Background Physicians face competing values of truth-telling and beneficence when deception may be employed in patient care. The purposes of this study were to assess resident physicians' attitudes towards lying, explore lie types and reported reasons for lying. Method After obtaining institutional review board review and receiving exempt status, posts written by Loma Linda University resident physicians in response to forum questions in required online courses were collected from 2002 to 2007. Responses were blinded and manually coded by two investigators (...) using NVivo software. Qualitative and quantitative analyses of the data were performed with links to various attributes. A 95% binomial proportion CI was used to analyse the attribute data. Results The study found that the majority of residents would disclose the truth about medical errors. Similarly, many residents would disclose the truth regarding unanticipated events, especially if the error was serious enough to result in a malpractice suit. However, many residents would not reveal a near miss event because they believe it has no impact on patient health. Some residents would deceive the insurance company for additional patient benefits. Of those willing to lie, only a small group gave self-serving reasons. Conclusions This study demonstrates that the ethical issues related to deception that trouble attending physicians also exist at the resident physician level. Residents primarily lie for altruistic reasons and rarely for egoistic or self-serving purposes that may or may not result in harm to patients, insurance companies and/or physicians themselves. (shrink)

The RWJF public health law faculty fellowship provided an opportunity for legal and public health scholars to come together to develop innovative approaches for teaching public health law in schools of law, public health, medicine, and social work nationally. The fellowship program emphasized the importance of integrating individual change with organizational change as twin pillars of the core competencies necessary for advancing public health law education. This article describes the curriculum and learning formats used throughout the fellowship to guide the (...) fellows' development in the areas of leading change, managing conflict, building collaborative partnerships, and maintaining personal resilience. (shrink)

In Why Some Things Should Not Be for Sale, philosopher Debra Satz takes a penetrating look at those commodity exchanges that strike most of us as problematic. What considerations, she asks, ought to guide the debates about such markets? What is it about a market involving prostitution or the sale of kidneys that makes it morally objectionable? How is a market in weapons or pollution different than a market in soybeans or automobiles? Are laws and social policies banning the (...) more noxious markets necessarily the best responses to them? Satz contends that categories previously used by philosophers and economists are of limited utility in addressing such questions because they have assumed markets to be homogenous. Accordingly, she offers a broader and more nuanced view of markets--one that goes beyond the usual discussions of efficiency and distributional equality--to show how markets shape our culture, foster or thwart human development, and create and support structures of power. (shrink)

Little is known about the consequences of moral distress. The purpose of this study was to identify clinical situations that caused nurses to experience moral distress, to understand the consequences of those situations, and to determine whether nurses would change their practice based on their experiences. The investigation used a descriptive approach. Open-ended surveys were distributed to a convenience sample of 204 critical care nurses employed at a university medical center. The analysis of participants’ responses used an inductive approach and (...) a thematic analysis. Each line of the data was reviewed and coded, and the codes were collapsed into themes. Methodological rigor was established. Forty-nine nurses responded to the survey. The majority of nurses had experienced moral distress, and the majority of situations that caused nurses to experience moral distress were related to end of life. The nurses described negative consequences for themselves, patients, and families. (shrink)

Challenges Beauvoir's self-portrait and argues that she was a philosopher in her own right.

This chapter contains sections titled: Meletus' Summons and the Political Background The Theaetetus: Trial and Death in Prospect The Euthyphro and Piety The Preliminary Hearing The Pretrial Examination The Trial and Socrates' Defense: The Apology The Crito and Socrates' Refusal to Escape The Execution of Socrates in the Phaedo.

The People of Plato is the first study since 1823 devoted exclusively to the identification of, and relationships among, the individuals represented in the complete Platonic corpus. It provides details of their lives, and it enables one to consider the persons of Plato's works, and those of other Socratics, within a nexus of important political, social, and familial relationships. Debra Nails makes a broad spectrum of scholarship accessible to the non-specialist. She distinguishes what can be stated confidently from what (...) remains controversial and--with full references to ancient and contemporary sources--advances our knowledge of the men and women of the Socratic milieu. Bringing the results of modern epigraphical and papyrological research to bear on long-standing questions, The People of Plato is a fascinating resource and valuable research tool for the field of ancient Greek philosophy and for literary, political, and historical studies more generally. In discrete sections, Nails discusses systems of Athenian affiliation, significant historical episodes that link lives and careers of the late fifth century, and their implications for the dramatic dates of the dialogues. The volume includes a rich array of maps, stemmata, and diagrams, plus a glossary, chronology, plan of the agora in 399 B.C.E., bibliography, and indices. (shrink)

This paper points to a lost and ignored strand of argument in the writings of liberalism's earliest defenders. These “classical” liberals recognized that market liberty was not always compatible with individual liberty. In particular, they argued that labor markets required intervention and regulation if workers were not to be wholly subjugated to the power of their employers. Functioning capitalist labor markets (along with functioning credit markets) are not “natural” outgrowths of exchange, but achievements hard won in the battle against feudalism. (...) Further, and crucially, the existence of such markets required closing off other market choices. Footnotesa I would like to thank the other contributors to this volume, and its editors, for their helpful comments on an earlier draft of this essay. (shrink)

This book brings together some of the best minds in neurology and philosophy to discuss the concept of personal identity and the moral dimensions of treating ...

Congdon (2017), Giladi (2018), and McConkey (2004) challenge feminist epistemologists and recognition theorists to come together to analyze epistemic injustice. I take up this challenge by highlighting the failure of recognition in cases of testimonial and hermeneutical injustice experienced by victims of sexual harassment and sexual assault. I offer the #MeToo movement as a case study to demonstrate how the process of mutual recognition makes visible and helps overcome the epistemic injustice suffered by victims of sexual harassment and sexual assault. (...) I argue that in declaring “me too,” the epistemic subject emerges in the context of a polyphonic symphony of victims claiming their status as agents who are able to make sense of their own social experiences and able to convey their knowledge to others. (shrink)

Having a self is associated with important advantages for an organism.These advantages have been suggested to include mechanisms supporting elaborate capacities for planning, decision-making, and behavioral control. Acknowledging such functionality offers possibilities for obtaining traction on investigation of neural correlates of selfhood. A method that has potential for investigating some of the brain-based properties of self arising in behavioral contexts varying in requirements for such behavioral guidance and control is functional brain imaging. Data obtained with this method are beginning to (...) converge on a set of brain areas that appear to play a significant role in permitting conscious access to representational content having reference to self as an embodied and independent experiencer and agent. These areas have been identified in a variety of imaging contexts ranging from passive state conditions in which they appear to manifest ongoing activity associated with spontaneous and typically ‘self-related’ cognition, to tasks targeting explicitly experienced properties of self, to demanding task conditions where activity within them is attenuated in apparent redirection of cognitive resources in the service of task guidance and control. In this paper, these data will be reviewed and a hypothesis presented regarding a significant role for these areas in enabling degrees of self-awareness and participating in the management of such behavioral control. (shrink)

Although consumers and physicians alike have long described the goal of aesthetic surgery as the production of an “improved” but still “natural-looking” body, interviews with women who had cosmetic surgery between 1990 and 2007 suggest that the “artificial” is becoming increasingly prevalent within consumers’ narratives of breast enlargement. This article explores that change in relation to processes of conspicuous consumption, the growing cultural emphasis on continual self-transformation, and the increasing normalization of cosmetic modification. Following Fraser, it treats consumers’ accounts not (...) as the reflection of “reality” or a “true self” but instead as indicators of the kinds of options, expressions, assumptions, and perspectives that are available for use in communication about cosmetic surgery. The analysis also draws on feminist writings about the social construction of “breastedness” in femininity. In so doing, it seeks to conceptualize the cultural significance of breasts that are “too good to be real.”. (shrink)

Dissecting Bioethics, edited by Tuija Takala and Matti Hayry, welcomes contributions on the conceptual and theoretical dimensions of bioethics. The department is dedicated to the idea that words defined by bioethicists and others should not be allowed to imprison people’s actual concerns, emotions, and thoughts. Papers that expose the many meanings of a concept, describe the different readings of a moral doctrine, or provide an alternative angle to seemingly self-evident issues are particularly appreciated. To submit a paper or to discuss (...) a suitable topic, contact Tuija Takala [email protected].:This article examines some of the assumptions and implications associated with the Belmont era context in which the concept of therapeutic misconception was forged. We argue that the justification of therapeutic misconception should be reconsidered based on less paternalistic and more participatory models of research. Finally, we identify conceptual and practical approaches that might better reflect contemporary research practice. (shrink)

This paper defends mandatory national service as a response to democratic decay. Because democracy cannot be maintained by laws and incentives alone, citizens must care about the quality and attitudes of their society's members. In an age of increasing segregation and conflict on the basis of class and race, national service can bring citizens from different walks of life together to interact cooperatively on social problems. It offers a form of ‘forced solidarity’. The final sections of the paper consider objections (...) to this proposal. (shrink)

In this article, Satz critiques "both Pogge's use of the causal contribution principle as well as his attempt to derive all of our obligations to the global poor from the need to refrain from harming others.".

This article examines the construction of gender within men's accounts of domestic violence. Analyses of in-depth interviews conducted with 33 domestically violent heterosexual men indicate that these batterers used diverse strategies to present themselves as nonviolent, capable, and rational men. Respondents performed gender by contrasting effectual male violence with ineffectual female violence, by claiming that female partners were responsible for the violence in their relationships and by constructing men as victims of a biased criminal justice system. This study suggests that (...) violence against female partners is a means by which batterers reproduce a binary framework of gender. (shrink)

This book offers practical advice for legal professionals to optimize cognitive fitness and protect their brain from the damaging effects of chronic stress. Drawing on the latest research in neuroscience and psychology, it provides actionable information to help readers thrive amidst the demands and stressors of the legal profession.

This article considers matters of narration and intersubjectivity in cosmetic surgery by drawing from interviews with 80 British and American women who have had an aesthetic procedure and 16 British and American cosmetic surgeons. It explores constructions of the ‘surgical other’ — that is, the woman who has cosmetic surgery with little consideration of its risks, is motivated by vanity rather than need, has unreasonable expectations regarding its outcome and/or is obsessively concerned with her appearance. It shows that constructions of (...) surgical otherness are deeply contextual and interactive. They involve the production of narratives that reflect individual experience, are shaped by cultural imagery and incorporate narratives provided by other people. They also function as a form of identity work, as patients and surgeons draw upon them (and assist in reproducing them) in their performances of self. As part of that process, physicians not only confirm the patient’s self-presentation as a ‘good surgical candidate’, but also aid in producing her as such. Practitioners too engage in their own presentations of self; their negative commentary on surgical others implies a criticism of — and thus an effort to differentiate themselves from — the surgeons responsible for their production. (shrink)

This revised workbook is designed for patients' use as they work, either with a qualified mental health professional or on their own, to manage social anxiety. Based on the principles of cognitive-behavioral therapy, the treatment program described is evidence-based and proven effective. Complete with user-friendly forms and worksheets, as well as relatable case examples and chapter review questions, this workbook contains all the tools necessary to help patients manage their anxiety and improve their quality of life.

(1995). Synthesizing disciplinary narratives: George Gaylord Simpson's tempo and mode in evolution. Social Epistemology: Vol. 9, Boundary Rhetorics and the Work of Interdisciplinarity, pp. 113-150.

A selection of primary sources representing varying viewpoints on the subject of animal rights.

In this article I make links between melancholia, creativity and communion with God at a personal level, referencing John’s gospel, ‘God’s house has many rooms’ and ‘The Mansions’, a text written by Theresa of Avila where the ‘mansion’ is an analogy for the space in which God’s omniscient love is realized. My paintings were formed from the day-to-day lived experience of ‘psycheache’ and are a graphic representation of a non-explainable reality. I see in these paintings a transcendent reality for they (...) are the markings I made to express a state-of-being that could not be articulated. During this episode of Depression I painted dark interiors with rambling corridors, flights of steps and doorways leading into rooms empty of people. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Thinking Mortal ThoughtsDebra SanThere is something quite odd about the ancient Greek advice to “think mortal thoughts” (or “think of mortal things”), for what human being past the flush of youth has not trembled at the thought of mortality? Consciousness of our mortal condition is considered a hall-mark of the human species, and is no doubt the reason we alone among the species on the planet entertain notions of (...) divinity. Why then are we counseled to think about what we cannot help thinking about anyway? And what purpose does the advice serve: are those who tender it eager to promote their own fearful frame of mind? Or, on the contrary, are they urging us to be courageous in the face of death? Perhaps the advice intended is to eat, drink, and be merry, for tomorrow we die. Or perhaps “mortal thoughts” are suicidal thoughts, and the object is to shuffle off this mortal coil in a manner, time, and place of our own choosing.Clearly, taken out of context, the injunction “think mortal thoughts” can mean any number of things. But in the context of ancient Greek culture, “think mortal thoughts” means roughly this:“Since you are not one of the immortal gods, be mindful of your limits as a human being. Consciousness of the inevitability of your death should inform the way you live your life, for just as your lifespan is limited by your mortality, so too are your capacities for understanding, for action, and for achievement. This is the truth of your condition; if you don’t accept it, you’ll be frustrated at best, and at worst you’ll incur divine wrath and retribution for attempting to push past your proper human boundaries into sacred turf where you don’t belong and aren’t wanted. Don’t trespass. Don’t even think about it. Don’t assume, in a futile exercise of hubris, that you’re a special case whose transgression [End Page 16] (huperbasia) will be exempt from dire consequences. Gnothi sauton, know yourself as a mortal being, and meden agan, do nothing to excess, or you will suffer the fate of Icarus, who aimed too high and died for it, or the fate of Phaethon, who was destroyed by forces which he thought he could control.”The advice presented here echoes throughout classical Greek drama, whose tragic protagonists are the theatrical descendants of Icarus and Phaethon. When Antigone compares herself to Niobe, the Chorus must remind her that “she was a god, born of gods, and we are only mortals born to die” (925–26). 1 In her failure to think mortal thoughts, Antigone resembles her father, whose refusal to acknowledge his limits is so profound that even after mutilating himself in horror at the discovery of his own transgressions, he must still be reminded that he is no longer “the master of all things” (1675). 2 Pentheus in the Bacchae lacks the stature of either Oedipus or Antigone, but like them he has pretensions beyond the limits befitting a mortal; he fails to exercise the “simple wisdom [that] shuns the thoughts of proud, uncommon men and all their god-encroaching dreams” (427–29). 3 In his arrogant and unrealistic attempt to pit his own puny powers against the incomparable force of the immortal Dionysus, Pentheus suffers the fate of those whose hubris overcomes the temperate virtue of sōphrosunē, “the wisdom that accepts” (390). Even the bloodthirsty, pre-Eumenides Furies of the Eumenides accept the limits which moderation entails: they understand that Zeus “appointeth the mean as the master in all things” (531). 4One might expect that this cautionary, temperate strain in Greek thinking would appeal to Aristotle, whose doctrine of the mean in Book II of the Nicomachean Ethics might have come straight out of the Oresteia. And yet, when the caution is expressed in the maxim “think mortal thoughts,” Aristotle rejects it, claiming that human beings should try to aim their thoughts at a level so high it cannot really be reached by mortals, which is to say a level as high as that of the immortal gods, whose contemplative, intellectual activity (theōria) soars far above... (shrink)

The hypothesis that excessive early infant crying evolved to reduce the risk of withdrawal of parental care is disputed on the grounds that excessive infant crying is irritating and imposes fitness losses rather than gains. Alternative explanations for the early crying curve that take into account development on the part of the infant and the emerging infant-caregiver bond are proposed.

The concept of ‘accounts’ (Scott and Lyman, 1968) – or linguistic strategies for neutralizing the negative social meanings of norm violation – has a long history in sociology. This work examines British and American women's accounts of cosmetic surgery. In the medical literature, feminist writings and the popular press, aesthetic plastic surgery has been associated with narcissism, psychological instability and self-hatred. Given these negative connotations, cosmetic surgery remains a practice requiring justification even as its popularity increases. Drawing on interview data, (...) I argue that respondents' efforts to account for cosmetic surgery vary according to the ‘repertoires of evaluation’ (Lamont and Thévenot, 2000) made available by their own nation and, particularly, by its healthcare culture. In the market-based US healthcare system, women justify cosmetic surgery by referring to their personal and financial ‘investments’ in physical attractiveness and well-being. Such explanations are less legitimate in Britain, where healthcare is considered a social right rather than a consumer good. In the latter context, women employ narratives that medicalize the pre-surgical body by stressing the physical pain and emotional distress that it caused. (shrink)

In his article "How Certain Boundaries and Ethics Diminish Therapeutic Effectiveness", Lazarus asserts that many clinicians are adhering to strict therapeutic boundaries and ethics in a fear-driven effort to avoid unwarranted malpractice claims. Although I agree that maintenance of conventional therapeutic boundaries is apt to minimize malpractice claims in most cases, I believe that is because such boundaries are critical to protect patients' welfare and thereby promote effective treatment. My reasoning, discussed next, revolves around the following premises: 1. For many, (...) if not most, types of patient problems and patient populations, boundaries and the personal meaning of the therapeutic boundaries are an arena in which critical emotional issues are manifested and worked through. 2. Clear, consistent boundaries provide a structure and safety for many patients that is a curative factor in itself. 3. Patients' reactions to alterations in usual therapeutic boundaries are often unpredictable ahead of time (even if requested by the patient) and typically complex, ambivalent, and heavily colored by transferential meaning. 4. Because alterations in therapeutic boundaries typically add a new therapist role or activity that involves potential gratification of personal needs of the therapist, objectivity in evaluating such a change may be compromised by the inherent self-interest. 5. Consistent, clear boundaries need have no impact on therapist warmth and empathy. (shrink)

Allegations of scientific misconduct against graduate students appear to have unique attributes in the detection, investigation, processes used and sanctions imposed vis-à-vis other populations against which misconduct is alleged and found. An examination of the cases closed by the Department of Health and Human Services’ Office of Research Integrity and the National Science Foundation reveals that most of the allegations made against graduate and medical students are for falsification and fabrication. Further, additional processes are used in these cases, e.g., student (...) judicial processes, more students are “set up” and more students admit misconduct. Finally, the sanctions imposed when a finding is made typically involve separation from the institution and the federal sanction ranges from none to debarment. Drawing upon the teachings and circumstances of cases involving graduate student peers is a good vehicle for illustrating the concepts and perils of misconduct to graduate students. (shrink)