Garrett Hardin's 'lifeboat ethics' is examined in the light of historical evidence which may be applied in part and with moderation to avoid both Hardin's predicted catastrophe and the inevitable guilt for survivors. If the metaphor of the lifeboat is re-examined, and slightly modified by including examples of real open boat passages, a scheme for implementing lifeboat ethics may be supported. In a case where some or all of the victims outside the lifeboat may be safely rescued, it is the (...) moral obligation of those in the boat to do so. The goal of any lifeboat situation, actual or metaphorical, is to secure the rescue of the greatest number of victims. The wrecks of both Endurance, on an exploratory voyage to Antarctica, and Essex, a whaling voyage, give insight into the application of lifeboat ethics. (shrink)

Stanisław Brzozowski was under the influence of Romanticism in the area of philosophy and ethics as he says. He managed to cover a lot of topics in letters and theories. In this way deed philosophy and then work philosophy appeared. Although Brzozowski was a discursively receptive and changeable person. His "Legenda Młodej Polski" includes the intense analysis and widespread criticism of Polish Romanticism but the idea of romanticism was valued more than German philosophy. The attitude towards Polish Romanticism (...) was used to change from the great period of fundamental changes in national movement to magical feelings. Having your head in the clouds at the same time. He was a great believer in a human being that acts through creative work. The effect of this not subjected world was the result of efforts, work and was equally basic to change the world. Work enabled the adequate recognition of himself and others. (shrink)

Background Over the past few decades, moral distress has been examined in the nursing literature. It is thought to occur when an individual has made a moral decision but is unable to act on it, often attributable to constraints, internal or external. Varying definitions can be found throughout the healthcare literature. This lack of cohesion has led to complications for study of the phenomenon, along with its effects to nursing practice, education and targeted policy development. Objectives The aim of this (...) analysis was to uncover unique definitions of moral distress as found in the nursing literature and to examine the relationship between these definitions. Research Design and Context Morse’s method of concept clarification was applied given the large body of literature which includes definitions, descriptions and measurements of the concept in research. The steps include (a) conducting a literature review; (b) analysing the literature; and (c) identifying, describing, comparing, and contrasting attributes, antecedents and consequences of each category. Findings Each of the 18 included studies described constraints in their definition of moral distress, whether implied or explicitly stated. External constraints are widely described as obstacles outside of the individual, whether institutional, systemic or situational, while internal constraints are located within the individuals themselves and are described as personal limitations, failings or weakness of will. Conclusion Upon reviewing these definitions, we determined that the term ‘internal constraints’ is problematic due to the emphasis of responsibility on the individual experiencing moral distress. We propose an alteration to ‘internal characteristics’ that will assume less responsibility of change from the individual to place a heavier onus on systemic and institutional constraints. (shrink)

We respond to a Letter to the Editor regarding "Principlism and contemporary ethical considerations for providers of transgender health care." We address criticisms by Castle & Klein (2024) of blatant fatphobia related to the ethical elements concerning BMI restrictions for gender-affirming surgery. Our response corrects several mischaracterizations of the article and clarifies our position. My co-authors and I remain focused on advocating for patient-centered, ethically sound, evidence-based, and equitable healthcare policies.

Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support for gender (...) diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound. (shrink)

In pediatric critical care, nurses are the primary caregivers for critically ill children and are particularly vulnerable to moral distress. There is limited evidence on what approaches are effective to minimize moral distress among these nurses. To identify intervention attributes that critical care nurses with moral distress histories deem important to develop a moral distress intervention. We used a qualitative description approach. Participants were recruited using purposive sampling between October 2020 to May 2021 from pediatric critical care units in a (...) western Canadian province. We conducted individual semi-structured interviews via Zoom. A total of 10 registered nurses participated in the study. Four main themes were identified: (1) “I’m sorry, there’s nothing else”: increasing supports for patients and families; (2) “someone will commit suicide”: improving supports for nurses: (3) “Everyone needs to be heard”: improving patient care communication; and (4) “I didn’t see it coming”: providing education to mitigate moral distress. Most participants stated they wanted an intervention to improve communication among the healthcare team and noted changes to unit practices that could decrease moral distress. This is the first study that asks nurses what is needed to minimize their moral distress. Although there are multiple strategies in place to help nurses with difficult aspects of their work, additional strategies are needed to help nurses experiencing moral distress. Moving the research focus from identifying moral distress towards developing effective interventions is needed. Identifying what nurses need is critical to develop effective moral distress interventions. (shrink)

This paper is intended to stimulate debate amongst stakeholders in the international research community on the topic of returning individual genetic research results to study participants. Pharmacogenetics and disease genetics studies are becoming increasingly prevalent, leading to a growing body of information on genetic associations for drug responsiveness and disease susceptibility with the potential to improve health care. Much of these data are presently characterized as exploratory (non‐validated or hypothesis‐generating). There is, however, a trend for research participants to be permitted (...) access to their personal data if they so choose. Researchers, sponsors, patient advocacy groups, ethics committees and regulatory authorities are consequently confronting the issue of whether, and how, study participants might receive their individual results. Noted international ethico‐legal guidelines and public policy positions in Europe and the United States are reviewed for background. The authors offer ‘Points‐to‐Consider’ regarding returning research results in the context of drug development trials based on their knowledge and experience. These considerations include: the clinical relevance of data, laboratory qualifications, informed consent procedures, confidentiality of medical information and the competency of persons providing results to participants. The discussion is framed as a benefit‐to‐risk assessment to balance the potential positive versus negative consequences to participants, while maintaining the integrity and feasibility of conducting genetic research studies. (shrink)

ABSTRACT This paper is intended to stimulate debate amongst stakeholders in the international research community on the topic of returning individual genetic research results to study participants. Pharmacogenetics and disease genetics studies are becoming increasingly prevalent, leading to a growing body of information on genetic associations for drug responsiveness and disease susceptibility with the potential to improve health care. Much of these data are presently characterized as exploratory (non‐validated or hypothesis‐generating). There is, however, a trend for research participants to be (...) permitted access to their personal data if they so choose. Researchers, sponsors, patient advocacy groups, ethics committees and regulatory authorities are consequently confronting the issue of whether, and how, study participants might receive their individual results. Noted international ethico‐legal guidelines and public policy positions in Europe and the United States are reviewed for background. The authors offer ‘Points‐to‐Consider’ regarding returning research results in the context of drug development trials based on their knowledge and experience. These considerations include: the clinical relevance of data, laboratory qualifications, informed consent procedures, confidentiality of medical information and the competency of persons providing results to participants. The discussion is framed as a benefit‐to‐risk assessment to balance the potential positive versus negative consequences to participants, while maintaining the integrity and feasibility of conducting genetic research studies. (shrink)

Fertility preservation has become more common for various populations, including oncology patients, transgender individuals, and women who are concerned about age-related infertility. Little attention has been paid to fertility preservation for patients with differences/disorders of sex development (DSD). Our goal in this article is to address specific ethical considerations that are unique to this patient population. To this end, we present a hypothetical DSD case. We then explore ethical considerations related to patient’s age, risk of cancer, concern about genetic transmission (...) of a DSD condition to children, co-occurring gender dysphoria, and access to experimental fertility preservation procedures. Given the limitations of current technologies, we recommend offering fertility preservation to individuals living with DSD using an informed decision-making approach that instills realistic expectations and minimizes the potential for false hope. Finally, we conclude with practical recommendations for this case based on the ethical considerations. (shrink)

Mentoring literature explores the dark side of mentoring as factors such as gender and race and how they affect the overall mentoring experience. The sociocultural context of the nursing and midwifery professions presents unique characteristics warranting a qualitative exploration of negative mentoring experiences. We aimed to characterise the dark side of mentoring based on informal mentoring relationships occurring among nurses and midwives working in hospitals. Utilising semistructured interviews in a qualitative descriptive design and reflexive thematic analysis, we examined the perceptions (...) of 35 nurses and midwives from three public hospitals located in the Western, Northern and North‐western regions of Uganda. Findings emerged in four overarching themes mentoring process deficits, mentoring relational problems, organisational challenges in mentoring and implications of negative mentoring experiences. Our study findings underscore that, while mentoring is frequently beneficial, it can also be interspersed with negative experiences arising from relational dynamics, particular mentoring processes and the overarching hospital environment. Notably, nurses and midwives actively transformed these challenges into opportunities for growth and self‐improvement, while introspectively examining their roles in contributing to these negative experiences. Such a proactive approach highlights their resilience and steadfast commitment to professional development, even in the face of adversity. (shrink)

The so-called ‘type method’ widely employed in biological taxonomy is often seen as conforming to the causal-historical theory of reference. In this paper, I argue for an alternative account of reference for biological nomenclature in which taxon names are understood as descriptive names. A descriptive name, as the concept came to be known from the work of Gareth Evans, is a referring expression introduced by a definite description. There are three main differences between the DN and the causal account. First, (...) according to the DN account, rather than fixing a name to a referent, the assignment of a type specimen to serve as the name-bearer for a taxon should be seen as performatively establishing a synonymy between a name and a definite description of the form “the taxon whose type is t”. Each taxon name is therefore associated with a criterion of application, a semantic rule that establishes the connection between the name and the descriptive content. This is the second major difference from the causal account: taxon names do have some descriptive content associated with them. The final locus of dissent concerns the strength of the modality resulting from the usage of taxon names. In order to address this point, I use the DN account to focus on the debate between Matt Haber and Joeri Witteveen concerning misidentification of type specimens, misapplication of names, and the truth conditions of Joseph LaPorte’s de dicto necessary sentence “Necessarily, any species with a type specimen contains its type specimen”. Using a pragmatic variant of the distinction between attributive and referential uses of descriptions, I argue that a metalinguistic version of the de dicto sentence is in fact falsified, as previously argued by Haber. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

Editors’ Note:As a matter of policy, the editors believe that publishing several reviews of selected texts is a valuable exercise which will enable a cross-section of views to be aired. The recently published second edition of the National Academy of Sciences’ report “On Being a Scientist” was considered an appropriate text for such treatment. The reviewer, Kenneth D. Pimple, Ph.D., is a Research Associate at the Poynter Center for the Study of Ethics and American Institutions and a Visiting Lecturer in (...) the American Studies Program, both at Indiana University. He has been involved with training faculty members to teach ethics since 1989 and is the project director of “Teaching Research Ethics: A Workshop at Indiana University,” with funding from the Department of Education’s Fund for the Improvement of Postsecondary Education. Her interests include nerve development and regeneration. Her research is in the area of analytical chemistry and emphasizes spectroscopic techniques. (shrink)

Research within the H2020 PROGRESSIVE project has identified good practices in user co-production strategies and methodologies. Early findings from research in the PROGRESSIVE project were shared with relevant stakeholders outside the consortium for consultation and review. The outcomes of that initial investigation highlighted the need to focus on the objectives, processes, and methods used in user and older people co-production. This guide adapts these insights and makes them relevant specifically for standardisation in ICT for active and healthy ageing. This guide (...) was approved by representatives of the PROGRESSIVE project on 22 February 2018. The consortium has requested comments from interested stakeholders in an enquiry from 1 March to 30 April 2018. The PROGRESSIVE guide was approved on 5 June 2018. (shrink)

ObjectiveTo assess distracted attention and performance on a computer task following completion of a sustained attention and acute media multitasking task among adolescents with varying self-reported usual media multitasking.MethodsNinety-six 13- to 17-year-olds played the video game Tetris following completion of a Go/No-go paradigm to measure sustained attention in the presence of distractors, an acute media multitasking, or a passive viewing condition. Adolescents completed the conditions on separate visits in randomized order. Sustained attention was measured within the Go/No-go task by measuring (...) errors of omission. Distracted attention while playing the Tetris task was measured by computing eye tracking measures of attention to irrelevant distractor images that bordered the Tetris game. Participants also self-reported their daily media multitasking.ResultsThe Go/No-go task revealed important qualitative differences in sustained attention among low and high usual media multitaskers. There was a uniform improvement in sustained attention among low usual media multitaskers, demonstrated by a consistent linear decrease in omission errors. Among high usual media multitaskers, there was initially a decrease in sustained attention followed by an increase. Completing the Go/No-go task also statistically significantly reduced distractibility and increased performance while playing Tetris compared to the passive viewing condition, but only among those with low usual media multitasking. There was a non-statistically significant trend that completing the acute media multitask increased subsequent distractibility and performance while playing Tetris among high media multitaskers.ConclusionIn this sample of adolescents, practicing a sustained attention task reduces distractibility and improves task performance among those who have low levels of usual media multitasking. (shrink)

Communicative Understandings of Women's Leadership Development: From Ceilings of Glass to Labyrinth Paths, edited by Elesha L. Ruminski and Annette M. Holba, weaves the disciplines of communication studies, leadership studies, and women's studies to offer theoretical and practical reflection about women's leadership development in academic, organizational, and political contexts. This work claims a space for women's leadership studies and acknowledges the paradigmatic shift from discussing women's leadership using the glass ceiling to what Eagly and Carli identify as the labyrinth of (...) leadership. (shrink)

In this article I introduce a hybrid view of persistence whereby simple objects persist by enduring while composite objects persist by being stage-related. I first show how, by sharing certain features and not others with the standard views of persistence, this hybrid view navigates two metaphysical problems that have been raised against such standard views. I then consider some implications of the view by addressing a couple of worries that may be raised against it. I conclude that this hybrid view (...) provides an attractive theory, one that deserves further investigation in the debate on persistence. (shrink)

The first two sections of the paper draw attention to some incompletely interpreted issues within two Romantic dramas: the unclear status of the protagonist in Dziady, Part IV (on the one hand, representing the indefinability of man and, on the other, constituting the illustration of how lightly one may lose consistency and identity), and the ambiguous relationship between Goplana and Grabiec in Balladyna (which can be perceived in terms of the complex relations between ‘the angelic soul and the bluff head’ (...) (dusza anielska i czerep rubaszny). The third section of notes is an encouragement to discuss two topics: ‘From Zygmunt Krasiński’s Leonard to Jerzy Andrzejewski’s Diego de Manente’; ‘From Pierścień Wielkiej-Damy, czyli: Ex-machina-Durejko by Cyprian Norwid to Tango by Sławomir Mrożek’. (shrink)

The object of this paper is to suggest how the Frege–Dummettian notions of criterion of identity and criterion of application can be put to work within Putnam’s account of reference for natural kind terms in “Meaning of ‘Meaning’ ”. By doing so, some light can be shed on Putnam’s earlier views on “necessity relative to a body of knowledge” as well as his later views on sortal identity. If the Frege–Dummettian criteria are indeed at work within Putnam’s account, then we (...) must either give up rigidity or else give up the division of linguistic labor hypothesis. I will give an example from biological nomenclature that may sway us towards giving up the former. (shrink)

Two competing intuitions have dominated the debate over facial tissue transplantation. On one side are those who argue that relieving the suffering of those with severe facial disfigurement justifies the medical risks and possible loss of life associated with this experimental procedure. On the other are those who say that there is little evidence to show that such transplants would have longterm psychological benefits that couldn’t be achieved by other means and that without clear benefits, the risk is simply too (...) great. Ethicists on both sides have called for more analysis of the link between the face and personal identity in order to get a better grasp on potential gains and losses. This paper responds to that call by looking at contemporary philosophical analyses of the relation between organ transplants and personal identity and between the human face, human dignity, and human vulnerability. It is argued that the face matters not because it is the unique marker of our identity, but because of its role in the intersubjective constitution of moral identity and human dignity. (shrink)

The canonical version of possible worlds semantics for story prefixes is due to David Lewis. This paper reassesses Lewis's theory and draws attention to some novel problems for his account.