Professional identity and competent ethical behaviors of nursing students are commonly developed through curricular inclusion of professional nursing values education. Despite the enactment of this approach, nursing students continue to express difficulty in managing ethical conflicts encountered in their practice. This descriptive correlational study explores the relationships between professional nursing values, self-esteem, and ethical decision making among senior baccalaureate nursing students. A convenience sample of 47 senior nursing students from the United States were surveyed for their level of internalized professional (...) nursing values (Revised Professional Nursing Values Scale), level of self-esteem (Rosenberg’s Self-Esteem Scale), and perceived level of confidence in ethical decision making. A significant positive relationship (p < 0.05) was found between nursing students’ professional nursing values and levels of self-esteem. The results of this study can be useful to nursing educators whose efforts are focused on promoting professional identity development and competent ethical behaviors of future nurses. (shrink)

This clinical case report illustrates the potential dilemmas that can arise from knowledge gained through genetic analysis. These conflicts require careful ethical analysis of presumed duties to protect patient privacy and maintain confidentiality, the duty to warn a second party of a health risk, and the duty of veracity. While the questions raised by genetic testing of one individual for disease that reveals potentially important information about relatives, such as risk for Huntington chorea or breast cancer, have been discussed, the (...) continuing expansion in our capacity for sophisticated genetic analysis continues to present new and challenging situations. The resolution of this case and others like it requires close collaboration among the treatment team, geneticists, and clinical ethicists. (shrink)

Clinical ethics consultants represent a multidisciplinary group of scholars and practitioners with varied training backgrounds, who are integrated into a medical environment to assist in the provision of ethically supportable care. Little has been written about the degree to which such consultants are accountable for the patient care outcome of the advice given. We propose a model for examining degrees of internally motivated accountability that range from restricted to unbounded accountability, and support balanced accountability as a goal for practice. Finally, (...) we explore implications of this model for training of clinical ethics consultants from diverse academic backgrounds, including those disciplines that do not have a formal code of ethics relating to clinical practice. (shrink)

In the United States, there is no consensus about who should make decisions in acute but non-emergent situations for incapacitated patients who lack surrogates. For more than a decade, our academic medical center has utilized community volunteers from the hospital ethics committee to engage in shared decision-making with the medical providers for these patients. In order to add a different point of view and minimize conflict of interest, the volunteers are non-clinicians who are not employed by the hospital. Using case (...) examples and interviews with the community members, this paper describes how the protocol has translated into practice over the years since its inception. Members reported comfort with the role as well as satisfaction with the thoroughness of their discussions with the medical team. They acknowledged feelings of moral uncertainty, but expressed confidence in the process. Questions raised by the experience are discussed. Overall, the protocol has provided oversight, transparency, and protection from conflict of interest to the decision-making process for this vulnerable patient population. (shrink)

Numerous ethical issues are raised in cancer treatment and research. Informed consent is challenging due to complex treatment modalities and prognostic uncertainty. Busy oncology clinics limit the ability of oncologists to spend time reinforcing patient understanding and facilitating end-of-life planning. Despite these issues and the ethics consultations they generate, clinical ethicists receive little if any focused education about cancer and its treatment. As the field of clinical ethics develops standards for training, we argue that a basic knowledge of cancer should (...) be included and offer an example of what cancer ethics training components might look like. We further suggest some specific steps to increase collaboration between clinical ethicists and oncology providers in the outpatient setting to facilitate informed consent and proactively identify ethical issues. (shrink)

We examined differences in the knowledge and beliefs that exist among nurse researchers in the USA (n = 119) regarding informed consent and the use of data from patients’ medical records. Using a mail survey, two domains of ethical knowledge and beliefs were assessed: the legal right to privacy and the moral right to privacy. More than half of the participants were very confident in their knowledge of institutional review board procedures, research ethics, informed consent, the legal right to privacy, (...) and the moral right to privacy. In contrast, most rated themselves as uncertain about US federal research regulations and there was wide variation in knowledge about current federal guidelines. Those who were more confident in their knowledge of or had more practical experience with research ethics, were no more likely to answer correctly a question about current federal guidelines regulating the use of patient data from medical records than those who reported less confidence or experience. (shrink)

setting, are warranted. This article details a descriptive study in which patients were interviewed, during hospital stays, about their beliefs and understanding of advanced directions, as well as the processes used in completing them. The study was undertaken in a community hospital located in a rural area in the Midwest. Findings show that many patients were able to clearly articulate what an AD means in terms of making their choices known. However, misconceptions were found in patients' understanding of ADs and (...) only 46% reported discussing their ADs with a physician. Strategies for effective implementation of education programs related to ADs are detailed here. © 1999 Lippincott Williams & Wilkins, Inc.... (shrink)

Pilgrimage, Politics, and Pestilence: The Haj from the Indian Subcontinent 1860–1920. By Saurabh Mishra. New Delhi: Oxford University Press, 2011. Pp. ix +177. $55.

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

To date no one has identified or described the population of incapacitated patients being treated in an inpatient setting who lack proxy decision-makers. Nor, despite repeated calls for protocols to be developed for decision-making, has any institution reported on the utilization of such a protocol. In 2005, our urban tertiary care hospital instituted a protocol utilizing community members of the ethics committee to meet with the medical providers and engage in shared decision-making for patients without proxies. We conducted a retrospective (...) chart review and in this paper describe nearly 200 patients who were identified and treated according to the protocol over a 12 year period. After an aggressive search, family members were located for a surprising number of patients, leaving 80 patients who needed decisions to be made utilizing the PWP committee. We review the decisions required, the results of the shared decision-making meetings, and the patient outcomes. Our experience has shown that a protocol involving community volunteers to make decisions for PWPs in a timely manner is feasible and ethically defensible. The protocol has been accepted by physicians and utilized with increasing frequency. Because it was possible to gather at least minimal information on most patients, a standard of “informed best interest” was used to make decisions. PWP committee recommendations varied, but in all cases agreement was reached with the attending physicians. (shrink)

Standardizing consultation processes is increasingly important as clinical ethics consultation becomes more utilized in and vital to medical practice. Solid organ transplant represents a relatively nascent field replete with complex ethical issues that, while explored, have not been systematically classified. In this paper, we offer a proposed taxonomy that divides issues of resource allocation from viable solutions to the issue of organ shortage in transplant and then further distinguishes between policy and bedside level issues. We then identify all transplant related (...) ethics consults performed at the Cleveland Clinic between 2008 and 2013 in order to identify how consultants conceptually framed their consultations by the domains they ascribe to the case. We code the CC domains to those in the Core Competencies for Healthcare Consultation Ethics in order to initiate a broader conversation regarding best practices in these highly complex cases. A discussion of the ethical issues underlying living donor and recipient related consults ensues. Finally, we suggest that the ethical domains prescribed in the Core Competencies provide a strong starting ground for a common intra-disciplinary language in the realm of formal CEC. (shrink)

Returning genomic research results to family members raises complex questions. Genomic research on life-limiting conditions such as cancer, and research involving storage and reanalysis of data and specimens long into the future, makes these questions pressing. This author group, funded by an NIH grant, published consensus recommendations presenting a framework. This follow-up paper offers concrete guidance and tools for implementation. The group collected and analyzed relevant documents and guidance, including tools from the Clinical Sequencing Exploratory Research Consortium. The authors then (...) negotiated a consensus toolkit of processes and documents. That toolkit offers sample consent and notification documents plus decision flow-charts to address return of results to family of living and deceased participants, in adult and pediatric research. Core concerns are eliciting participant preferences on sharing results with family and on choice of a representative to make decisions about sharing after participant death. (shrink)

What makes teaching a moral endeavor? How can we prepare classroom practitioners for engaging in that moral endeavor in meaningful and effective ways? This volume brings together leading scholars who draw upon both their academic expertise and substantial wisdom of practice to offer a variety of perspectives on the challenge of preparing today’s teachers for the moral work of teaching. Book Features: Examines the role that teacher preparation and development can play in addressing the moral work of teaching. Highlights the (...) work of leading scholars from educational psychology, educational philosophy, and teacher education. Provides compelling insights for identifying the next generation of our nation’s best teachers. Contributors: Wolfgang Althof, Karen Benson, Marvin Berkowitz, Donald Blumenfeld-Jones, Elizabeth Campbell, Julie Canniff, Mary Crawford, Lana Daly, Rebecca Evers, Catherine Fallona, Gary Fenstermacher, Anthony Holter, Lisa Johnson, Daniel Lapsley, Darcia Narvaez, Virginia Navarro, Larry Nucci, Joy Pelton, Virginia Richardson, Don Senneville, David Light Shields, Barbara Stengel, Jonatha Vare, Marilyn Watson. (shrink)

There is a recent and growing trend in philosophy that involves deferring to the claims of certain disciplines outside of philosophy, such as mathematics, the natural sciences, and linguistics. According to this trend— deferentialism , as we will call it—certain disciplines outside of philosophy make claims that have a decisive bearing on philosophical disputes, where those claims are more epistemically justified than any philosophical considerations just because those claims are made by those disciplines. Deferentialists believe that certain longstanding philosophical problems (...) can be swiftly and decisively dispatched by appeal to disciplines other than philosophy. In this paper we will argue that such an attitude of uncritical deference to any non-philosophical discipline is badly misguided. With reference to the work of John Burgess and David Lewis, we consider deference to mathematics. We show that deference to mathematics is implausible and that main arguments for it fail. With reference to the work of Michael Blome-Tillmann, we consider deference to linguistics. We show that his arguments appealing to deference to linguistics are unsuccessful. We then show that naturalism does not entail deferentialism and that naturalistic considerations even motivate some anti-deferentialist views. Finally, we set out deferentialism’s failings and present our own anti-deferentialist approach to philosophical inquiry. (shrink)

We defend Joseph Melia's thesis that the role of mathematics in scientific theory is to 'index' quantities, and that even if mathematics is indispensable to scientific explanations of concrete phenomena, it does not explain any of those phenomena. This thesis is defended against objections by Mark Colyvan and Alan Baker.

At the beginning of your paper you identify Dewey's concept of experience with "knowing how" to do something, skilled coping (pages 5 & 6). But as you discuss Dewey's concept in relation to Gibson's affordances, connectionist nets, and Schusterman's critique, it grows to encompass emotions, goals, and the felt quality of an experience. Still there is no full statement of how Dewey conceived of experience, much less, quotes from his work to match the many quotes from Sellars' work on sensation. (...) Let me propose one from among the many he wrote. (shrink)

Chris Daly; Tropes, Proceedings of the Aristotelian Society, Volume 94, Issue 1, 1 June 1994, Pages 253–262, https://doi.org/10.1093/aristotelian/94.1.253.

This paper distinguishes revolutionary fictionalism from other forms of fictionalism and also from other philosophical views. The paper takes fictionalism about mathematical objects and fictionalism about scientific unobservables as illustrations. The paper evaluates arguments that purport to show that this form of fictionalism is incoherent on the grounds that there is no tenable distinction between believing a sentence and taking the fictionalist's distinctive attitude to that sentence. The argument that fictionalism about mathematics is ‘comically immodest’ is also evaluated. In place (...) of those arguments, an argument against fictionalism about abstract objects of any kind is presented in the last section. This argument takes the form of a trilemma against the fictionalist. (shrink)

This paper concerns an issue in the metaphysics of properties. The issue is: what are physical properties? What distinguishes physical properties from all other properties? My conclusions will be ‘downbeat’. I will argue that some major recent approaches to this issue prove unsatisfactory, and that the issue is much more intractable than has widely been supposed. The moral I draw is that there is no principled and well‐defined distinction between physical properties and all other properties, and accordingly certain programmes in (...) metaphysics should be abandoned because they mistakenly assume that there is such a distinction. (shrink)

Many contemporary philosophers rate error theories poorly. We identify the arguments these philosophers invoke, and expose their deficiencies. We thereby show that the prospects for error theory have been systematically underestimated. By undermining general arguments against all error theories, we leave it open whether any more particular arguments against particular error theories are more successful. The merits of error theories need to be settled on a case-by-case basis: there is no good general argument against error theories.

The conference did not target only the U.S. Christian right for opposing such things as stem cell research. It challenged every faith community that believes a human being is more than just one more biological product. The weekend of Aug. 7 was organized by the World Transhumanist Association. In 2005 its conference will be in Caracas, Venezuela, where this small band of transhumanists will continue to challenge all larger faith communities to review what they have to say about a "brave (...) new world" that would carry us far beyond the engineered manipulations that seemed so distant when Aldous Huxley wrote in 1932 about creating babies in test tubes. (shrink)

An Introduction to Philosophical Methods is the first book to survey the various methods that philosophers use to support their views. Rigorous yet accessible, the book introduces and illustrates the methodological considerations that are involved in current philosophical debates. Where there is controversy, the book presents the case for each side, but highlights where the key difficulties with them lie. While eminently student-friendly, the book makes an important contribution to the debate regarding the acceptability of the various philosophical methods, and (...) so it will also be of interest to more experienced philosophers. (shrink)

ABSTRACTThe central hypothesis of this paper is that the phenomenology of Merleau-Ponty offers significant philosophical groundwork for an ethics that honours key feminist commitments – embodiment, situatedness, diversity and the intrinsic sociality of subjectivity. Part I evaluates feminist criticisms of Merleau-Ponty. Part II defends the claim that Merleau-Ponty’s non-dualist ontology underwrites leading approaches in feminist ethics, notably Care Ethics and the Ethics of Vulnerability. Part III examines Merleau-Ponty’s analyses of embodied percipience, arguing that these offer a powerful critique of the (...) view from nowhere, a totalizing God’s-eye-view with pretensions to objectivity. By revealing the normative structure of perceptual gestalts in the intersubjective domain, he establishes the view from everywhere. Normativity is no longer deferred to higher authorities such as duty, utility or the valorized virtue, but through the perceptual gestalt it is returned to the perceiving embodied subject. This... (shrink)

This article investigates a series of additions made to JRL Gaster MS 2037, a newly identified copy of Peter of Poitier‘s Compendium historiae in genealogia Christi. Following a detailed description and dating of the manuscript, it investigates two sets of additions to the roll in depth. It establishes that the first motive behind the inclusion of such additions was educative – serving to extend the historic information given in the Compendium, while the second motive was devotional – elevating the status (...) of the Virgin Mary through the enhancement of her genealogical record. Given the fact that the manuscript was produced in the mid-fifteenth century, this focus on the Virgin likely had a polemic purpose, situating the manuscript in the context of debates over the Immaculate Conception, and using Alexander Nequams Expositio super Cantica canticorumto this end. In identifying the sources used, as well as the limits on the compiler imposed by the physical form of the roll, this examination of Gaster MS 2037 offers an insight into the later reception of this popular text. (shrink)

Sex- and age-specific rates of killing unrelated persons of one’s own sex were computed for Canada (1974–1983), England/Wales (1977–1986), Chicago (1965–1981), and Detroit (1972) from census information and data archives of all homicides known to police. Patterns in relation to sex and age were virtually identical among the four samples, although the rates varied enormously (from 3.7 per million citizens per annum in England/Wales to 216.3 in Detroit). Men’s marital status was related to the probability of committing a same-sex, nonrelative (...) homicide, but age effects remained conspicuous when married and unmarried men were distinguished.These findings and the treatment of age and sex effects by criminologists are discussed in the light of contemporary evolutionary psychological models of sex differences and life-span development. Same-sex homicides in which killer and victim are unrelated can be interpreted as an assay of competitive conflict. In every human society for which relevant information exists, men kill one another vastly more often than do women. Lethal interpersonal competition is especially prevalent among young men, which accords with many other aspects of life-span development in suggesting that sexual selection has maximized male competitive prowess and inclination in young adulthood. (shrink)

Offers a comprehensive view of St Augustine's political ideas.

The virtue of internalizing environmental costs so that prices reflect full social opportunity costs at the margin, reaffirmed by Terry Anderson and Donald Leal, is unarguable. Beyond that, however, Anderson and Leal's Free Market Environmentalism neglects the classic works in the intellectual tradition to which it is supposed to be a contribution; is unconvincing and inconsistent in the functions it ascribes to the ?environmental entrepreneur?; conflates problems of distribution and scale with the problem of allocation; ignores international dimensions; and misrepresents (...) the debate over ?sustainable development.? (shrink)

Rousseau’s embrace of popular sovereignty – a sovereignty that is unmediated and unrepresented – is often understood as entailing a kind of democratic absolutism. However, Richard Tuck has argued t...

© The Author 2018. Published by Oxford University Press on behalf of The Analysis Trust. All rights reserved. For permissions, please email: [email protected] article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model...This is a clear and extremely stimulating book in which the authors present a series of innovative, even unorthodox, views on the relation between language and biology. It treats the study of language, and human cognition in general, as a matter of (...) biology. More bluntly: linguistics is biology at a suitable level of abstraction.Given that it is a biological fact that human beings have language, we might expect there to be a Darwinian explanation of the evolution of language. The puzzle is that there seems to be no biological function of language that could not be fulfilled by a species lacking language. So why... (shrink)

Some philosophers deny the existence of composite material objects. Other philosophers hold that whenever there are some things, they compose something. The purpose of this paper is to scrutinize an objection to these revisionary views: the objection that nihilism and universalism are both unacceptably uncharitable because each of them implies that a great deal of what we ordinarily believe is false. Our main business is to show how nihilism and universalism can be defended against the objection. A secondary point is (...) that universalism is harder to defend than nihilism. (shrink)