In the specialized area of pediatric endocrinology, the use of human growth hormone (hGH) both for children who have a growth hormone abnormality and for the treatment of non-hGH-deficient children who are short is a current clinical reality that raises important ethical questions. Generally speaking, the use of hGH for those children who are clearly lacking it is an efficacious intervention based upon established clinical criteria. The use of hGH for children who are short, but have no growth hormone abnormality (...) is ethically and clinically more controversial. The moral conundrum of how to gain knowledge about new medical treatments that may be beneficial to children while, at the same time, ethically enrolling them in clinical trials with placebo arms in order to gain such knowledge will continue to be a contentious issue in the conduct of research and in the delivery of health care. In addition, there are questions about what ought to be studied and whether a physical characteristic such as short stature ought to be viewed as a circumstance of less than optimal health. (shrink)

Background Caring is a core function of nurses and it confers upon them ethical obligations as ethical agents. Failure to carry out such ethical obligations raises ethical concerns. This study was not intended to explore ethical concerns, but the reported findings reveal problems which have ethical implications. This paper aims to elucidate the ethical issues inherent in the findings and propose strategies to mitigate them. Research design and methods An exploratory-descriptive qualitative design was used within a larger Action Research Study. (...) Data were collected through focus group discussions with nurse/midwives, and through exit interviews which were conducted with the women who participated in the study on their day of discharge. Six focus group discussions and thirty exit interviews were conducted, and data were analysed through thematic analysis. Participants and research context The study took place at selected maternal and child healthcare settings in Lilongwe, Malawi. The participants were nurse/midwives and women who were admitted in maternal and child healthcare settings and were purposively sampled. Ethical considerations Ethical approval was obtained from the relevant ethics committee and all ethical guidelines were followed in the conduct of the study. Findings The findings are presented under three themes which emerged from the data. The findings reveal effects of staff shortages on patient outcomes, problems experienced in low resource clinical settings and disrespectful nurse/patient communication. Conclusion The findings reveal that institutional factors constrain moral agency and patient safety is severely compromised in some of the clinical settings in Malawi which raises serious ethical concerns. (shrink)

The issues of tithes and seed sowing have taken a central focus in contemporary Christianity in Nigeria among the preachers. Many a time, it is assumed that tithes and seed sowing are requirements for salvation, prosperity and total well-being of the members. Making many to believe that Christianity is a money-venture business one can succeed if he knows how to hoodwink the gullible. Many have been deceived that by parting with a substantial amount of money in the name of sowing (...) seed, their problems would be solved. Unfortunately, the person’s problem may remain the same or even be compounded. This paper evaluates the activities, attitude and their inordinate ambitions. It examines the impact of tithe and seed sowing on Christianity in Nigeria. The research method adopted for this work is the qualitative phenomenological method. The paper observed that the value of tithe and seed sowing has changed from what is prescribed in the bible to what is preached on the pulpits. The study recommends among other things, that these preachers should preach the gospel with decorum and as it were in the bible so that its influence on Nigerians will bring about a reduction in crime, corruption and other immoral activities in Nigeria. Contribution: The article is focused on the issues of tithes and seed sowing. It underscores the fact that the message of tithe and seed sowing has become a means of siphoning members and enriching the preachers. It further reveals its negative and positive impacts such as, the promotion of corruption and fraud in the church and society, contribution to the decline of morality in the church and the society, increasing crime rate and increasing poverty rate in Nigeria among others. (shrink)

A wide range of conflicting established moral viewpoints makes development of public policy related to infertility difficult. Where there are pluralities of viewpoints and no single established moral approach, uniform solutions are questionable. The Office of Technology Assessment (OTA), is a nonpartisan analytic support agency that serves the United States Congress by providing objective analyses of major public policy issues related to scientific and technological change. Because analysis of ethical issues is an important part of technology assessment, OTA included a (...) thematic analysis of ethical issues in the report, Infertility: Medical and Social Choices . A consideration of whether infertility is a disease was an important conceptual starting point, and religious perspectives were reviewed as possible sources of moral and ethical insight. Keywords: infertility, U.S. Congress, Office of Technology Assessment, infertility, right to reproduce, embryo CiteULike Connotea Del.icio.us What's this? (shrink)

This document describes the technique and technology currently used to apply cryosurgery, a technic based on low temperatures for medical purposes that allows the controlled destruction of pathological cells and tissues. Cryosurgery is an effective and innocuous process that is painless, safe and economical, applied to multiple specialities in which it provides alternatives to its traditional methods. A search was carried out for articles and bibliographic reviews referring to Cryosurgery and from whose information this technical note was obtained. Research on (...) the application of Cryosurgery presents solid evidence of its benefits. Therefore, it has been used in several countries and health campaigns, showing excellent results, so it is advisable to implement it in health systems. (shrink)

Background: Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty. Objectives: The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi. Methodology: A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of (...) 271 clinical nurses. Data were collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0. Ethical consideration: The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi. Results: The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings. Conclusion: The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

Recent ideological positioning on the world stage has born a startling resemblance to a form of positioning within nursing theory – that of taking complex ideas, reducing them to a simplistic binary form, and uncritically adopting one half of that form. In some cases, this adoption of a binary position has led to a passionately held form of ‘othering’ that prohibits a healthy and critical engagement with ideas. As alluring as settling for the binary form may be – we argue (...) for holding binaries in tension as a catalyst for stimulating dialogue – reasoning and exploration of new ways of wrestling with the social and moral complexity of nursing. (shrink)

The limitations of rational models of ethical decision making and the importance of nurses’ human involvement as moral agents is increasingly being emphasized in the nursing literature. However, little is known about how nurses involve themselves in ethical decision making and action or about educational processes that support such practice. A recent study that examined the meaning and enactment of ethical nursing practice for three groups of nurses (nurses in direct care positions, student nurses, and nurses in advanced practice positions) (...) highlighted that humanly involved ethical nursing practice is also simultaneously a personal process and a socially mediated one. Of particular significance was the way in which differing role expectations and contexts shaped the nurses’ ethical practice. The study findings pointed to types of educative experiences that may help nurses to develop the knowledge and ability to live in and navigate their way through the complex, ambiguous and shifting terrain of ethical nursing practice. (shrink)

Inspired by three monographs of Gladys Swain and Marcel Gauchet, my presentation traces the rise of the new science of psychiatry in Revolutionary France, with Philippe Pinel and his student J.-E. Esquirol. As the directors of the division of the aliénés in the Hôpital Bicêtre (Paris), Pinel and Esquirol pioneered a therapeutic programme that spread out between their “traitement moral” (reasoning with the passions) and an “energetic repression,” wherever necessary. The discipline they created sought to gain autonomy from medicine (...) treating diseases of the body, much as pathology would do in regard to physiology, some fifty years later. Using Canguilhem, Foucault’s teacher and significant influence, I show how the unfolding of a science of disorders (for Canguilhem, this was pathology) poses questions of taxonomy and runs the inevitable ‘risk’ of extensive fragmentation. This is what happens in France after Pinel. However, Pinel, above all, will have made one contribution that—by Swain and Gauchet’s argument—stands in stark contrast to the theses of the young Foucault. Rather than sequestering and excluding the fou by forcing him or her into exaggerated, discursive revelations or silence, Pinel and Esquirol “discover” the sense, or sens , at the heart of madness, notably in what Pinel called “manie intermittente.” Esquirol takes this discovery one step further, to discern in various attacks, a certain rationality. This rather modern conception of madness exerts a considerable influence on literature, criticism, philosophy, and medicine in their time. Hegel’s understanding of madness will come directly from Pinel, and it will see in folie the internal division of subjective Reason. From this characterization comes a therapeutics based on the conviction that one could often reintegrate the mad into society, and avoid prolonged sequestration and exclusion. Thus the presentation focuses on Swain and Gauchet’s question to Foucault ( Histoire de la folie à l’âge classique , notably), using the work of Pinel and Hegel to illustrate their claim. (shrink)

L'oeuvre de Pinel a donné lieu à des évaluations tout à fait contradictoires : certains, comme Pierre Pichot, Kavka, Zilboorg et Gladys Swain ont estimé, en effet, que Pinel n’avait pas été sensible à l'influence de la psychologie « sensualiste » et « associationniste »; Pichot et Zilboorg pour en conclure que ce que souhaitait Pinel, c'était en fait une psychiatrie sans psychologie ; Kavka et Swain pour en déduire l’opposé. Mon intention est de montrer brièvement : l) que (...) dans l’esprit de l'Idéologie il n’y a pas fondamentalement de contradiction entre le physiologisme organiciste et la psychologie associationniste , ce qui explique la coexistence du traitement médical et du traitement moral chez Pinel dans le traitement des maladies mentales, y compris la folie raisonnante ; 2) que l’influence de Condillac sur Pinel est beaucoup plus grande qu’on ne le croit généralement ; et 3) que Pinel a décidément bien peu à voir avec la psychanalyse.Pinel's works have been evaluated in completely contradictory ways : some, like Pierre Pichot, Kavka, Zilboorg and Gladys Swain have indeed considered that Pinel was not sensitive to the influence of "sensualist" and "associationist" psychology. Pichot and Zilboorg conclude from this that what Pinel was hoping for was in fact psychiatry without psychology. Kavka and Swain deduce the opposite. 1) intended to show, briefly : I) that in the minds of the ideologists there is fundamentally no contradiction between organicist physiologism and association nist psychology , which explains the coexistence of medical treatment and moral treatment of mental illness, including mania without delirium, in Pinel's work ; 2) that Condillac's influence on Pinel is much greater than is generally believed ; and 3) that Pinel has really very little to do with psychoanalysis. (shrink)

This article reports findings of a hermeneutic phenomenological study that explored the clinical learning experience for Malawian undergraduate student nurses. The study revealed issues that touch on both nursing education and practice, but the article mainly reports the practice issues. The findings reveal the emotions that healthcare workers in Malawi encounter as a consequence of practising in resource-poor settings. Furthermore, there is severe nursing shortage in most clinical settings in Malawi, and this adversely affects the performance of nurses because of (...) the excess workload it imposes on them. The results of the study also illustrate loss of professional pride among some of the nurses, and the article argues that such a demeanour is a consequence of burnout. However, despite these problems, the study also reveals that there are some nurses who have maintained their passion to care. (shrink)

An important question in the business ethics literature concerns organizational response in the aftermath of an unethical business practice. This study examines factors affecting firms’ decision to take reparative action in the aftermath of an environmental violation. Specifically, we investigate environmental violators’ decision to undertake a Supplemental Environmental Project (SEP), which is an initiative that promotes restorative justice. To settle an environmental violation, the United States’ environmental regulator allows offenders the option of either paying the full penalty or a reduced (...) sum while spending additional effort and engaging in an environmental project. As predicted, we find that firms with poorer past environmental performance and greater shareholder environmental activism are more likely to engage and invest in a SEP. Additionally, there is a stronger association between shareholder activism and SEP investment when firms have poorer past environmental performance. Our findings inform regulators, stakeholders, and business ethics researchers on the factors that lead firms to undertake reparative action following unethical business practices. (shrink)

Este artículo presenta una aproximación al sentido de la esperanza en María Zambrano. Para ello fue necesario hacer uso de la hermenéutica como método filosófico. Por tanto, se presenta una aproximación al pensamiento de María Zambrano en relación con la esperanza, reflexión que en tiempos de desesperanza recobra sentido en tanto la intención subyacente que anima este escrito es invitar al hombre contemporáneo para que se sitúe en la esquina de la esperanza zambraniana, desde la cual le será posible transitar (...) de la esfera de lo imposible al escenario de lo posible, para ello se acudirá a algunas obras clave de la autora. A través de cuatro momentos: la esperanza en el proyecto de llegar a ser; la esperanza desesperanzada; la esperanza confundida; y esperanza y confesión; circula la idea de un hombre renovado, proyectándose con optimismo hacia la construcción de un nuevo humanismo animado por la esperanza y la reconciliación.AbstractThis article offers an approximation to the sense of hope in María Zambrano. We turned to the use of hermeneutics as a philosophical method. Thus, we presented an approximation to the thought of María Zambrano regarding hope, a reflection that in times of despair regains sense since the underlying intention of this paper is to invite contemporary man to place himself in the corner of Zambrano’s hope, from which it will be possible to move from the realm of the impossible to the scenario of the possible, recurring to some key works by the author. Through four stages: hope in the project of becoming; the hopeless hope; the confused hope; and hope confession; circulated the idea of a renewed man, projecting optimism towards building a new humanism animated by hope and reconciliation. (shrink)

The purpose of this study is to examine whether United States -style regulatory intervention to encourage whistle-blowing can be immediately effective if transplanted into another country with a distinctly different historical cultural background and institutional system. A total of 98 U.S. and 84 German accountants participated in a laboratory experiment relating to a case of financial statement fraud. The provision of anti-retaliation protection and monetary rewards for whistle-blowing were manipulated and participants were asked to assume the role of an internal (...) auditor. We hypothesize and find that the provision of anti-retaliation protection and monetary rewards encourage U.S. accountants to blow the whistle. In contrast, among German accountants, where their country features a historical fear and distrust of whistle-blowers, U.S.-style regulatory interventions are less effective. Together, our findings provide strong support for the theory of path-dependence, suggesting that whistle-blowing regulation should not be uniformly transplanted without due consideration of the unique history and culture of a country. (shrink)

How the insane asylum became a laboratory of democracy is revealed in this provocative look at the treatment of the mentally ill in nineteenth-century France. Political thinkers reasoned that if government was to rest in the hands of individuals, then measures should be taken to understand the deepest reaches of the self, including the state of madness. Marcel Gauchet and Gladys Swain maintain that the asylum originally embodied the revolutionary hope of curing all the insane by saving the glimmer (...) of sanity left in them. Their analysis of why this utopian vision failed ultimately constitutes both a powerful argument for liberalism and a direct challenge to Michel Foucault's indictment of liberal institutions. The creation of an artificial environment was meant to encourage the mentally ill to live as social beings, in conditions that resembled as much as possible those prevailing in real life. The asylum was therefore the first instance of a modern utopian community in which a scientifically designed environment was supposed to achieve complete control over the minds of a whole category of human beings. Gauchet and Swain argue that the social domination of the inner self, far from being the hidden truth of emancipation, represented the failure of its overly optimistic beginnings. Madness and Democracy combines rich details of nineteenth-century asylum life with reflections on the crucial role of subjectivity and difference within modernism. Its final achievement is to show that the lessons learned from the failure of the asylum led to the rise of psychoanalysis, an endeavor focused on individual care and on the cooperation between psychiatrist and patient. By linking the rise of liberalism to a chapter in the history of psychiatry, Gauchet and Swain offer a fascinating reassessment of political modernity. (shrink)

This article examines the role of culture in the metaphorical/metonymic conceptualizations of fear, a primary emotion, in two languages—Akan (a West African, Kwa language) and English. The article adopts the general framework of conceptual metaphor theory (CMT) to compare and contrast the differences and/or similarities in the conceptualizations as well as the language-specific construals or elaborations of shared conceptual metaphors of fear in the two languages. The analysis of the language-specific realizations of the shared metaphorical/metonymic conceptualizations of the emotion concept (...) reveals both similarities and differences in the two languages, showing support for the cultural embodied cognition thesis, namely, the similarities in the conceptualization of emotions across cultures may be explained in terms of universal embodied cognition from which general metaphorical principles derive. However, the differences in language-specific elaborations may be explained in terms of cultural filtering of the general universal conceptualizations to reflect human experiences that are more salient to a particular sociocultural group. This analysis also shows a metaphor–metonymy interaction in the conceptualization of emotions across cultures. (shrink)

November 4th-5th, 2012 at Kyoto University. Organizers: Hisashi Nakao & Pierre-Alain Braillard.

This report examines the role of 1890 land-grant institutions and Tuskegee University in international research and curriculum development. It discusses the need for internationalizing curricula and the benefits and costs for 1890 institutions. Two particular strategies for infusing global perspectives using a small land-grant university as a case-study are presented. Two international projects served as a vehicle for enhancing faculty teaching, research and service capabilities.

The article is the result of the research project “Higher Education in Humanistic Perspective: An Approach from Martha Nussbaum”, having Nussbaum’s book Cultivating Humanity: A Classical Defense of Reform in Liberal Education as the main referent for the considerations presented. Hermeneutics is used as the philosophical method. One of the purposes of the article is to reveal how higher education courses in human development might be transformed from the perspective of self-examination in Martha Nussbaum’s thought, understanding the latter as one (...) of the three skills required for cultivating humanity. Self-examination is related to Bioethics in two different ways: first, by considering the current scientific context where some relevant issues arise and, second, it is exposed how its practice, by being in close relationship to the ethical and bioethical training of future professionals, is relevant for higher education teaching. Therefore, the consideration here presented is relevant and necessary precisely at a time when science progresses rapidly and not likewise the sense of humanity that should underlie and guide the actions of those involved in scientific progress and Health Care. Three topics are presented in the article: some considerations regarding the importance of bioethical thought, an approach to the particular meaning of Martha Nussbaum’s “self-examination”, and the examination of oneself and human formation related to Bioethics. (shrink)

This paper addresses the coconstruction of identities and emotions through the human/animal relationship, arguing that nonhuman animals can and do act as coagents in interspecies encounters. The paper narrates the extraordinary boundary-transgressing experiences of a particular kind of cogency labeled “huminality” . An autoethnographic account of pet-visitation involving a woman, a West Highland white terrier named Fergus, and geriatric residents demonstrates the power of huminality to authorize the emergence and realization of different identities and selves. Examples include the intimate friend, (...) the dignified self, the institutional resister, the gift-giver, and the available self. Huminality, in the emotional spacetime of the hospital, is rooted in empathy, concern, and affection. As ontological choreography, huminality takes us past the animal-Nature/human-culture frontier into uncharted territories of spacetime to engage in forms of life with nonhuman others. Encounters with animals, even on a geriatric ward, can transform our universe and our selves. (shrink)