor of the causal theory is examined and dismissed. More refined interpretations of Aristotle's thought on action yield two different concepts: action as change, and action as a unified psychophysical process. The latter in particular is argued to hold promise as a basis for developing the disjunctivist approach to action. The remainder of the thesis therefore considers a contemporary account of psychophysicality, known as 'embodiment theory', with the conclusion that the intelligibility of the account depends on appeal to a recent variant of top-down causation. The thesis also concludes that consideration of the concept of an animal agent makes it entirely unsurprising that the mental and physical are always found together in voluntary movement, and that the embodiment theory’s central notion of ‘property fusion’ potentially complements a naturalistic variant of top-down causation in explanations of agency. (shrink)

Current incentive structures are more favorably aligned with the world’s problems than with their solutions. We conceptualize this as the paradox of incentives to argue the need for new thinking and restructuring of incentives to break the paradox during the COVID-19 pandemic and beyond, and create new opportunities for societal transformation.

The importance of value-based leadership such as authentic, ethical, and servant leadership is inconspicuous. However, the benefits of these leadership approaches are often only explained through the behaviors of their followers. As such, limited research has communicated the leader’s motivation for pursuing such leadership behavior, resulting in such discourse to escape theorizing. We draw upon role theory and paid attention to the role of higher-level management (leadership) through the trickle-down model to underline their importance in the organization. We then expand (...) this role theory framework by synthesizing research to explain the emergence of value-based leadership behavior at the frontline of management. In doing so, we aim to provide a stronger explanation of the emergence of value-based leadership in organizations. We conclude this analysis by guiding future research in the form of propositions to investigate the psychological process and organizational factors to empirically examine the proposed role framework. (shrink)

We present a technique called Random Image Structure Evolution (RISE) for use in experimental investigations of high‐level visual perception. Potential applications of RISE include the quantitative measurement of perceptual hysteresis and priming, the study of the neural substrates of object perception, and the assessment and detection of subtle forms of agnosia. In simple terms, RISE involves the measurement of perceptual and/or neural responses as visual stimuli are systematically transformed—in particular, as recognizable objects evolve from, then dissolve into, randomness. Points along (...) the sequences corresponding to the onset and offset of subjects' percepts serve as markers for quantitatively and objectively characterizing several perceptual phenomena. Notably, these image sequences are created in a manner that strictly controls a number of important low‐level image properties, such as luminance and frequency spectra, thus reducing confounds in the analysis of high‐level visual processes. Here we describe the RISE paradigm, report the results of a few basic RISE experiments, and discuss a number of experimental and clinical applications of this approach. (shrink)

Owing to the growing academic and practitioner’s interest in the field of Corporate Social Responsibility, there is a need to do a comprehensive assessment and synthesis of research activities. This article addresses this need and examines the academic literature on Corporate Social Responsibility and Performance using a paradigmatic and methodological lens. The objective of this article is fourfold. First, it examines the status of CSR research from its beginning especially after 1970 to year 2008 in leading academic journals and reports (...) to assess the focus areas of research on CSR so far. Second, it analyzes the research paradigms adopted in these research articles using the Operations Research Paradigm framework. Third, it compares and contrasts various kinds of research articles, methodologies, and research designs used in various researches in literature. Finally, it uncovers the implications of this study and directions for future research. (shrink)

This article reports the findings of a field study conducted on the purchasing intentions of ethical consumers in India. We explored how the involvement of ethical consumers with social networking sites (SNSs such as Facebook, Twitter, Instagram, Snapchat, LinkedIn, and others) affects their intentions to buy ethical products. Applying an extended theoretical lens of theory of planned behavior and social capital, we present an analysis of a rich qualitative data. We identify and describe 7 dimensions, representing the 19 factors and (...) manifesting the informational, relational, and valuation usage of SNSs that explain their impact on the purchase intention of ethical consumers in India. We conclude by highlighting the decision-making role played by the ethical knowledge and price sensitivity of ethical consumers, reflecting the peculiarities and dynamics of ethical consumption in India. (shrink)

As a result of the time‐ and context‐dependency of gene expression, gene regulatory and signaling pathways undergo dynamic changes during development. Creating a model of the dynamics of molecular interaction networks offers enormous potential for understanding how a genome orchestrates the developmental processes of an organism. The dynamic nature of pathway topology calls for new modeling strategies that can capture transient molecular links at the runtime. The aim of this paper is to present a brief and informative, but not all‐inclusive, (...) viewpoint on the computational aspects of modeling and simulation of a non‐static molecular network. BioEssays 26:68–72, 2004. © 2003 Wiley Periodicals, Inc. (shrink)

Scepticism about ought simpliciter is the view that there is no such thing as what one ought simpliciter to do. Instead, practical deliberation is governed by a plurality of normative standpoints, each authoritative from their own perspective but none authoritative simpliciter. This paper aims to resist such scepticism. After setting out the challenge in general terms, I argue that scepticism can be resisted by rejecting a key assumption in the sceptic’s argument. This is the assumption that standpoint-relative ought judgments bring (...) with them a commitment to act in accordance with those judgments. Instead, I propose an alternative account of our normative concepts according to which only ought simpliciter judgments commit one to acting in accordance with those judgments. In addition to answering the sceptical challenge, the proposal offers an independently motivated account of what makes a concept normatively authoritative. (shrink)

Building on earlier work on the relationship between corporate social performance (CSP) and a firm’s financial performance, this integrative empirical study supports the theoretical argument that the higher a firm’s CSP the lower its financial risk. Specifically, the relationship between CSP and risk appears to be one of reciprocal causality, because prior CSP is negatively related to subsequent financial risk, and prior financial risk is negatively related to subsequent CSP. Additionally, CSP is more strongly correlated with measures of market risk (...) than measures of accounting risk. Of all CSP measures, reputation for social responsibility appears to be the most important one in terms of its risk implications. (shrink)

I challenge the common view that trust is characteristically risky compared to distrust by drawing attention to the moral and epistemic risks of distrust. Distrust that is based in real fear yet fails to target ill will, lack of integrity, or incompetence, serves to marginalize and exclude individuals who have done nothing that would justify their marginalization or exclusion. I begin with a characterization of the suite of behaviors characteristic of trust and distrust. I then survey the epistemic and moral (...) hazards of distrust, in particular, distrust’s propensity to bias interpretation, to perpetuate itself, to confirm itself, to dishonor, and to insult. Taking seriously these moral and epistemic hazards requires taking affirmative measures to respond to them. I elaborate one such response: “humble trust”. The practice of humble trust issues from skepticism about the warrant of one’s own felt attitudes of trust and distrust, curiosity about who might be unexpectedly responsive to trust and in which contexts, and commitment to abjure and to avoid distrust of the trustworthy. Humble trust enables individuals to trust that they will be trusted. (shrink)

First published in 1991. Routledge is an imprint of Taylor & Francis, an informa company.

The use of the symbol ∨for disjunction in formal logic is ubiquitous. Where did it come from? The paper details the evolution of the symbol ∨ in its historical and logical context. Some sources say that disjunction in its use as connecting propositions or formulas was introduced by Peano; others suggest that it originated as an abbreviation of the Latin word for “or,” vel. We show that the origin of the symbol ∨ for disjunction can be traced to Whitehead and (...) Russell’s pre-Principia work in formal logic. Because of Principia’s influence, its notation was widely adopted by philosophers working in logic (the logical empiricists in the 1920s and 1930s, especially Carnap and early Quine). Hilbert’s adoption of ∨ in his Grundzüge der theoretischen Logik guaranteed its widespread use by mathematical logicians. The origins of other logical symbols are also discussed. (shrink)

The Peruvian sociologist Aníbal Quijano is widely considered to be a foundational figure of the decolonial perspective grounded on three basic concepts: coloniality, coloniality of power, and colonial matrix of power. His decolonial theorizations of these three concepts have transformed the principles and assumptions of the very idea of knowledge, impacted the social sciences and humanities, and questioned the myth of rationality in natural sciences. The essays in this volume encompass nearly thirty years of Quijano’s work, bringing them to an (...) English reading audience for the first time. This volume is not simply an introduction to Quijano’s work; it achieves one of his unfulfilled goals: to write a book that contains his main hypotheses, concepts, and arguments. In this regard, the collection encourages a fuller understanding and broader implementation of the analyses and concepts that he developed over the course of his long career. Moreover, it demonstrates that the tools for reading and dismantling coloniality originated outside the academy in Latin America and the former Third World. (shrink)

Although rationing of scarce health-care resources is inevitable in clinical practice, there is still limited and scattered information about how physicians perceive and execute this bedside rationing (BSR) and how it can be performed in an ethically fair way. This review gives a systematic overview on physicians’ perspectives on influences, strategies, and consequences of health-care rationing. Relevant references as identified by systematically screening major electronic databases and manuscript references were synthesized by thematic analysis. Retrieved studies focused on themes that fell (...) under three major headings: (i) conditions and influences of BSR, (ii) strategies of BSR, and (iii) consequences of BSR. The range of themes indicates that physicians’ rationing behavior is highly variable, strongly influenced by context-related factors, and consists mainly of implicit rationing strategies. Torn between patient advocacy and the obligation to contain costs, physicians experience various role conflicts. The development of explicit rationing strategies seems necessary to avoid arbitrary BSR and allow a fair allocation of health-care resources. (shrink)

First published in 1996. Routledge is an imprint of Taylor & Francis, an informa company.

De Neys makes a compelling case that the sacrificial moral dilemmas do not elicit competing “fast and slow” processes. But are there even two processes? Or just two intuitions? There remains strong evidence, most notably from lesion studies, that sacrificial dilemmas engage distinct cognitive processes generating conflicting emotional and rational responses. The dual-process theory gets much right, but needs revision.

It is now commonly held that values play a role in scientific judgment, but many arguments for that conclusion are limited. First, many arguments do not show that values are, strictly speaking, indispensable. The role of values could in principle be filled by a random or arbitrary decision. Second, many arguments concern scientific theories and concepts which have obvious practical consequences, thus suggesting or at least leaving open the possibility that abstruse sciences without such a connection could be value-free. Third, (...) many arguments concern the role values play in inferring from evidence, thus taking evidence as given. This paper argues that these limitations do not hold in general. There are values involved in every scientific judgment. They cannot even conceivably be replaced by a coin toss, they arise as much for exotic as for practical sciences, and they are at issue as much for observation as for explicit inference. (shrink)

What is the true worth of Wittgenstein's contribution to philosophy? Answers to this question are strongly divided. However, most assessments rest on certain popular misreadings of his purpose. This book challenges both "theoretical" and "therapeutic" interpretations. In their place, it seeks to establish that, from beginning to end, Wittgenstein regarded clarification as the true end of philosophy. It argues that, properly understood, his approach exemplifies rather than betrays critical philosophy and provides a viable alternative to other contemporary offerings.

Moral distress is a well-documented phenomenon for health care providers (HCPs). Exploring HCPs’ perceptions of participation in moral distress interventions using qualitative and quantitative methods enhances understanding of intervention effectiveness. The purpose of this study was to measure and describe the impact of a two-phased intervention on participants’ moral distress. Using a cross-over design, the project aimed to determine if the intervention would decrease moral distress, enhance moral agency, and improve perceptions about the work environment. We used quantitative instruments and (...) explored participants’ perceptions of the intervention using semi-structured interviews. Participants were from inpatient settings, within three major hospitals of a large, urban healthcare system in the Midwest, United States. Participants included nurses (80.6%) and other clinical care providers. Using generalized linear mixed modeling we assessed the change in each of the outcome variables over time controlling for groups. Interviews were audiotaped and professionally transcribed. The written narratives were coded into themes. The change in scores on study instruments trended in the desired direction however did not meet statistical significance. Qualitative interviews revealed that intervention effectiveness was derived from a combination of learning benefits, psychological benefits, and building community that promoted moral agency. Findings demonstrate a clear link between moral distress and moral agency and suggest that Facilitated Ethics Conversations can enhance the work environment. Findings provide insight for developing evidenced-based approaches to address moral distress of hospital nurses. (shrink)

Background: Nurse managers are placed in a unique position within the healthcare system where they greatly impact upon the nursing work environment. Ethical dilemmas and moral distress have been reported for staff nurses but not for nurse middle managers. Objective: To describe ethical dilemmas and moral distress among nurse middle managers arising from situations of ethical conflict. Methods: The Ethical Dilemmas in Nursing–Middle Manager Questionnaire and a personal characteristics questionnaire were administered to a convenience sample of middle managers from four (...) hospitals in Israel. Results: Middle managers report low to moderate levels of frequency and intensity of ethical dilemmas and moral distress. Highest scores were for administrative dilemmas. Conclusion: Middle managers experience lower levels of ethical dilemmas and moral distress than staff nurses, which are irrespective of their personal characteristics. Interventions should be developed, studied, and then incorporated into institutional frameworks in order to improve this situation. (shrink)

Past research has found that the value of a person's activities can affect observers' judgments about whether that person is experiencing certain emotions (e.g., people consider morally good agents happier than morally bad agents). One proposed explanation for this effect is that emotion attributions are influenced by judgments about fittingness (whether the emotion is merited). Another hypothesis is that emotion attributions are influenced by judgments about the agent's true self (whether the emotion reflects how the agent feels “deep down”). We (...) tested these hypotheses in six studies. After finding that people think a wide range of emotions can be fitting and reflect a person's true self (Study 1), we tested the predictions of these two hypotheses for attributions of happiness, love, sadness, and hatred. We manipulated the emotions' fittingness (Studies 2a-b and 4) and whether the emotions reflected an agent's true self (Studies 3 and 5), measuring emotion attributions as well as fittingness judgments and true self judgments. The fittingness manipulation only impacted emotion attributions in the cases where it also impacted true self judgments, whereas the true self manipulation impacted emotion attribution in all cases, including those where it did not impact fittingness judgments. These results cast serious doubt on the fittingness hypothesis and offer some support for the true self hypothesis, which could be developed further in future work. -/- . (shrink)

Journal of Mathematical Logic, Ahead of Print. Given a structure [math] and a stably embedded [math]-definable set [math], we prove tameness preservation results when enriching the induced structure on [math] by some further structure [math]. In particular, we show that if [math] and [math] are stable (respectively, superstable, [math]-stable), then so is the theory [math] of the enrichment of [math] by [math]. Assuming simplicity of [math], elimination of hyperimaginaries and a further condition on [math] related to the behavior of algebraic (...) closure, we also show that simplicity and NSOP1 pass from [math] to [math]. We then prove several applications for tame expansions of weakly minimal structures and, in particular, the group of integers. For example, we construct the first known examples of strictly stable expansions of [math]. More generally, we show that any stable (respectively, superstable, simple, NIP, NTP2, NSOP1) countable graph can be defined in a stable (respectively, superstable, simple, NIP, NTP2, NSOP1) expansion of [math] by some unary predicate [math]. (shrink)

Advocates of linguistic pragmatics often appeal to a principle which Paul Grice called Modified Occam's Razor: 'Senses are not to be multiplied beyond necessity'. Superficially, Grice's principle seems a routine application of the principle of parsimony ('Entities are not to be multiplied beyond necessity'). But parsimony arguments, though common in science, are notoriously problematic, and their use by Griceans faces numerous objections. This paper argues that Modified Occam's Razor makes considerably more sense in light of certain assumptions about the processes (...) involved in language acquisition, and it describes recent empirical findings that bear these assumptions out. The resulting account solves several difficulties that otherwise confront Grice's principle, and it draws attention to problematic assumptions involved in using parsimony to argue for pragmatic accounts of linguistic phenomena. (shrink)