Traditionally, hospital emergency readiness plans primarily addressed natural disasters, but because of preparations for year 2000, the arrival of terrorism in the United States, and the potential for mass casualties, hospitals were prompted to bring together new partners and create new emergency readiness plans. These new plans, however, give rise to a number of important issues hospitals must consider. First, hospitals must consider legal liability that might arise during an emergency. For example, what liability might arise when decision are made (...) regarding the provision of individual treatment versus mass triage? Second, hospitals must be cognizant of relevant privacy rules, such as the Health Insurance Portability and Accountability Act, as they apply to public health emergencies activities. Third, hospitals must be aware of the Emergency Medical Treatment and Active Labor Act which requires Medicarefunded hospitals to screen patients for emergency medical conditions and prohibits their transfer until they are stabilized. (shrink)

Gilles de la Tourette syndrome (TS) is a childhood neuropsychiatric disorder characterised by the presence of motor and vocal tics. Patients with malignant TS experience severe disease sequelae; risking morbidity and mortality due to tics, self-harm, psychiatric comorbidities and suicide. By definition, those cases termed ‘malignant’ are refractory to all conventional psychiatric and pharmacological regimens. In these instances, deep brain stimulation (DBS) may be efficacious. Current 2015 guidelines recommend a 6-month period absent of suicidal ideation before DBS is offered to (...) patients with TS. We therefore wondered whether it may be ethically justifiable to offer DBS to a minor with malignant TS. We begin with a discussion of non-maleficence and beneficence. New evidence suggests that suicide risk in young patients with TS has been underestimated. In turn, DBS may represent an invaluable opportunity for children with malignant TS to secure future safety, independence and fulfilment. Postponing treatment is associated with additional risks. Ultimately, we assert this unique risk-benefit calculus justifies offering DBS to paediatric patients with malignant TS. A multidisciplinary team of clinicians must determine whether DBS is in the best interest of their individual patients. We conclude with a suggestion for future TS-DBS guidelines regarding suicidal ideation. The importance of informed consent and assent is underscored. (shrink)

Primary progressive aphasia is a degenerative disease affecting language while leaving other cognitive facilities relatively unscathed. The agrammatic subtype of PPA is characterized by agrammatic language production with impaired comprehension of noncanonical filler-gap syntactic structures, such as object-relatives [e.g., The sandwich that the girl ate was tasty], in which the filler is displaced from the object position within the relative clause to a position preceding both the verb and the agent and is replaced by a gap linked with the filler. (...) One hypothesis suggests that the observed deficits of these structures reflect impaired thematic integration, including impaired prediction of the thematic role of the filler and impaired thematic integration at the gap, but spared structure building. In the current study, we examined the on-line comprehension of object-relative and subject-relative clauses in healthy controls and individuals with agrammatic and logopenic PPA using eye-tracking. Eye-movement patterns in canonical subject-relative clause structures were essentially spared in both PPA groups. In contrast, eye-movement patterns in noncanonical object-relative clauses revealed delayed thematic prediction in both agrammatic and logopenic PPA, on-time structure building in both groups, and abnormal thematic integration in agrammatic, but not logopenic, PPA. We argue that these results are consistent with the hypothesis that agrammatic comprehension deficits reflect impaired thematic integration. (shrink)

Nursing has improved over the centuries from the physician's handmaiden to a recognised profession. Yet, the image of a nurse is often associated with notions of caring and nurturing‐ attributes considered feminine. Indeed, cultural, and societal biases exist that can deter men from entering the nursing profession where their sense of masculinity is questioned. Several studies have highlighted the existence of gender‐based stereotypes, stigma, rejection, loneliness and discrimination which impact the retention of men in the nursing profession. Despite the established (...) evidence regarding negative experiences, it appears limited attention has been paid to the men who decide to stay in nursing: how do they thrive in a profession wherein biases are evident within and in the wider societal context? Undoubtedly, several factors such as job security and financial incentives may contribute to men remaining in nursing. Beyond these, we borrow the notion of ‘constructive resistance’ to underscore that though the biases may be apparent, male nurses are able to construct alternatives that accommodate the image of a man in the nursing profession. Strategies such as developing the image as a ‘super nurse’ can create opportunities for male nurses to be preferred by other healthcare providers as well as female nurses. Thus, although resistance may usually appear as a negative phenomenon, constructive resistance represents hidden advantages which offers an opportunity to retain male nurses. These need to be highlighted and explored more as they can offer deeper insight into strategies that can be employed to improve retention and representation of men in nursing particularly at a time when the impact of nursing shortage remains a global issue. (shrink)

When patients are admitted to the hospital, they are generally expected to remain in or within close proximity to their assigned rooms in order to promote their safety and appropriate medical care. Although there are circumstances when patients may safely leave their hospital room or floor, guidance within the medical literature for the management of patient movement within the hospital are lacking. Excessive restrictions on patient movement may be seen as overly paternalistic, while lax requirements may interfere with high quality (...) care, patient safety and efficient hospital practice. As a result, guidance in the form of institutional policy is warranted. Such policy development should take into consideration the potential clinical, legal, and ethical concerns in balancing the competing values of patients’ preferences and respect for autonomy, while ensuring high quality, safe, and efficacious medical care. This paper will provide a framework for hospitals to create institution-specific patient movement policies that are fair, systematic, and transparent. (shrink)

Historical demographic research shows that the factors influencing mortality risk are labile across time and space. This is particularly true for datasets that span societal transitions. Here, we seek to understand how marriage, migration, and the local economy influenced mortality dynamics in a rapidly changing environment characterized by high in-migration and male-biased sex ratios. Mortality records were extracted from a compendium of historical vital records for the Baja California peninsula (Mexico). Our sample consists of 1,201 mortality records spanning AD 1835–1900. (...) Findings from Cox proportional hazard models indicate that (1) marriage was associated with a protective effect for both sexes; (2) residing in a mining town was associated with higher mortality for men, but not women; (3) migration was associated with decreased mortality risk for women, but not men; and (4) the risk of mortality increased in the face of infectious disease, but decreased over time. Despite the early initiation of reproduction for women, marriage had a protective effect, likely because marriage linked women to resources. Although mining boomtowns were associated with elevated risk factors generally, only men experienced greater mortality risk, likely due to dangerous working conditions that women did not experience. Last, female, but not male, migrants experienced greater longevity, possibly because exposure to harsh labor conditions eroded the protective effect of selection bias for men. Together, these results shed light on an understudied historical population and broaden our understanding of demographic dynamics in preindustrial settings. (shrink)

Surgery is an increasingly common and expensive mode of medical intervention. The ethical dimensions of the surgeon-patient relationship, including respect for personal autonomy and informed consent, are much discussed; but broader equity issues have not received the same attention. This paper extends the understanding of surgical ethics by considering the nature of evidence in surgery and its relationship to a just provision of healthcare for individuals and their populations.

Chapter One The most plausible arguments for the identity of mind and body that have been advanced in this century have been for the identity of mental ...

There has never been a greater need for reliable, truthful news to help citizens navigate and assess the veracity of what they are reading and viewing, especially on social media. Widespread concerns around ‘fake’ news demonstrate an enduring requirement for curated and trustworthy children’s news that addresses children as young citizens with certain rights. Drawing on recent UK events, we discuss the case for children’s news provision by public service broadcasting from a communication rights perspective by analyzing the BBC’s 2019 (...) plans to reduce the broadcast presence and originated hours of its flagship news service, Newsround, in favor of online distribution. (shrink)

What is introspective know ledge of one’s own intentional states like? This paper aims to make plausible the view that certain cases of self-knowledge, namely the cogito-type ones, are enough like perception to count as cases of quasi-observation. To this end it considers the highly influential arguments developed by Sydney Shoemaker in his recent Royce Lectures. These present the most formidable challenge to the view that certain cases of self-knowledge are quasi-observational and so deserve detailed examination. Shoemaker’s arguments are directed (...) against two models of ordinary perception, the “object perception model” and the “broad perceptual model”. I argue that the core theses that Shoemaker associated with them are either dubious in their own right or applicable to certain cases of self-knowledge. Overall the aim is to show that there is such a variety of patterns in each case that simple analogies or disanalogies are unhelpful. (shrink)

Cynthia Willett brings together diverse insights from social psychology, classical and contemporary literature, and legal and justice theory to redefine the basis of the moral and legal person. Feminists, communitarians, and postmodern thinkers have made clear that classical liberalism, with its emphasis on individual autonomy and excessive rationalism, is severely limited. Although she is sympathetic with the liberal view, Willett finds it necessary to go further. For her, attention to the social dimensions of the family and civil society is (...) critical if issues of race, gender, class, and sexuality are to be taken seriously. Interdependency, not autonomy, is of increasing significance in an era of globalization. Willett proposes an alternate normative theory that recognizes the impact of social forces on individual well-being. Citizenship in a democracy should not be defined solely on the basis of rights to autonomy, such as bare rights to property or free speech, she explains. Rather, citizenship should be defined first of all in terms of the rights, responsibilities, and capacities of the social person. It is within the African American tradition of political thought that Willett finds a more useful definition of human identity and political freedom. The African American experience offers a compelling vision of social change and a deeper understanding of what it means to be a social person. By focusing on everyday battles against racism, Willett contends, we can gain valuable insight into the meaning of justice. (shrink)

Comedy, from social ridicule to the unruly laughter of the carnival, provides effective tools for reinforcing social patterns of domination as well as weapons for emancipation. In Irony in the Age of Empire, Cynthia Willett asks: What could embody liberation better than laughter? Why do the oppressed laugh? What vision does the comic world prescribe? For Willett, the comic trumps standard liberal accounts of freedom by drawing attention to bodies, affects, and intimate relationships, topics which are usually neglected by (...) political philosophy. Willett's philosophical reflection on comedy issues a powerful challenge to standard conceptions of freedom by proposing a new kind of freedom that is unapologetically feminist, queer, and multiracial. This book provides a wide-ranging, original, thoughtful, and expansive discussion of citizenship, social manners, and political freedom in our world today. (shrink)

A radical new approach to humor, where traditional targets become its agents Humor is often dismissed as cruel ridicule or harmless fun. But what if laughter is a vital force to channel rage against patriarchy, Islamophobia, mass incarceration? To create moments of empathy and dialogue between #Black Lives Matter and the police? These and other such questions are at the heart of this powerful reassessment of humor. Placing theorists in conversation with comedians, Uproarious offers a full-frontal approach to the very (...) foundation of comedy and its profound political impact. Here Cynthia Willett and Julie Willett address the four major theories of humor—superiority, relief, incongruity, and social play—through the lens of feminist and game-changing comics such as Wanda Sykes, Margaret Cho, Hannah Gadsby, Hari Kondabolu, and Tig Notaro. They take a radical and holistic approach to the understanding of humor, particularly of humor deployed by those from groups long relegated to the margins and propose a powerful new understanding of humor as a force that can engender politically progressive social movements. Drawing on a range of cross-disciplinary sources, from philosophies and histories of humor to the psychology and physiology of laughter to animal studies, Uproarious offers a richer understanding of the political and cathartic potential of humor. (shrink)

In this interview, Cynthia Hammond sits down with Marc Lafrance in order to discuss the 30-year sketching practice that led to her exhibition, Drawings for a Thicker Skin, in 2012. In this practice, Hammond made small, quick drawings of the clothes she would need for trips or key professional events. As she explains, the drawings were not just essential to knowing what to pack; they were essential to being able to pack. While she never conceived of the practice as (...) art, when invited to exhibit the drawings she found a way to relate this idiosyncratic and private practice to a larger set of ontological concerns. Clothing as a second skin is the key idea here, as Hammond and Lafrance explore what it means to navigate identity, idealized self-image, professional ‘passing’ and the skin ego. (shrink)

Across normative and empirical disciplines, considerable attention has been devoted to the prevalence and ethics of the non-medical use of prescription and illegal stimulants for neuroenhancement among students. A predominant assumption is that neuroenhancement is prevalent, in demand, and calls for appropriate policy action. In this paper, we present data on the prevalence, views and knowledge from a large sample of German students in three different universities and analyze the findings from a moral pragmatics perspective. The results of our study (...) indicate that neuroenhancement is a well-known phenomenon among German students, but not prevalent. 2.2 % of our sample reported having used a prescription medication for neuroenhancement. Exams and competitive situations were predominant motivators of use. Students were unenthusiastic and critical about neuroenhancement in the academic context and disapproved of neuroenhancement for professionals. The majority of respondents agreed that neuroenhancing substances should be regulated by the state. These stances were based on strong beliefs in resisting peer pressure, avoiding the creation of injustice and valuing of hard work. From a moral pragmatics standpoint, these results challenge the assumption that policy on neuroenhancement is necessary in academic environments. (shrink)

Recent research finds that people respond more generously to individual victims described in detail than to equivalent statistical victims described in general terms. We propose that this “identified victim effect” is one manifestation of a more general phenomenon: a positive influence of tangible information on generosity. In three experiments, we find evidence for an “identified intervention effect”; providing tangible details about a charity’s interventions significantly increases donations to that charity. Although previous work described sympathy as the primary mediator between tangible (...) information and giving, current mediational analyses show that the influence of tangible details can operate through donors’ perception that their contribution will have impact. Taken together with past work, the results suggest that tangible information of many types promotes generosity and can do so either via sympathy or via perceived impact. The ability of tangible information to increase impact points to new ways for charities to encourage generosity. (shrink)

_Varieties of Things: Foundations of Contemporary Metaphysics_ is about some of the most fundamental kinds of things that there are; the things that we encounter in everyday experience. A book about the things that we encounter in everyday experience. Contains a thorough and accessible discussion of the nature and aims of metaphysics. Examines a wide range of ontological categories, including both particulars and universals. Mounts a forceful and persuasive case for anti-reductionism.

Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...) of DBS and negative perceptions of clinician-scientists engaged in DBS. These concerns have real world implications for funding future innovative, DBS trials aimed to reduce suffering as well as hampering true interdisciplinary scholarship. We argue that the philosophical tradition of pragmatism and the value it places on empirical inquiry, experiential knowledge, and inter-disciplinary scholarship – reflecting diverse ways of knowing – provides a framework to start to address the important questions Gilbert and colleagues raise. In particular, we highlight the importance of expert clinician knowledge in contributing to the neuroethical questions raised by Gilbert and colleagues. Finally, we provide illustrative examples of some of our interdisciplinary empirical research that demonstrate the iterative cycle of inquiry characteristic of pragmatism in which conceptual neuroethics questions have led to empirical studies whose results then raise additional conceptual questions that give rise to new empirical studies in a way that highlights the contributions of the humanities and the sciences. (shrink)

There is substantial evidence that methylphenidate (MPH; Ritalin), is being used by healthy university students for non-medical motives such as the improvement of concentration, alertness, and academic performance. The scope and potential consequences of the non-medical use of MPH upon healthcare and society bring about many points of view.

The importance of personal connections and relationships, or guanxi when doing business with the Chinese is widely acknowledged amongst Western academics and business managers alike. However, aspects of guanxi-rehted behaviours in the workplace are often misunderstood by Westerners with some going so far as to equate guanxi with forms of corruption. This study extends earlier study of Tan and Snell: 2002, Journal of Business Ethics 41 (December), 361-384) in its investigation of the underlying modes of moral reasoning in ethical decisions (...) relating to aspects of guanxi, amongst Hong Kong managers. Managers' ethical judgements and underlying moral reasoning relating to a series of guanxi related behaviours were recorded. Content analysis yielded categories that correspond with categories of moral reasoning described in Kohlberg's (1969, Handbook of Socialization Theory and Research, Rand McNally, Chicago, pp. 347-480) model. As hypothesised, it was found that harsher ethical evaluations of guanxi-vehted behaviours were positively correlated with the stage of moral reasoning. The most common types of reasoning were those corresponding to Kohlberg's stages four and five which relate to moral reasoning based on law and order, and on reason rather than emotion. Stage 6, concerned with more universalistic approaches to moral reasoning, was utilised considerably less, consistent with popularly held beliefs of the relativistic nature of Chinese ethics. (shrink)

In ____Maternal Ethics and Other Slave Moralities__ which includes the first extended philosophical discussion of the works of Frederick Douglass, Cynthia Willett puts forward a novel theory of ethical subjectivity that is aimed to counter prevailing pathologies of sexist, racist Eurocentric culture. Weaving together accounts of the self drawn from African-American and European philosophies, psychoanalysis, slave narratives and sociology, Willett interrogates what Hegel locates as the core of the self: the desire for.

This paper contributes to the ongoing discussion of sustainability behaviors by introducing the construct of perceived organizational support toward the environment. We propose and empirically test an integrated model whereby we test the association of POS-E with employees’ organizational citizenship behaviors toward the environment as well as to job attitudes. Results indicated that POS-E was positively related to OCB-E, job satisfaction, organizational identification, and psychological empowerment, and negatively related to turnover intentions. We also found that psychological empowerment partially mediated the (...) relationship between POS-E and the dependent variables. We discuss the theoretical implications as well as practical implications for managers seeking to encourage sustainability in their organizations. (shrink)

Three global developments situate the context of this investigation: the increasing use of social media by organizations and their employees, the burgeoning presence of social media policies, and the heightened focus on corporate social responsibility. In this study the intersection of these trends is examined through a content analysis of 112 publicly available social media policies from the largest corporations in the world. The extent to which social media policies facilitate and/or constrain the communicative sensibilities and values associated with contemporary (...) notions of CSR is considered. Overall, findings indicate that a large majority of policies, regardless of sector or national headquarters, increasingly inhibit communicative tenets of contemporary CSR and thereby diminish employee negotiation and participation in the social responsibilities of corporations. Moreover, policies generally enact organizational communication practices that are contrary to international CSR guidelines. Findings suggest that social media policies represent a relatively unrecognized development in the institutionalization of CSR communicative norms and practices that call into question the promising affordances of social media for the inclusion of various voices in the public negotiation of what constitutes corporate social responsibility. (shrink)

Recently, Hosmer (1994a) proposed a model linking right, just, and fair treatment of extended stakeholders with trust and innovation in organizations. The current study tests this model by using Victor and Cullen''s (1988) ethical work climate instrument to measure the perceptions of the right, just, and fair treatment of employee stakeholders.In addition, this study extends Hosmer''s model to include the effect of right, just, and fair treatment on employee communication, also believed to be an underlying dynamic of trust.More specifically, the (...) current study used a survey of 111 managers to test (1) whether right, just, and fair treatment influences trust, both directly as well as indirectly via communication, and (2) whether trust influences perceptions of commitment and innovation. Strong support for the study''s hypotheses and Hosmer''s (1994a) model was found. Such findings support those who argue that moral management may be good management. (shrink)

Externalism in the philosophy of mind has been thought by many to pose a serious threat to the claim that subjects are in general authoritative with regard to certain of their own intentional states.¹ In a series of papers, Tyler Burge (1985_a_, 1985_b_, 1988, 1996) has argued that the distinctive entitlement or right that subjects have to self- knowledge in certain cases is compatible with externalism, since that entitlement is environmentally neutral, neutral with respect to the issue of the individuation (...) dependence of subjects' intentional states on factors beyond their bodies. His reason is that whereas externalism—the view that certain intentional states of persons are individuation-dependent on objects and/or phenomena external to their bodies—is a metaphysical thesis, authoritative self-knowledge is an epistemological matter. This being so, there is no reason to suppose that the two need conflict with one another. (shrink)

Massively parallel sequencing, also known as next‐generation sequencing, has the potential to significantly improve newborn screening programs in the United States and around the world. Compared to genetic tests whose use is well established, sequencing allows for the analysis of large amounts of DNA, providing more comprehensive and rapid results at a lower cost. It is already being used in limited ways by some public health newborn screening laboratories in the United States and other countries—and it is under study for (...) broader and more widespread use, including as a core part of newborn screening programs. Sequencing technology has the potential to significantly improve these essential public health programs. For many of the conditions that newborns are already screened for, sequencing can return more specific and more sensitive results. The technology could also enable newborn screening programs to expand the list of rare pediatric conditions that they look for, thereby identifying more infants who can benefit from immediate care. (shrink)

Although nanotechnology is often defined as operations on the 10-9 meters, the lack of charisma in the scale-bound definitions has been fortified by remarkable dreams and alluring promises that spark excitement for nanotechnology. The story of the rhetorical development of nanotechnology reveals how speculative claims are powerful constructions that create legitimacy in this emerging technological domain. From its inception, nanotechnology has been more of a dream than reality, more fiction than fact. In recent years, however, the term nanotechnology has been (...) actively drawn toward the present to begin to deliver on the fantastic expectations. This debate over time and timing is loaded with paradox. This work examines how future claims work to define what counts as nanotechnology and reveals dilemmas that accompany temporal disjunctures. Science and politics converge in debates about the future of technology as expectations serve to create and enforce power and legitimacy in the emerging area. (shrink)

Volume 20, Issue 3, March 2020, Page 46-50.

The literature of Adrienne Rich, Toni Morrison, Ana Castillo, and Chimamanda Adichie teaches a risky, self-giving way of reading that brings home the dangers and the possibilities of suffering as an ethical good. Working the thought of feminist theologians and philosophers into an analysis of these women's writings, Cynthia R. Wallace crafts a literary ethics attentive to the paradoxes of critique and re-vision, universality and particularity, reading in suffering a redemptive or redeemable reality.

This paper explores the meaning of interpretation in the works of Hans-Georg Gadamer and Glenn Gould, the Canadian pianist and intellectual. As a performing art, music illustrates the cognitive and practical dimensions of interpretation. While emphasizing the pre-interpreted character of musical reception and performance, both authors point to the fact that difference, alterity, and negativity lie at the heart of creative interpretation, cultivation and self-knowledge. The notion of ecstasy, understood as a type of self-forgetfulness that represents a radical form of (...) encounter with alterity, provides the basis for a conception of subjectivity as grounded on linguistic, historical and cultural conditions, albeit not reducible to them. I maintain that the notion of ecstatic subjects is a powerful alternative to both the self-centred notion of subjectivity and its anti-humanistic counterpart in accounting for human agency. (shrink)