In this engagingly written book, Colin McGinn advances a number of related theses, most prominent among them, that moral philosophy is in need of new methodologies in order to get at neglected questions about moral character. The methodology McGinn urges involves drawing upon literature for its deep and intricate portrayals of ethical themes. This would seem a natural approach given McGinn’s substantive views about ethics. He contends that our ethical knowledge is aesthetically mediated ; he speculates that the “innateness” of (...) ethics may be “a by-product of our innate grasp of folk psychology” which comes into play when we interpret literature; and he defends an “aesthetic theory of virtue” according to which virtue coincides with beauty of soul. (shrink)

The effects of psycholinguistic variables on reading development are critical to the evaluation of theories about the reading system. Although we know that the development of reading depends on both individual differences (endogenous) and item-level effects (exogenous), developmental research has focused mostly on average-level performance, ignoring individual differences. We investigated how the development of word recognition in Chinese children in both Chinese and English is affected by (a) item-level, exogenous effects (word frequency, radical consistency, and curricular grade level); (b) subject-level, (...) endogenous individual differences (orthographic awareness and phonological awareness); and (c) their interactive effect. We tested native Chinese (Putonghua)-speaking children (n = 763) in grades 1 to 6 with both Chinese character and English word identification (lexical) decision tasks. Our findings show that (a) there were effects of both word frequency and age of acquisition in both Chinese and English, but these item-level effects generally weakened with increasing age; (b) individual differences in phonological and orthographic awareness each contributed to successful performance; and (c) in Chinese, item-level effects were weaker for more proficient readers. We contend that our findings can be explained by theoretical models that incorporate cumulative learning as the basis for development of item-level effects in the reading system. (shrink)

Connie Wang ABSTRACT: Accounts of deep disagreements can generally be categorized as optimistic or pessimistic. Pessimistic interpretations insist that the depth of deep disagreements precludes the possibility of rational resolution altogether, while optimistic variations maintain the contrary. Despite both approaches’ respective positions, they nevertheless often, either explicitly or implicitly, agree on the underlying assumption that...

Importance Informed consent is essential to ethical, rigorous research and is important to recruitment and retention in cancer trials.Objective To examine cancer clinical trial (CCT) participants’ perceptions of informed consent processes and variations in perceptions by cancer type.Design and Setting and Participants Cross-sectional survey from mixed-methods study at National Cancer Institute–designated Northeast comprehensive cancer center. Open-ended and forced-choice items addressed: (1) enrollment and informed consent experiences and (2) decision-making processes, including risk-benefit assessment. Eligibility: CCT participant with gastro-intestinal or genitourinary, hematologic-lymphatic (...) malignancies, lung cancer, and breast or gynecological cancer (N = 334).Main Outcome Measures Percentages satisfied with consent process and information provided; and assessing participation’s perceptions of risks/benefits. Multivariable logistic or ordinal regression examined differences by cancer type.Results Most patient-participants felt well informed by the consent process (more than 90% overall and by cancer type) and. most (87.4%) reported that the consent form provided all the information they wanted, although nearly half (44.8%) reported that they read the form somewhat carefully or less. More than half (57.9%) said that talking to research staff (i.e., the consent process) had a greater impact on participation decisions than reading the consent form (2.1%). A third (31.1%) were very sure of joining in research studies before the informed consent process (almost half of lung cancer patients did—47.1%). Most patients personally assessed the risks and benefits before consenting. However, trust in physicians played an important role in the decision to enroll in CCT.Conclusions and Relevance Cancer patients rely less on written features of the informed consent process than on information obtained from the research staff and their own physicians. Research should focus on information and communication strategies that support informed consent from referring physicians, researchers, and others to improve patient risk-benefit assessment and decision-making. (shrink)

The idea that normativity and agency are importantly connected goes back at least as far as Kant. But it has recently become associated with a view called “constitutivism.” Perhaps the best-known critique of constitutivism appears in David Enoch’s article, “Agency, Shmagency,” which is the focus of this chapter. His critique of my article, “Agency and the Open Question Argument,” is briefly addressed, explaining why, contrary to his claims, I do not therein defend a form of constitutivism. It is then explained (...) why his “shmagency challenge” does not effectively expose the real challenge faced by those who might wish to develop constitutivist theories. Finally, the chapter considers why we should take seriously the idea that normativity and agency are importantly connected, an idea that neither Enoch’s challenge nor the challenge articulated for constitutivism here does anything to defeat. Enoch has not shown that normativity won’t come from what is constitutive of agency. (shrink)

Proponents of numerous recent theories of a person's good hold that a plausible account of the good for a person must satisfy existence internalism. Yet little direct defense has been given for this position. I argue that the principal intuition behind internalism supports a stronger version of the thesis than it might appear--one that effects a "double link" to motivation. I then identify and develop the main arguments that have been or might be given in support of internalism about a (...) person's good, showing how these arguments support this stronger version of internalism. (shrink)

Istarted my nursing career as a pediatric nurse working with children and their families at the Children's Hospital National Medical Center in Washington, DC. My first position was a staff nurse on a busy surgical floor called 4 Blue. To some degree, and as I reflect on that time, one is never truly prepared as a newly minted nurse or physician for the realities of becoming a clinician. So it was for me. I initially worked a rotational schedule of two (...) weeks of days and two weeks of nights where textbook pediatric cases became everyday experiences. Caring for the most complex of childhood illnesses included patients with osteosarcoma, Wilms tumor, neuroblastoma, short gut syndrome, biliary... (shrink)

Volume 20, Issue 6, June 2020, Page 68-70.

In our everyday lives, we confront a host of moral issues. Once we have deliberated and formed judgments about what is right or wrong, good or bad, these judgments tend to have a marked hold on us. Although in the end, we do not always behave as we think we ought, our moral judgments typically motivate us, at least to some degree, to act in accordance with them. When philosophers talk about moral motivation, this is the basic phenomenon they seek (...) to understand. Moral motivation is an instance of a more general phenomenon—what we might call normative motivation—for our other normative judgments also typically have some motivating force. When we make the normative judgment that something is good for us, or that we have a reason to act in a particular way, or that a specific course of action is the rational course, we also tend to be moved. Many philosophers have regarded the motivating force of normative judgments as the key feature that marks them as normative, thereby distinguishing them from the many other judgments we make. In contrast to our normative judgments, our mathematical and empirical judgments, for example, seem to have no intrinsic connection to motivation and action. The belief that an antibiotic will cure a specific infection may move an individual to take the antibiotic, if she also believes that she has the infection, and if she either desires to be cured or judges that she ought to treat the infection for her own good. All on its own, however, an empirical belief like this one appears to carry with it no particular motivational impact; a person can judge that an antibiotic will most effectively cure a specific infection without being moved one way or another. (shrink)

This article is a comparative study between predictive processing (PP, or predictive coding) and cognitive dissonance (CD) theory. The theory of CD, one of the most influential and extensively studied theories in social psychology, is shown to be highly compatible with recent developments in PP. This is particularly evident in the notion that both theories deal with strategies to reduce perceived error signals. However, reasons exist to update the theory of CD to one of “predictive dissonance.” First, the hierarchical PP (...) framework can be helpful in understanding varying nested levels of CD. If dissonance arises from a cascade of downstream and lateral predictions and consequent prediction errors, dissonance can exist at a multitude of scales, all the way up from sensory perception to higher order cognitions. This helps understand the previously problematic dichotomy between “dissonant cognitive relations” and “dissonant psychological states,” which are part of the same perception-action process while still hierarchically distinct. Second, since PP is action-oriented, it can be read to support recent action-based models of CD. Third, PP can potentially help us understand the recently speculated evolutionary origins of CD. Here, the argument is that responses to CD can instill meta-learning which serves to prevent the overfitting of generative models to ephemeral local conditions. This can increase action-oriented ecological rationality and enhanced capabilities to interact with a rich landscape of affordances. The downside is that in today’s world where social institutions such as science a priori separate noise from signal, some reactions to predictive dissonance might propagate ecologically unsound (underfitted, confirmation-biased) mental models such as climate denialism. (shrink)

To combat the ecological crisis, fundamental change is required in how humans perceive nature. This paper proposes that the human-nature bifurcation, a metaphysical mental model that is deeply entrenched and may be environmentally unsound, stems from embodied and tacitly-held substance-biased belief systems. Process philosophy can aid us, among other things, in providing an alternative framework for reinterpreting this bifurcation by drawing an ontological bridge between humans and nature, thus providing a coherent philosophical basis for sustainable dwelling and policy-making. Michael Polanyi's (...) epistemology can further help us understand these environmentally-oriented tacit processes of knowing, and also provide a basis for the political and educational implementation of process-philosophical insights, particularly via the nudging of mental models. (shrink)

Background The COVID-19 pandemic continues to disrupt every society as SARs-CoV-2 variants surge among the populations. Health care providers are exhausted, becoming ill themselves, and in some instances have died. Indeed, hospitals are struggling to find staff to care for critically ill patients most in need. Previous work has reported on the unending work-related conditions that hospital staff are laboring under and their subsequent mental and physical health strains. Health care providers need support, but it is not clear where that (...) support is to come from. While much research has reported on the COVID-19-related fears of nurses and physicians, fewer studies have focused on supportive features of the hospital work environment and how it may provide relief to front-line health care providers.Purpose This purpose of this study was to explore an often-overlooked resource within hospital systems across the United States—clinical ethicists—and examine their many roles during COVID-19 and the types of ethical issues they addressed with nurses, physicians, administrators, and others.Methods This was a primary analysis of semi-structured, qualitative interviews with 23 clinical ethicists across the United States. The interviews were conducted from November 2020–April 2021 and were audiotaped, transcribed verbatim, and de-identified; both inductive and deductive analyses were used to identify qualitative themes.Results Five major themes were identified: ethical issues that were increasingly more complex, moral distress that was “endemic,” shifting ethical paradigms from the focus on the individual to the population, fostering a supportive environment, and organizational ethics: variation in the value, roles, and policy input of clinical ethicists.Conclusions Our findings report on the integral and expanded role of clinical ethicists at an unprecedented time in our nation, and how they stepped forward to support front-line clinicians in hospitals across the country. (shrink)

Human behavior is an underlying cause for many of the ecological crises faced in the 21st century, and there is no escaping from the fact that widespread behavior change is necessary for socio-ecological systems to take a sustainable turn. Whilst making people and communities behave sustainably is a fundamental objective for environmental policy, behavior change interventions and policies are often implemented from a very limited non-systemic perspective. Environmental policy-makers and psychologists alike often reduce cognition ‘to the brain,’ focusing only to (...) a minor extent on how everyday environments systemically afford pro-environmental behavior. Symptomatic of this are the widely prevalent attitude–action, value–action or knowledge–action gaps, understood in this paper as the gulfs lying between sustainable thinking and behavior due to lack of affordances. I suggest that by adopting a theory of affordances as a guiding heuristic, environmental policy-makers are better equipped to promote policies that translate sustainable thinking into sustainable behavior, often self-reinforcingly, and have better conceptual tools to nudge our socio–ecological system toward a sustainable turn. Affordance theory, which studies the relations between abilities to perceive and act and environmental features, is shown to provide a systemic framework for analyzing environmental policies and the ecology of human behavior. This facilitates the location and activation of leverage points for systemic policy interventions, which can help socio–ecological systems to learn to adapt to more sustainable habits. Affordance theory is presented to be applicable and pertinent to technically all nested levels of socio–ecological systems from the studies of sustainable objects and households to sustainable urban environments, making it an immensely versatile conceptual policy tool. Finally, affordance theory is also discussed from a participatory perspective. Increasing the fit between local thinking and external behavior possibilities entails a deep understanding of tacit and explicit attitudes, values, knowledge as well as physical and social environments, best gained via inclusive and polycentric policy approaches. (shrink)

Successful marketing efforts and professional sales encounters often depend on consumer involvement in the purchase decision process itself, which in turn may impact firm performance. Despite the importance of consumer involvement, research has yet to fully explain the relationship between consumer personality characteristics and the nature of consumer purchase involvement. This study explores the degree to which consumer perception of salesperson ethical treatment helps explain the relationship between consumer personality characteristics and nature of involvement. Data were collected from a large (...) sample of working adults placed in two scenario-based positive professional sales encounters featuring an important purchase decision. The results indicated that adult consumers’ personality characteristics functioned through judgment of salesperson ethical treatment to affect the nature of purchase involvement. Specifically, consumer judgment of salesperson ethical treatment fully mediated a positive relationship between internal locus of control and cognitive involvement. By comparison, consumer judgment of a salesperson ethical treatment partially mediated the positive relationship between emotional awareness and cognitive involvement. The above findings were similar for informational and relational salesperson customer-orientated scenarios. Key implications for selling professionals and sales organizations are discussed, such as augmenting consumers’ self-assessments to increase their perceptions of salesperson ethics and purchase involvement. The limitations and recommendations for future research are also presented. (shrink)

The goal of the current study is to investigate the effects of the distractive textual information on the activation of predictive inference online, and how the readers with high or low working memory capacity differ in their online activation and text memory. To test the two hypothesis of attentional competition and semantic integration, we conducted three experiments to investigate whether a local prediction and a global prediction, both of which could be derived from the description of a critical event, are (...) generated in the mind of the reader, and how this generation process is influenced by contextual and cognitive factors of the reader. The results of Experiment 1 and 2 suggest that the elaboration of the global aspects in the narrative reduces the local prediction, but makes the global prediction more salient to occur. The evidence from Experiment 3 confirms the hypothesis that even automatic processes are constrained by distant contextual factors, in combination with differences in working memory, and examines how referentially local and global predictions are intertwined in text comprehension. Overall, these data support the immediate integration hypothesis across sentence boundaries at different representation levels, as well as interaction assumptions of different processing levels within referentially local and referentially global processing contexts. (shrink)

This paper explores the role of measurement as a cognitive technology across human history, emphasizing the coexistence of formal and informal measurement systems. While standardized systems dominate contemporary culture and are well documented across large-scale societies of the past, this manuscript highlights the less explored domain of informal measurement practices that have been integral to daily life from the past to the present. Through the examination of body-based measurement systems and proportional heuristics, we demonstrate how these informal strategies were not (...) merely precursors to formal standards but essential adaptive tools for solving everyday problems. Often, these informal solutions come with practical advantages. This manuscript calls for a broader recognition of their significance in cultural and technological evolution. (shrink)

Introduces tolerance through examples of everyday situations where this character trait can be used"--Provided by publisher.

In this illustrated choose-your-own-ending book, Margo must choose between cleaning her room or putting it off to do something fun. Readers make choices for Margo and read what happens next, with each story path leading to different consequences. Includes four different endings and discussion questions.

We review three possible theoretical mechanisms for the placebo effect: conditioning, expectancy and endogenous opiates and consider the implications of the first two for clinical research and practice in the area of pain management. Methodological issues in the use of placebos as controls are discussed and include subtractive versus additive expectancy effects, no treatment controls, active placebo controls, the balanced placebo design, between- versus within-group designs, triple blind methodology and the double expectancy design. Therapeutically, the possibility of shaping negative placebo (...) responses through placebo sag, overservicing and the use of placebos on their own are explored. Suggestions for using conditioned placebos strategically in conjunction with nonplacebos are made and ways of maximizing the placebo component of nonplacebo treatments are examined. Finally, the importance of investigating the placebo effect in its own right is advocated in order to better understand the long-neglected psychological aspects of the therapeutic transaction. (shrink)

There has been neglect of systematic conceptual development and empirical investigation within consumer ethics. Scenarios have been a long-standing tool yet their development has been haphazard with little theory guiding their development. This research answers four questions relative to this gap: Do different scenario decision frames encourage different moral reasoning styles? Does the way in which framing effects are measured make a difference in the measurement of the relationship between moral reasoning and judgment by gender? Are true framing effects likely (...) to vary with the situation? and Are true framing effects likely to vary by gender? The conclusions reached were that (1) different scenario frames encourage both types of reasoning, but rule based moral reasoning is dominant regardless of frame, (2) accounting for formal equivalency in the measurement of true framing effects is likely to enhance the interpretation of studies in moral reasoning and judgment, (3) True framing effects are more likely to occur in situations with low to moderate perceived ethicality, and (4) true framing effects are not likely to vary by gender. Explanations as to why these results occurred are discussed. (shrink)

This essay explores the nature of narrative representations of individual lives and the connection between these narratives and personal good. It poses the challenge of determining how thinking of our lives in story form contributes distinctively to our good in a way not reducible to other value-conferring features of our lives. Because we can meaningfully talk about our lives going well for us at particular moments even if they fail to go well overall or over time, the essay maintains that (...) our good must consist in something more than an accumulation of good discrete moments. Since persons have the capacities to reason, remember, and imagine, our good depends on a larger view of our lives that integrates its particular moments in a narrative. That narrative provides shape and texture to our lives. Storytelling serves to connect the events of our lives to each other, and to explain why the meaning and value of past events or features of our lives can shift as the life, and hence the story of the life, continues to unfold. The essay concludes that narrative enables us to see our lives in ways that support, encourage, or promote our self-concept and self-worth as agents who have controlling authority over our own lives. (shrink)

Background The field of nursing has long been concerned with ethical issues. The history of the nursing profession has a rich legacy of attention to social justice and to societal questions regarding issues of fairness, access, equity, and equality. Some nurses have found that their clinical experiences spur an interest in ethical patient care, and many are now nurse bioethicists, having pursued additional training in bioethics and related fields (e.g., psychology, sociology). Purpose The authors describe how the clinical and research (...) experiences of nurses give them a unique voice in the field of bioethics. Results Authors present reasons for the relative invisibility of nurse bioethicists, compared with physician, theologian, or philosopher bioethicists, as well as current efforts to increase the visibility of nurse bioethicists. They also describe four specific areas where nurse bioethicists have made and continue to make important contributions: as ethics consultants to colleagues in hospitals and other settings; as bioethics researchers or as advisers to researchers conducting trials with human subjects; as educators of trainees, patients and families, healthcare providers, and the public; and in helping to draft humane and ethical policies for the care of vulnerable patients and underserved populations. Conclusion Nurse bioethicists are central to the future goals of healthcare bringing a unique perspective to the day-to-day ethical challenges of both clinical care and research, as well as to the education of health professionals and the public. (shrink)

On elective students may not always be clear about safeguarding themselves and others. It is important that placements are safe, and ethically grounded. A concern for medical schools is equipping their students for exposure to and response to uncomfortable and/or unfamiliar requests in locations away from home, where their comfort and safety, or that of the patient, may be compromised. This can require legal, ethical, and/or moral reasoning on the part of the student. The goal of this article is to (...) establish what students actually encounter on elective, to inform better preparing students for safe and ethical medical placements. We discuss the implications of our findings, which are arguably applicable to other areas of graduate training, e.g. first medical roles post-qualification. An anonymised survey exploring clinical and ethical dilemmas on elective was issued across 3 years of returning final year elective medical students. Questions included the prevalence and type of potentially unsafe scenarios encountered, barriers to saying ‘no’ in unsafe situations, perceived differences between resource poor and developed world settings and the degree to which students refused or consented to participation in events outside of the ‘norms’ of their own training experience. Three hundred seventy-nine students participated. 45% were asked to do something “not permissible” at home. 27% were asked to do something they felt “uncomfortable” with, often an invasive clinical task. Half asked to do something not usually permissible were “comfortable”. 48% felt it more acceptable to bypass guidelines in developing settings. 27% refused an offer outside their experience. Of interest are reasons for “going along with” uncomfortable invitations, e.g. “emergency”, self-belief in ‘capability’ and being ‘more qualified’ than host-personnel. This “best pair of hands available” merits scrutiny. Adverse scenarios were not exclusive to developing settings. We discuss preparing students for decision-making in new contexts, and address whether ‘home’ processes are too inflexible to prepare students for ‘real’ medical life? Ethical decision-making and communicating reluctance should be included in elective preparation. (shrink)

Signed utterances are densely packed with pointing signs, reaching a frequency of one in six signs in spontaneous conversations . These pointing signs attain a wide range of functions and are formally highly diversified. Based on corpus analysis of spontaneous pointing signs in Kata Kolok, a rural signing variety of Bali, this paper argues that the full meaning potentials of pointing signs come about through the integration of a varied set of linguistic and extralinguistic cues. Taking this hybrid nature of (...) pointing phenomena into account, it is argued that pointing signs may become an intrinsic aspect of sign language grammars through two mechanisms: morphemization and syntactic integration. Although not entailed in this research, this approach could implicate that some highly systematized pointing systems of speaking communities may to a degree be grammatical as well. (shrink)

It is no secret that there are problems within hospitals and other healthcare settings across the United States that have been simmering for some time. With the emergence of the deadly SARs-CoV-2 v...

Moral distress is indeed distressing for those who experience it and whose sense of integrity can be shaken by exposure to events or situations that test their core values and ethical belief system...

Public “upstream engagement” and other approaches to the social control of technology are currently receiving international attention in policy discourses around emerging technologies such as nanotechnology. To the extent that such approaches hold implications for research and development (R&D) activities, the distinct participation of scientists and engineers is required. The capacity of technoscientists to broaden the influences on R&D activities, however, implies that they conduct R&D differently. This article discusses the possibility for more reflexive participation by scientists and engineers in (...) the internal governance of technology development. It reviews various historical attempts to govern technoscience and introduces the concept of midstream modulation, through which scientists and engineers, ideally in concert with others, bring societal considerations to bear on their work. (shrink)

We examined participants' reading and recall of informed consent documents presented via paper or computer. Within each presentation medium, we presented the document as a continuous or paginated document to simulate common computer and paper presentation formats. Participants took slightly longer to read paginated and computer informed consent documents and recalled slightly more information from the paginated documents. We concluded that obtaining informed consent online is not substantially different than obtaining it via paper presentation. We also provide suggestions for improving (...) informed consent-in both face-to-face and online experiments. (shrink)

Dialogical egalitarianism is the thesis that any proposition asserted in dialogue, if questioned, must be supported or else retracted. Dialogical foundationalism is the thesis that some propositions are privileged over this burden of proof, standing in no need of support unless and until support for their negation is provided. I first discuss existing arguments for either thesis, dismissing each one of them. Absent a successful principled argument, I then examine which thesis it is pragmatically more advantageous to adopt in analytic (...) philosophical dialogue. This requires identifying the goal of such dialogue, to the attainment of which the thesis would be so advantageous. To identify this goal, I draw on Douglas Walton’s typology of dialogues for an analysis of the types of dialogue of 110 representatively selected journal articles in current analytic philosophy. 95% of articles are found to instantiate persuasion dialogue. In light of the thus prevalent goal of persuading one’s opponent, I argue that the adoption of dialogical egalitarianism in analytic philosophical dialogue is pragmatically inescapable. (shrink)