ABSTRACT BACKGROUND: The objective of this study was to identify factors motivating women to take part in endometriosis research and to determine if these factors differ for women participating in clinical versus basic science studies. METHODS: A consecutive series of 24 women volunteering for participation in endometriosis‐related research were asked to indicate, in their own words, why they chose to volunteer. In addition, the women were asked to rate, on a scale of 0 to 10, sixteen potentially motivating factors. The (...) information was gathered in the form of an anonymous self‐administered questionnaire. RESULTS: Strong motivating factors (mean score >8) included potential benefit to other women's health, improvement to one's own condition, and participation in scientific advancement. Weak motivating factors (mean score <3) included financial compensation, making one's doctor happy, and use of ‘natural’ products. No difference was detected between clinical and basic science study participants. CONCLUSION: This study is the first study to specifically investigate the factors that motivate women to take part in endometriosis research. Understanding why women choose to take part in such research is important to the integrity of the informed consent process. The factors most strongly motivating women to participate in endometriosis research related to improving personal or public health; the weakest, to financial compensation and pleasing the doctor. (shrink)

In recent years there has been an increased awareness with regards to ethics in business. More specifically, the abundance of well-publicized examples of cheating, greed, and hypocrisy has created some alarm about the general state of personal ethics. Recent examples include the Oliver North, Ivan Boesky, and Jimmy Swaggart cases. The tax practitioner probably has little direct concern for matters of misconduct and ethical improprieties as mentioned above. Adherence to a code of conduct appears to circumvent the ethical conflict typically (...) found in the business environment. The tax practitioner's ultimate goal is tax minimization for clients. This goal has the blessings of the courts and the writers of tax law.The present day dynamic global economic system includes organizations which have extensive international activity. In an effort to enhance the performance of these organizations, there is typically decentralization of operations. When decentralization exists it is necessary to evaluate the decentralized units. Profit centers are commonly used for this purpose. With profit centers comes the need for transfer pricing between profit centers. The transfer price should be determined in some objective fashion. However, tax minimization often is the driving force in the transfer price decision. (shrink)

McTaggart raised a famed paradox regarding the transientist conception of time, the idea that the present moves into the future to overtake future events (or, alternatively, that future events move into the present) and past events recede further and further into the past as time goes on. Schlesinger has recently attempted an ingenious transientist solution to McTaggart's paradox. We will argue that Schlesinger's solution to McTaggart's paradox itself gives rise to a new, yet perfectly parallel, paradox which can only be (...) resolved by abandoning the transientist view of time. (shrink)

It is common to think of medical and ethical modes of thought as different in kind. In such terms, some clinical situations are made more complicated by an additional ethical component. Against this picture, we propose that medical and ethical modes of thought are not different in kind, but merely different aspects of what it means to be human. We further propose that clinicians are uniquely positioned to synthesise these two aspects without prior knowledge of philosophical ethics.

In this essay, I investigate the longstanding philosophical problem of whether we have control over our actions in a deterministic world. In working through a range of everyday situations in which this problem could arise, I come to the realisation that determinism has no bearing on whether we have control over our actions, because having control over our actions and determinism only make sense under different aspects.

Healthcare systems around the world are struggling to maintain a sufficient workforce to provide adequate care during the COVID-19 pandemic. Staffing problems have been exacerbated by healthcare workers (HCWs) refusing to work out of concern for their families. I sketch a deontological framework for assessing when it is morally permissible for HCWs to abstain from work to protect their families from infection and when it is a dereliction of duty to patients. I argue that it is morally permissible for HCWs (...) to abstain from work when their duty to treat is outweighed by the combined risks and burdens of that work. For HCWs who live with their families, the obligation to protect one’s family from infection contributes significantly to those burdens. There are, however, a range of complicating factors including the strength of duty to treat which varies according to the HCW’s role, the vulnerability of family members to the disease, the willingness of family members to risk infection and the resources available to the HCW to protect their family. In many cases, HCWs in ‘frontline’ roles with a weak duty to treat and families at home will be morally permitted to abstain from work given the risks posed by COVID-19; therefore, society should provide additional incentives to maintain sufficient staff in these roles. (shrink)

Psychiatric involvement in patient morality is controversial. If psychiatrists are tasked with shaping patient morality, the coercive potential of psychiatry is increased, treatment may be unfairly administered on the basis of patients’ moral beliefs rather than medical need, moral disputes could damage the therapeutic relationship and, in any case, we are often uncertain or conflicted about what is morally right. Yet, there is also a strong case for the view that psychiatry often works through improving patient morality and, therefore, should (...) aim to do so. Our goal is to offer a practical and ethical path through this conflict. We argue that the default psychiatric approach to patient morality should be procedural, whereby patients are helped to express their own moral beliefs. Such a procedural approach avoids the brunt of objections to psychiatric involvement in patient morality. However, in a small subset of cases where patients’ moral beliefs are sufficiently distorted or underdeveloped, we claim that psychiatrists should move to a substantive approach and shape thecontentof those beliefs when they are relevant to psychiatric outcomes. The substantive approach is prone to the above objections but we argue it is nevertheless justified in this subset of cases. (shrink)

We conducted and analyzed qualitative interviews with 12 persons working on the Healthy Public Housing Initiative in Boston, Massachusetts in 2001. Our goal was to generate ideas and themes related to the ethics of the community-based participatory research in which they were engaged. Specifically, we wanted to see if we found themes that differed from conventional research that is based on an individualistic ethics. There were clearly distinct ethical issues raised with respect to projects and individuals who engage in community-based (...) collaborations. The differences that arose from the interviews were seeking equality between the partners, the need for the community partner to defend the community, dealing with unflattering data, meeting community expectations and producing tangible benefits to the community. (shrink)

This essay explores the process and issues related to community collaborative research that involves Native Americans generally, and specifically examines the Navajo Nation’s efforts to regulate research within its jurisdiction. Researchers need to account for both the experience of Native Americans and their own preconceptions about Native Americans when conducting research about Native Americans. The Navajo Nation institutionalized an approach to protecting members of the nation when it took over Institutional Review Board (IRB) responsibilities from the US Indian Health Service (...) (IHS) in 1996. While written regulations for the Navajo Nation IRB are not dissimilar, and in some ways are less detailed than those of the IHS IRB, in practice the Navajo Nation allows less flexibility. Primary examples of this include not allowing expedited review and requiring prepublication review of all manuscripts. Because of its broad mandate, the Navajo Nation IRB may also require review of some projects that would not normally be subject to IRB approval, including investigative journalism and secondary research about Navajo People that does not involve direct data collection from human subjects. (shrink)

Daniel Sulmasy has recently argued that good medicine depends on physicians having a wide discretionary space in which they can act on their consciences. The only constraints Sulmasy believes we should place on physicians’ discretionary space are those defined by a form of tolerance he derives from Locke whereby people can publicly act in accordance with their personal religious and moral beliefs as long as their actions are not destructive to society. Sulmasy also claims that those who would reject physicians’ (...) right to conscientious objection eliminate discretionary space thus undermining good medicine and unnecessarily limiting religious freedom. I argue that, although Sulmasy is correct that some discretionary space is necessary for good medicine, he is wrong in thinking that proscribing conscientious objection entails eliminating discretionary space. I illustrate this using Julian Savulescu and Udo Schuklenk’s system for restricting conscientious objections as a counter-example. I then argue that a narrow discretionary space constrained by professional ideals will promote good medicine better than Sulmasy’s wider discretionary space constrained by his conception of tolerance. Sulmasy’s version of discretionary space would have us tolerate actions that are at odds with aspects of good medicine, including aspects that Sulmasy himself explicitly values, such as fiduciary duty. Therefore, if we want the degree of religious freedom in the public sphere that Sulmasy favours then we must decide whether it is worth the cost to the healthcare system. (shrink)

On one hand, it is commonly accepted that clinicians should not deceive their patients, yet on the other there are many instances in which deception could be in a patient’s best interest. In this paper, I propose that this conflict is in part driven by a narrow conception of deception as contingent on belief. I argue that we cannot equate non-deceptive care solely with introducing or sustaining a patient’s true belief about their condition or treatment, because there are many instances (...) of clinical care which are non-doxastic and non-deceptive. Inasmuch as this is true, better understanding of non-doxastic attitudes, such as hope and pretence, could improve our understanding of deception in clinical practice. (shrink)

The 2023 doctors’ strikes in the UK have elicited a familiar moral outcry that such strikes are morally wrong. We consider five arguments that might be thought to show doctors’ strikes are morally impermissible but show that they all fail. The most we can conclude from such arguments is that doctors’ strikes are morally permissible in a narrower range of circumstances than strikes in other sectors.We then outline two independent but compatible justifications for doctors’ strikes, one that appeals to doctors’ (...) interests in fair pay and working conditions and one that appeals to doctors’ duty to protect public health. We also suggest that doctors’ strikes can be supererogatory when they aim to correct a government failing in its own duty to protect public health. Finally, we assess the 2023 UK doctors’ strikes. We conclude that they are justified and there is a case for considering them supererogatory. (shrink)

Harold Shapiro, the former president of Princeton, ventured to say that theology had been divorced from the liberal. Professor Doug Dix's book is about arranging a remarriage. His analysis suggests the divorce goes deeper than Shapiro may have realized. Love has been divorced from learning because money has replaced truth as the object of affection. Now students learn to earn. Natural Literacy strives to motivate students and faculty to instead learn to love.

Plato seems to have been pessimistic about how most people stand with regard to virtue. However, unlike the Stoics, he did not conclude that most people are vicious. Rather, as we know from discussions across several dialogues, he countenanced decent ethical conditions that fall short of genuine virtue, which he limited to the philosopher. Despite Plato's obvious interest in this issue, commentators rarely follow his lead by investigating in detail such conditions in the dialogues. When scholars do investigate what kind (...) of virtue, if any, Plato thinks is open to non-philosophers, they typically look to the Republic. But in the Republic Plato sets out an ideal city; therefore, the virtue available to non-philosophers there is likely different from what he thinks is available to them in the real world. If we want to determine Plato's thoughts about the virtue of actual non-philosophers, we must look elsewhere. In this paper, I set my sights on the Phaedo. (shrink)

© The Author 2017. Published by Oxford University Press on behalf of The Analysis Trust. All rights reserved. For Permissions, please email: [email protected] volume collects nine of Mark Schroeder’s essays on expressivism, two of which are previously unpublished, along with a substantial introduction that helpfully ties them all together.1 The essays work very nicely as a collection. They are mutually illuminating, and together they make a ‘cumulative case’ for a particular conclusion – namely, that expressivist theories are best understood in (...) terms of their ‘surprising and novel views’ about the nature of propositions and propositional attitudes. As Schroeder sees things, the most promising way for expressivists to develop their view is for them to ‘get over’ their hesitation about propositions and to embrace an expressivist-friendly account of what propositions are. This requires going beyond the ‘merely deflationary talk about propositions’ that is typically endorsed... (shrink)

The theory of sexual selection suggests several possible explanations for the development of standards of physical attractiveness in humans. Asymmetry and departures from average proportions may be markers of the breakdown of developmental stability. Supernormal traits may present age- and sex-typical features in exaggerated form. Evidence from social psychology suggests that both average proportions and (in females) “neotenous” facial traits are indeed more attractive. Using facial photographs from three populations (United States, Brazil, Paraguayan Indians), rated by members of the same (...) three populations, plus Russians and Venezuelan Indians, we show that age, average features, and (in females) feminine/neotenous features all play a role in facial attractiveness. (shrink)

Current mainstream approaches to conscientious objection either uphold the standards of public health care by preventing objections or protect the consciences of health‐care professionals by accommodating objections. Public justification approaches are a compromise position that accommodate conscientious objections only when objectors can publicly justify the grounds of their objections. Public justification approaches require objectors and assessors to speak a common normative language and to this end it has been suggested that objectors should be required to cast their objection in terms (...) of public reason. We provide critical support for such a public reason condition and argue that it would be neither too demanding nor too permissive. We also respond to objections that it unfairly favours secular over religious objectors and that public reasons cannot be held with the kind of sincerity thought to characterize conscientious objections. (shrink)

ABSTRACT‘Self-ambiguity’, we suggest, is best understood as an uncertainty about how strongly a given feature reflects who one truly is. When this understanding of self-ambiguity is applied to a view of the self as having both essential and shapable components, self-ambiguity can be seen to have two aspects: (1) uncertainty about one's essential or relatively unchangeable characteristics, e.g. one's sexuality, and (2) uncertainty about how to shape oneself, e.g. which values to commit to, actions to pursue, or essential features to (...) identify with. We explain how a narrative account of agency can accommodate these forms of self-ambiguity and argue that such an account also reveals another kind of self-ambiguity, namely, (3) uncertainty about whether one's established self-narrative represents who one really is. We illustrate this third form of self-ambiguity in the context of addiction where people's established addiction self-narratives make it difficult to identify with recovery. We argue that recovery will require embracing, especially, our third form of self-ambiguity as a chance for positive self-transformation. Treatment for addiction should, therefore, support people in going through and ultimately narratively resolving the inevitable self-ambiguities of the recovery process. (shrink)

Addiction involves a chronic deficit in self-governance that treatment aims to restore. We draw on our interviews with addicted people to argue that addiction is, in part, a problem of self-narrative change. Over time, agents come to strongly identify with the aspects of their self-narratives that are consistently verified by others. When addiction self-narratives become established, they shape the addicted person’s experience, plans, and expectations so that pathways to recovery appear implausible and feel alien. Therefore, the agent may prefer to (...) enact her disvalued self-narrative because at least it represents who she takes herself to be. To recover, the agent needs to conduct narrative work, adjusting her existing self-narrative so that it better supports recovery-directed narrative projections. Reducing cravings, managing withdrawals, increasing self-control, and developing goals are all important for recovery but those approaches will often be in vain if the influence of self-narrative is ignored. If our analysis is correct, addiction treatment will typically be more effective if it incorporates support for self-narrative change. (shrink)

A rich exhibition of Minnesota’s beloved libraries, with stunning photographs by the popular Doug Ohman and library stories by seven of Minnesota’s best-known writers of books for children and young adults.

In Keeping Your Ethical Edge Sharp, Doug Sherman and Bill Hendricks discuss the critical issues that confront us in the workplace--possibly our most strategic sphere of influence today. They point put the obstacles that often keep our lights from shining in the darkness, and they present six principles we must be mindful of if we're to keep our ethical edge sharp and our witness distinctive.

The author uses an intersectionality framework to examine how lesbian, gay, bisexual, and transgender people evaluate the severity of their violent experiences. Previous research focusing on the severity of anti-LGBT violence has given relatively little attention to race, class, and gender as systems of power. In contrast, results from this study, based on 47 semi-structured, in-depth interviews, reveal that Black and Latino/latina respondents often perceived anti-queer violence as implying that they had negatively represented their racial communities, whereas white respondents typically (...) overlooked the racialized implications of their violent experiences. Furthermore, while lesbians of color emphasized their autonomy and self-sufficiency to challenge this discourse, Black and Latino gay men underscored their emotional and physical strength to undermine perceptions that they were weak for identifying as gay. Results also indicate that LGBT people experience forms of anti-queer violence in different ways depending on their social position, as Black lesbians faced discourse that neither white lesbians nor Black gay men were likely to confront. Thus, these findings suggest that topics primarily associated with homophobia should be examined through an intersectional lens. (shrink)

In this essay, I consider whether it makes sense to say that our cognitive capacities—remembering, imagining, intending, hoping, expecting and so on—manifest as inner, subpersonal processes. Given whether something makes sense is a grammatical rather than theoretical or empirical issue, it cannot be explained but can only be better understood by describing and reflecting on situations in which it arises. As such, I approach this issue using the descriptive method of O.K. Bouwsma, which is a development of Wittgenstein's latter methodological (...) approach of conceptually clarifying our bounds of sense. In the course of my investigation, I come to the realisation that cognitive capacities do not, as much psychology and cognitive science imply, make sense as inner, subpersonal processes. Instead, they make sense as personal capacities, which manifest in many ways of acting. (shrink)

Priority setting (also known as resource allocation or rationing) occurs at every level of every health system and is one of the most significant health care policy questions of the 21st century. Because it is so prevalent and context specific, improving priority setting in a health system entails improving it in the institutions that constitute the system. But, how should this be done? Normative approaches are necessary because they help identify key values that clarify policy choices, but insufficient because different (...) approaches lead to different conclusions and there is no consensus about which ones are correct, and they are too abstract to be directly used in actual decision making. Empirical approaches are necessary because they help to identify what is being done and what can be done, but are insufficient because they cannot identify what should be done. Moreover, to be really helpful, an improvement strategy must utilize rigorous research methods that are able to analyze and capture experience so that past problems are corrected and lessons can be shared with others. Therefore, a constructive, practical and accessible improvement strategy must be research-based and combine both normative and empirical methods. In this paper we propose a research-based improvement strategy that involves combining three linked methods: case study research to describe priority setting; interdisciplinary research to evaluate the description using an ethical framework; and action research to improve priority setting. This describe-evaluate-improve strategy is a generalizable method that can be used in different health care institutions to improve priority setting in that context. (shrink)

Cognitive Science, Volume 46, Issue 7, July 2022.

The Stoics claim that the sage is free from emotions, experiencing instead εὐπάθειαι (‘good feelings’). It is, however, unclear whether the sage experiences εὐπάθειαι about virtue/vice only, indifferents only, or both. Here, I argue that εὐπάθειαι are exclusively about virtue/vice by showing that this reading alone accommodates the Stoic claim that there is not a εὐπάθειαι corresponding to emotional pain. I close by considering the consequences of this view for the coherence and viability of Stoic ethics.

In this paper, we explicate the method of Investigative Ordinary Language Philosophy (IOLP). The term was coined by John Cook to describe the unique philosophical approach of Frank Ebersole. We argue that (i) IOLP is an overlooked yet valuable philosophical method grounded in our everyday experiences and concerns; and (ii) as such, Frank Ebersole is an important but neglected figure in the history of ordinary language philosophy.

In The Time After, which references the process of photography as well as the future fate of our planet, fine arts photographer Doug Fogelson uses an iconoclastic multiple exposure technique in order to depict our collective surroundings, producing imagery that reflects our own alien experience of nature, as well as the distanced perspective of the viewer. This volume collects over 160 of Fogelson's spectacular images and pairs them with speculative and poetic essays by Derrick Jensen, Eiren Caffall, and Bridgette (...) R. McCullough. (shrink)

Robert Card’s “Reasonability View” is a significant contribution to the debate over the place of conscientious objection in health care. In his view, conscientious objections can only be accommodated if the grounds for the objection meet a reasonability standard. I identify inconsistencies in Card’s description of the reasonability standard and argue that each version he specifies is unsatisfactory. The criteria for reasonability that Card sets out most frequently have no clear underpinning principle and are too permissive of immoral objections. Card (...) has also claimed that petitioners must justify their positions with Rawlsian public reason. I argue that, although the resulting reasonability standard is principled, it is overly restrictive. I also show that a reasonability standard built on Rawls’ more lenient conception of reasonableness would be overly permissive of objections at odds with professional healthcare standards. Finally, I argue for my favored solution, which bases the reasonability standard on minimal professional standards. (shrink)

On the mainstream view, consciences are valuable because they promote moral unity. However, conscience, so defined, will systematically prevent moral growth that threatens unity, even when unity has formed around oppressive moral values. This motivates Carolyn McLeod's alternative ‘Dynamic View’ whereby consciences are valuable to the extent that they are dynamic. Consciences are dynamic when they interact with our best moral judgements to shape or ‘retool’ the moral values underpinning conscience, sometimes at an initial cost to unity. We modify and (...) extend McLeod's account in two ways: (1) We object to her claim that conscience encourages its own retooling. We argue that the opposite is true – conscience creates a motivational barrier to change that moral judgement must overcome to successfully retool conscience. The task of ensuring dynamism, therefore, falls to moral judgement. (2) However, this motivational barrier enables conscience to play a valuable role that McLeod overlooks – compensating for the limitations of moral judgement. On our Balanced View, the value of conscience depends on it being sufficiently open to being shaped by our best moral judgements but inert enough to compensate for distorted moral judgements and to guide action when under cognitive load. (shrink)

Among the most noteworthy and impressive aspects of A.P. Simester’s monumental Fundamentals of Criminal Law is its pervasive pluralism. Many philosophers of criminal law, I have frequently complained, are excessively monistic on a number of basic questions about which pluralism is the more defensible option. I fear, however, that Simester’s views are sometimes too pluralistic. In particular, he assigns five separate functions to mens rea, and advances the novel claim that “mens rea is not, uniquely or even predominately, about culpability.” (...) He alleges that “the so-called ‘fault’ requirements plays an important role in mediating the scope of prohibitions.? My central objective is to challenge whether Simester is correct about whether mens rea has this alleged. (shrink)

In this paper I investigate whether in the 'Phaedo' the body or the soul is the subject of bodily desires. By analyzing Plato’s portrayal of the disembodied soul in the dialogue, I argue that because many souls are shown possessing bodily desires after death, the soul can possess bodily desires. Part of my analysis is built on my argument that the best way to understand afterlife punishment in the dialogue is as the necessary frustration of persistent bodily desires. Finally, I (...) end the paper by offering some reasons to think that the soul is the only subject of bodily desires in the dialogue. (shrink)