Problems arise when applying the current procedural conceptualization of decision-making capacity to paediatric healthcare: Its emphasis on content-neutrality and rational cognition as well as its implicit assumption that capacity is an ability that resides within a person jeopardizes children’s position in decision-making. The purpose of the paper is to challenge this dominant account of capacity and provide an alternative for how capacity should be understood in paediatric care. First, the influence of developmental psychologist Jean Piaget upon the notion of capacity (...) is discussed, followed by an examination of Vygostky’s contextualist view on children’s development, which emphasizes social interactions and learning for decision-making capacity. In drawing parallels between autonomy and capacity, substantive approaches to relational autonomy are presented that underline the importance of the content of a decision. The authors then provide a relational reconceptualization of capacity that leads the focus away from the individual to include important social others such as parents and physicians. Within this new approach, the outcome of adults’ decision-making processes is accepted as a guiding factor for a good decision for the child. If the child makes a choice that is not approved by adults, the new conceptualization emphasizes mutual exchange and engagement by both parties. (shrink)

Paradoxes are more than just intellectual puzzles - they raise substantive philosophical issues and offer the promise of increased philosophical knowledge. In this introduction to paradox and paradoxes, Doris Olin shows how seductive paradoxes can be, why they confuse and confound, and why they continue to fascinate. Olin examines the nature of paradox, outlining a rigorous definition and providing a clear and incisive statement of what does and does not count as a resolution of a paradox. The view that (...) a statement can be both true and false, that contradictions can be true, is seen to provide a challenge to the account of paradox resolution, and is explored. With this framework in place, the book then turns to an in-depth treatment of the Prediction Paradox, versions of the Preface/Fallibility Paradox, the Lottery Paradox, Newcomb's Problem, the Prisoner's Dilemma and the Sorites Paradox. Each of these paradoxes is shown to have considerable philosophical punch. Olin unpacks the central arguments in a clear and systematic fashion, offers original analyses and solutions, and exposes further unsettling implications for some of our most deep-seated principles and convictions. (shrink)

The pragmatic inquiry process used in the Corporantes Pathfinder Notebook (CPN) enables students and others to discern their gifts, find purpose and direction in their lives, and seek a FIT between their values and various corporate cultures before making extensive commitments in their field of studies and their employment. Based on Peirce''s theory of Pragmatism the CPN fosters investigation, interpretation, and action resulting from reflected narratives written in response to a series of questions in the CPN. The CPN was used (...) successfully as a framework in a Business Ethics course for connecting career decisions to their personal lives. Other pedagogic activities were used such as case studies, role playing, service learning, team projects investigating ethical climates of corporations, as well as Socratic questioning and discussions of moral dilemmas to develop ethical sensitivity and understanding of ethical challenges and decisions. The CPN also has been used successfully by senior executives in over fifty applications. (shrink)

__Demoralized: Why Teachers Leave the Profession They Love and How They Can Stay_ offers a timely analysis of professional dissatisfaction that challenges the common explanation of burnout. _Featuring the voices of educators, the book offers concrete lessons for practitioners, school leaders, and policy makers on how to think more strategically to retain experienced teachers and make a difference in the lives of students. Based on ten years of research and interviews with practitioners across the United States, the book theorizes the (...) existence of a “moral center” that can be pivotal in guiding teacher actions and expectations on the job. Education philosopher Doris Santoro argues that demoralization offers a more precise diagnosis that is born out of ongoing value conflicts with pedagogical policies, reform mandates, and school practices. _Demoralized_ reveals that this condition is reversible when educators are able to tap into authentic professional communities and shows that individuals can help themselves. Detailed stories from veteran educators are included to illustrate the variety of contexts in which demoralization can occur. Based on these insights, Santoro offers an array of recommendations and promising strategies for how school leaders, union leaders, teacher groups, and individual practitioners can enact and support “re-moralization” by working to change the conditions leading to demoralization. (shrink)

Do we know what we're doing, and why? Psychological research seems to suggest not: reflection and self-awareness are surprisingly uncommon and inaccurate. John M. Doris presents a new account of agency and responsibility, which reconciles our understanding of ourselves as moral agents with empirical work on the unconscious mind.

This book is a provocative contribution to contemporary ethical theory challenging foundational conceptions of character that date back to Aristotle. John Doris draws on behavioral science, especially social psychology, to argue that we misattribute the causes of behavior to personality traits and other fixed aspects of character rather than to the situational context. More often than not it is the situation not the nature of the personality that really counts. The author elaborates the philosophical consequences of this research for (...) a whole array of ethical theories and shows that, once rid of the misleading conception of motivation, moral psychology can support more robust ethical theories and more humane ethical practices. (shrink)

Imagine you are walking down a city street. It is windy and raining. Amidst the bustle you see a young woman. She sits under a railway bridge, hardly protected from the rain and holds a woolen hat containing a small number of coins. You can see that she trembles from the cold. Or imagine seeing an old woman walking in the street at dusk, clutching her bag with one hand and a walking stick with the other. A group of male (...) youths walk behind her without overtaking, drunk and in the mood for mischief. It doesn't need an academic to say what vulnerability is. We can all see it, much more often than we care to. (shrink)

Codes of ethics and conduct typically demand the highest standard of ethical behaviour from every single employee. This implies a democratic or lobbyist understanding of ethics in business. The contrasting view would argue that business ethics is an elitist undertaking that can only be instigated from the top, by managing directors or owner managers. This article looks at three types of ethical businesses, three types of approaches to ethical problem‐solving, and three possible incentives for ethical business to see which of (...) the above is more convincing. It will be argued that the impulse for value‐driven business has to come from the top. Only top management and owner managers have the opportunity to foster major change in business practice. (shrink)

This open access book offers insights into the development of the ground-breaking Global Code of Conduct for Research in Resource-Poor Settings (GCC) and the San Code of Research Ethics. Using a new, intuitive moral framework predicated on fairness, respect, care and honesty, both codes target ethics dumping – the export of unethical research practices from a high-income setting to a lower- or middle-income setting. The book is a rich resource of information and argument for any research stakeholder who opposes double (...) standards in research. It will be indispensable for applicants to European Union framework programmes, as the GCC is now a mandatory reference document for EU funding. (shrink)

The Blochian concept of cipher is discussed in some detail with a view to possible developments in the modern philosophy of nature. Parallels and differences are listed as to the Idealistic tradition in Germany preceding Bloch’s approach. It is found that within the framework of a strict process philosophy of the Blochian type, life forms and human (reflexive) life in particular show up as systemic parts of a nature that is projecting itself towards what has not yet become, hence a (...) strong similarity to Schelling’s approach. (shrink)

This paper connects to Jon Bing’s great vision of an integrated national legal information system. The intention of this paper is to variegate Bing’s vision of an integrated information system by shifting the focus to the lay users, thus to those, who are subject to the law. The modified vision is an integrated information system that supports intelligible access to law for the citizens. This presupposes however an unambiguous and transparent legal system. Accordingly, it is also stressed that intelligent legal (...) knowledge engineering has high potential to increase precision and rationality in law, and hence safeguard the predictability of law and legal certainty. The central hypothesis is that putting the person who is subject to the law at the centre provides more rational reason to aim for the greatest possible precision of law by exploiting the means and technologies of our time than to uphold strategic vagueness. On this basis, the paper proposes the development of a basic set of controllable and justiciable basic legal drafting standards on EU and on national level, and promotes a transparency by design approach for legal knowledge engineering in order to enhance precision, integrity, comprehensibility and accessibility of law. Similarly to Jon Bing’s vision, this modified vision of an integrated legal information systems is, most probably, also likely to remain unfulfilled. However, what would science be without visions and (science) fictions? (shrink)

This open access book provides original, up-to-date case studies of “ethics dumping” that were largely facilitated by loopholes in the ethics governance of low and middle-income countries. It is instructive even to experienced researchers since it provides a voice to vulnerable populations from the fore mentioned countries. Ensuring the ethical conduct of North-South collaborations in research is a process fraught with difficulties. The background conditions under which such collaborations take place include extreme differentials in available income and power, as well (...) as a past history of colonialism, while differences in culture can add a new layer of complications. In this context, up-to-date case studies of unethical conduct are essential for research ethics training. (shrink)

The Moral Psychology Handbook offers a survey of contemporary moral psychology, integrating evidence and argument from philosophy and the human sciences.

Background: Pediatric guidelines recommend that children and adolescents participate in a developmentally appropriate way in end-of-life decision making. Shared decision making in pediatrics is unique because of the triadic relationship of patient, parents, and physician. The involvement of the patient may vary on a continuum from no involvement to being the sole decision maker. However, the effects of child participation have not been thoroughly studied. The aims of this literature review are to identify studies on end-of-life decision making in pediatrics, (...) to explore patient participation, and to assess the effects of such participation. Methods: Five databases—PubMed, PsycInfo, Medline, CINAHL, and Sociological Abstract—were searched for empirical studies on end-of-life decision making in pediatrics. Selected articles fulfilling the criteria were assessed for type of decision, participants’ characteristics, reports on participation of the minor patient, and outcome. Results: Fifty-seven articles on end-of-life decision making in pediatrics were identified. The majority of papers (n = 43, 75%) investigated parents’ and clinicians’ perspectives, while only 14 articles (25%) included perspectives of children and adolescents. Twenty-two articles (39%) reported some details on various forms of children's participation (e.g., receive information, plan care details, consulted before or after a decision was made). Positive (e.g., respect for patient's preferences) and negative (e.g., conflict due to diverging opinions) effects of children's participation in end-of-life decision making were reported. Conclusions: This systematic review highlights the need for research to identify factors that contribute to a favorable participation of minors in decision-making processes, as well as strategies to solve possible conflicts. More research should take into account the dynamics in the triadic process of decision making and emphasize children and adolescents’ perspectives. A better understanding of how to meaningfully involve children and adolescents in end-of-life decision making could facilitate the practice of patient participation in pediatrics. (shrink)

Background There are legal protections for nurse researchers at public universities who employ community-based participatory research (CBPR) in research about social or health inequities. Dissemination of CBPR research data by researchers or participants may divulge unjust laws and create an imperative for university involvement. Research Question What are United States-based legal dissemination protections for CBPR health equity nurse researchers? Research Design Three case examples employing CBPR are examined: 1) a mixed methods study with participants reporting illegal discrimination in a municipal (...) initiative about capacity building in community-based organizations serving children; 2) a visual methods study exposing potential clean air law violations in environmental justice research; and 3) a study examining workload violations and illegal discrimination among hotel workers. Participants and Research Context The cases involved participants from protected social class backgrounds. The research is described with respect to: background, funding, research purpose, and research team; research participants’ power and legal vulnerability; dissemination of relevant research information balancing vulnerability and power; research dissemination issues; potential legal issues involved; and laws researchers may use. Ethical Considerations IRB approval was obtained for the studies. Using a social justice ethical framework, studies highlight actual or potential legal aspects of data dissemination in the context of gathering data about injustice. Findings Legal protections for research data dissemination, whistleblower protection, research advancement protection, anti-harassment protection, false claims, defamation, and visual data liabilities are described. Conclusion Knowledge of legal research data dissemination protections is an essential competency for nurse researchers invested in uplifting social justice. (shrink)

In a recent work, we introduced a theoretical model for fulfillment in life that covers cognitive and affective components and distinguishes different time frames. The present study evaluates this model and describes the construction of the Fulfilled Life Scale to assess fulfillment regarding the whole lived life retrospectively. We investigated the scale in two samples. The model of the cognitive component combines three sources of fulfillment with three criteria, yielding nine facets. Employing hierarchical factor analysis, we inspected all solutions between (...) one and nine. We identified three optimal factors, which we labeled unfolded self and life, the worthwhile life, and positive impact and legacy. Next, we selected marker items and replicated the factor structure in Sample 2. The three scales were positively intercorrelated and showed good internal consistency in both samples. For the affective component, exploratory and confirmatory factor analyses established a one-factor structure in both samples, and high internal consistency was obtained. Across a range of related constructs, we demonstrated construct and criterion validity. Notably, cognitive and affective fulfillment incrementally predicted a global rating of a fulfilled life and mental well-being, even after controlling for subjective and eudaimonic well-being. Overall, the study proves that the FLS is necessary to capture people’s experience of a fulfilled life, which could not be assessed sufficiently with previous well-being measures. Both cognitive and affective fulfillment were able to predict additional variance in mental well-being. Moreover, the study reveals psychometric support for the FLS and presents the first evidence on its validity. Lastly, applications in research and practice are discussed, especially in the context of living and aging well in the second half of life. (shrink)

Journal Name: Cognitive Linguistics Issue: Ahead of print.

In 2006, the Indonesian government decided to withhold avian flu samples from the World Health Organization. They argued that even though Indonesian samples were crucial to the development of vaccines, the results of vaccine research would be unaffordable for its citizens. Commentaries on the case varied from alleging blackmail to welcoming this strong stance against alleged exploitation. What is clear is that the concern expressed is related to benefit sharing.Benefit sharing requires resource users to return benefits to resource providers in (...) order to achieve justice. One benefit sharing tool within health research is the duty to provide a health care intervention which has been proven to be beneficial (or alternative benefits) to research participants after a study has been concluded. This duty is generally known as a post-study obligation. It was enshrined in the Declaration of Helsinki in 2000 and re-emphasized in 2008. Yet, there are few, if any, examples of good practice.In this article, we analyse the obstacles to giving more bite to benefit sharing provisions in health research through ethical review. We conclude that the provision of post-study access to healthcare interventions is not a promising mechanism when monitored through research ethics committees. Alternative benefit provision is preferable if one focuses on achieving compliance. However, even the latter faces challenges, which we address in specific recommendations. (shrink)

Global bioethics is a bold project. In its moderate form, it aims to find solutions to the dilemmas posed by modern medicine and the biological sciences through intercultural understanding of human obligations and opportunities. In its more ambitious form, it endeavors to cover all possible ethical problems arising with regard to life and living things on earth. Given the ambitiousness of even the moderate aim, it is unsurprising that disputes are frequent and agreements are scarce. One of the most contentious (...) issues is whether human rights should play an important role in global bioethics or not. a. (shrink)

While nothing justifies atrocity, many perpetrators manifest cognitive impairments that profoundly degrade their capacity for moral judgment, and such impairments, we shall argue, preclude the attribution of moral responsibility.

Recently, we initiated a new research line on fulfillment in life by developing a conceptual framework and a self-report measure. To enhance conceptual clarity and complement theoretical considerations and empirical findings, we investigated lay conceptions of a fulfilled life in German-speaking participants at different life stages. First, we selected a qualitative approach using an open-ended question asking participants to describe a fulfilled life. Second, for a more comprehensive understanding, quantitative data were collected about the relevance of sources in providing fulfillment (...) and ratings on a fulfilling life in the present and a fulfilled life in retrospect. Qualitative content analysis was used to assess the responses to the open-ended question. One-fifth of the data was double coded, and intercoder reliability was high. Responses comprised a variety of descriptions, and we grouped them into seven themes, three of which overlapped with the prior conceptualization, namely the core elements of general description, cognitive appraisals, and affective appraisals. Cognitive evaluations related to intrapersonal aspects, particularly having lived life fully, attained personally significant goals, and developed oneself, as well as interpersonal, generative aspects, such as having made a contribution and been able to leave something of value. These categories are mostly in line with what the Fulfilled Life Scale measures. Further themes referred to correlates—including sources—and antecedents, including resources, personal characteristics, and quality of life, all considered worthy to be the subject of empirical investigation but which were not included in the conceptual model. Qualitative and quantitative results suggest that individuals derive fulfillment from different sources. Fulfillment from a profession and having a life task was strongly associated with longer-term fulfillment. Only a few age and sex differences were found. The overarching framework developed from the qualitative results can stimulate further investigation. Our findings underscore that a fulfilled life as a distinct construct should be measured directly rather than via a proxy. Insights into the constituents, sources, and antecedents of a fulfilled life can inform practice to promote a life well lived. (shrink)

The original 1907 text is accompanied with a series of critical essays from scholars including Moore and Russell. In the introduction Olin evaluates the strength of the criticisms made against James.

Background: Healthcare providers who are accountable for patient care safety and quality but who are not empowered to actualize them experience moral distress. Interventions to mitigate moral distress in the healthcare organization are needed. Objective: To evaluate the effect on moral distress and clinician empowerment of an established, health-system-wide intervention, Moral Distress Consultation. Methods: A quasi-experimental, mixed methods study using pre/post surveys, structured interviews, and evaluation of consult themes was used. Consults were requested by staff when moral distress was present. (...) The purpose of consultation is to identify the causes of moral distress, barriers to action, and strategies to improve the situation. Intervention participants were those who attended a moral distress consult. Control participants were staff surveyed prior to the consult. Interviews were conducted after the consult with willing participants and unit managers. Moral distress was measured using the Moral Distress Thermometer. Empowerment was measured using the Global Empowerment Scale. Results: Twenty-one consults were conducted. Analysis included 116 intervention and 30 control surveys, and 11 interviews. A small but significant decrease was found among intervention participants, especially intensive care staff. Empowerment was unchanged. Interview themes support the consult service as an effective mode for open discussion of difficult circumstances and an important aspect of a healthy work environment. Conclusions: Moral distress consultation is an organization-wide mechanism for addressing moral distress. Consultation does not resolve moral distress but helps staff identify strategies to improve the situation. Further studies including follow up may elucidate consultation effectiveness. (shrink)

Response Content Type Journal Article DOI 10.1007/s11673-010-9259-x Authors Doris Schroeder, Centre for Professional Ethics, University of Central Lancashire, Preston, PR1 2HE England Journal Journal of Bioethical Inquiry Online ISSN 1872-4353 Print ISSN 1176-7529.

In this essay, Doris Santoro examines the discourse of “fidelity of instruction” to show how it is doublespeak for teacher compliance that is incompatible with democracy and education. Analyzing the distorted use of the term “fidelity” by market-based reformers, Santoro illustrates how it can be used as a weapon against teacher intelligence and moral response. She argues that John Dewey's philosophy provides conceptual resources to reframe some teacher infidelity as intelligent response, the moral agency required for pedagogical responsibility.

For persons serving life-without-parole (LWOP) sentences in California, a commutation usually offers them the sole glimpse of hope for release from prison. While governors were reluctant to consider any sentence reductions from 1975 to 2016, commutations—including those for LWOP—have become a more frequent occurrence since. Yet, little is still known about how governors have justified reducing a sentence that initially offered no prospect of release from prison. Given the apparent change in practice, themes emerging from the content of 177 gubernatorial (...) commutation summaries granted to persons serving LWOP sentences between 2017 and 2021 are analyzed in this paper. Through open coding, rehabilitative indicators (programming and institutional conduct) emerged as necessary preconditions for a commutation, while retributive factors (a reassessment of the nature of the crime and the prerogative to adjust excessive prison sentences or to correct sentencing errors) complemented sentence reductions. The findings expose the ethical issues that arise from an LWOP sentence and the subsequent commutation. More specifically, they shed light on the commitment offenses underlying commuted LWOP sentences and raise questions regarding the penal objectives that are supposed to be accomplished with permanent imprisonment. (shrink)

Médecins Sans Frontières is one of the world’s leading humanitarian medical organizations. The increased emphasis in MSF on research led to the creation of an ethics review board in 2001. The ERB has encouraged innovation in the review of proposals and the interaction between the ERB and the organization. This has led to some of the advances in ethics governance described in this paper.

In its essence, post-trial obligations describe a duty by research sponsors to provide a successfully tested drug to research participants who took part in the relevant clinical trials after the trial has been concluded. In some instances,this duty is extended beyond the research participants. This article is divided into three main parts. The first part outlines the legal basis for post-trial obligations by looking at international guidelines, including those issued by the World Medical Association. National legislation is exemplified through resolutions (...) and guidelines issued by Brazil and South Africa respectively. The second part analyses the ethical foundation for post-trial obligations, in particular the attempt to minimize exploitation of research subjects. The third part raises obstacles and challenges for the implementation of post-trial obligations. The jury is still out on whether post-trial obligations in the form of access to drugs for clinical trial participants is the best, or even a good way, to avoid exploitation in medical research. (shrink)

La lecture que Deleuze fait de Bartleby, d’Herman Melville, dans la postface intitulée Bartleby, ou la formule, a d’abord ceci d’intéressant qu’elle apparaît comme paradoxale : Deleuze prétend ne s’intéresser qu’à la « littéralité » du texte et de la formule bartlebienne, or, son interprétation semble hautement métaphorique. En partant de l’analyse que Deleuze fait de la formule I would prefer not to, ainsi que de la typologie « clinique » qu’il met en place dans sa postface, il s’agit de (...) s’interroger sur la folie qui est à l’œuvre dans Bartleby. (shrink)