A 1999–2000 national study of U.S. hospitals raised concerns about ethics consultation (EC) practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administered a 105-item survey to “best informants” in a stratified random sample of 600 U.S. general hospitals. This primary article details the methods for the entire study, then focuses on the 16 items from the prior study. Compared with 2000, the estimated number of case consultations performed annually rose by 94% to 68,000. The (...) median number of consults per hospital was unchanged at 3, but more than doubled for hospitals with 400+ beds. The level of education of EC practitioners was unchanged, while the percentage of hospitals formally evaluating their ECS decreased from 28.0% to 19.1%. The gap between large, teaching hospitals and small, nonteaching hospitals widened since the prior study. We suggest targeting future improvement efforts to hospitals where needs are not being met by current approaches to EC. (shrink)

What do biologists want? If, unlike their counterparts in physics, biologists are generally wary of a grand, overarching theory, at what kinds of explanation do biologists aim? A history of the diverse and changing nature of biological explanation in a particularly charged field, "Making Sense of Life" draws our attention to the temporal, disciplinary, and cultural components of what biologists mean, and what they understand, when they propose to explain life.

The annual volume of ethics consultations (ECs) has been a topic of interest in the bioethics literature, in part because of its presumed relationship to quality. To better understand factors associated with EC volume, we used multiple linear regression to model the number of case consultations performed in the last year based on a national survey. We found that hospital bed size, academic affiliation, and urban/rural location were all associated with EC volume, but were not the primary drivers. Instead, these (...) variables affected EC volume through three other variables, all of which relate to ethics staffing: the percentage of case consultations performed by a single individual; whether the survey respondent’s main role at the hospital contained the word “ethics”; and especially, the number of full-time ethics program staff. We conclude that EC is an example of supply-sensitive care, and further research is needed to determine the optimal level of EC activity. (shrink)

We propose a modification of the exhaustivity operator from Fox Presupposition and implicature in compositional semantics, Palgrave Macmillan, London, pp 71–120, 2007. https://doi.org/10.1057/9780230210752_4) that on top of negating all the Innocently Excludable alternatives affirms all the ‘Innocently Includable’ ones. The main result of supplementing the notion of Innocent Exclusion with that of Innocent Inclusion is that it allows the exhaustivity operator to identify cells in the partition induced by the set of alternatives whenever possible. We argue for this property of (...) ‘cell identification’ based on the simplification of disjunctive antecedents and the effects on free choice that arise as the result of the introduction of universal quantifiers. We further argue for our proposal based on the interaction of only with free choice disjunction. (shrink)

The aim of this study was to explore ethically problematic situations in the long-term nursing care of elderly people. It was assumed that greater awareness of ethical problems in caring for elderly people helps to ensure ethically high standards of nursing care. To obtain a broad perspective on the current situation, the data for this study were collected among elderly patients, their relatives and nurses in one long-term care institution in Finland. The patients (n=10) were interviewed, while the relatives (n=17) (...) and nurses (n=9) wrote an essay. Interpretation of the data was based on qualitative content analysis. Problematic experiences were divided into three categories concerning patients’ psychological, physical and social integrity. In the case of psychological integrity, the problems were seen as being related to treatment, self-determination and obtaining information; for physical integrity, they were related to physical abuse and lack of individualized care; and for social integrity, to loneliness and social isolation. This study provided no information on the prevalence of ethical problems. However, it is clear from the results that patient integrity warrants more attention in the nursing care of elderly patients. (shrink)

After a brief introduction to Kuipers' views on explanations of laws we argue that micro-explanations of laws can have two formats: they work either by aggregation and transformation (as Kuipers suggests) or by means of function ascriptions (Kuipers neglects this possibility). We compare both types from an epistemic point of view (which information is needed to construct the explanation?) and from a means-end perspective (do both types serve the same purposes? are they equally good?).

This paper argues in favor of two claims: (a) that Scope Shifting Operations (Quantifier Raising and Quantifier Lowering) are restricted by economy considerations, and (b) that the relevant economy considerations compare syntactic derivations that end up interpretively identical. These ideas are shown to solve several puzzles having to do with the interaction of scope with VP ellipsis, coordination, and the interpretation of bare plurals. Further, the paper suggests a way of dealing with the otherwise puzzling clause-boundedness of Quantifier Raising.

To quote Yogi Berra, writing this editorial is a “déja vu all over again” experience for us. It entails not only collaborating once more as coauthors but also reiterating some of the criticisms and concerns that have figured prominently in virtually all our previous publications about bioethics—most recently in our book Observing Bioethics.

Does responsible leadership matter when assembling an inclusive supply chain at the Base-of-the-Pyramid? Current literature implicitly assumes that it does not. BOP scholars initially focused on the importance of shaping innovative and disruptive offerings, with radically improved price–performance ratios. Subsequent studies tended to focus on barriers to implementation of large-scale ventures at the BOP. Their common characteristic was the fact that the attributes and roles of the individuals involved were deemed unimportant. If the opportunity was there, provided barriers were removed (...) and the right value proposition was offered, the inclusive venture should take off. We evaluate three cases of leaders who succeeded in building inclusive ventures at the BOP, in contexts marked by institutional voids—where formal markets were weakly structured or nonexistent. Building a viable business under those circumstances entailed two tasks: imagining what is possible and then turning that vision into a reality. We found that, in carrying out those tasks, individuals do matter. Sampled cases show that working with nontraditional partners in inclusive supply chains requires more than aligning material incentives. Our analysis suggests that responsible leadership with a strong ethical foundation can provide powerful leverage to ensure buy-in and commitment from the various actors involved. We show how RL can impact organizations and external stakeholders through positive upward spirals. Our analysis contributes to the literature on BOP and RL by confirming, extending, and challenging existing knowledge. We propose two novel attributes and argue that context matters, influencing how RL is operationalized and defined. Understanding the critical role of RL in the construction of inclusive supply chains adds a critical missing link that sheds light into the micro level of new business creation, development, and consolidation at the BOP. (shrink)

This Article examines the influence of the Americans with Disabilities Act (ADA) on affective attitudes toward children with disabilities and on the incidence of disability-selective abortion. Applying regression analysis to U.S. natality data, we find that the birthrate of children with Down syndrome declined significantly in the years following the ADA's passage. Controlling for technological, demographic, and cultural variables suggests that the ADA may have encouraged prospective parents to prevent the existence of the very class of people the Act was (...) designed to protect. We explain this paradox by showing how specific ADA provisions could have given rise to demeaning media depictions and social conditions that reinforced negative understandings and expectations among prospective parents about what it means to have a child with a disability. We discuss implications for reproduction law and antidiscrimination policy. (shrink)

It is well-known that constructions involving ellipsis share many properties with constructions that involve phonological reduction. The similarity between ECs and PRCs is semantic: the interpretation of both is constrained by the interpretation of an antecedent. Rooth and Tancredi have pointed out that this similarity follows from an independently needed theory of focus.

Individuals with high levels of growth mindsets believe that attributes are malleable. Although links between acute stress responses and growth mindsets of thought, emotion, and behaviour are central to the conceptualisation of psychological disorders and their treatment, such links have yet to be examined. Undergraduate participants (N = 135) completed a modified Trier Social Stress Test (TSST), and their salivary cortisol and anxiety were assessed throughout the session. Hierarchical linear models revealed that higher growth mindset of behaviour was associated with (...) lower cortisol levels at 25-min after the TSST onset (i.e. peak cortisol stress reactivity) in men, but not in women. Considering one’s gender may be critical in understanding the relationship between growth mindset and stress responses. (shrink)

: Puritanism and Confucianism have little in common in terms of their substantive teachings, but they do share an emphasis on bounded, authoritative, localized human arrangements, and this profoundly challenges the dominant presumptions of contemporary globalization. It is not enough to say that these worldviews are ‘‘communitarian’’ alternatives to globalism, for that defines away what needs to be explained. This article compares the ontology of certain elements of the Puritan and Confucian worldviews, and, by focusing on the role of both (...) authority and activity in these systems, assesses (with the assistance of Max Weber) the theories of harmony that each invoke. It concludes by identifying the distinct options that these two modes of human existence suggest for those who wish to defend the relevance of boundedness and authority, and thus the very possibility of a human-scaled politics, in today’s world. (shrink)

Historically, living was divided from dead, inert matter by its autonomous activity. Today, a number of materials not themselves alive are characterized as having inherent activity, and this activity has become the subject of a hot new field of physics, “Active Matter”, or “Soft matter become alive.” For active matter scientists, the relation of physics to biology is guaranteed in one direction by the assertion that the cell is a material, and hence its study can be considered a branch of (...) material science, and in the other direction, by the claim that the physical dynamics of this material IS what brings the cell to life, and therefore its study is a proper branch of biology. I will examine these claims in relation to the concerns of nineteenth century scientists on the one hand, and on the other, in relation to future prospects of the division between animate and inanimate. -/- . (shrink)

Throughout the history of molecular biology, the primary meaning of biological information has been taken from the image of a word-based linguistic code. I want to argue that the metaphor of such a code does not begin to capture either the variety or the richness of the processes by which nucleotide sequences inform biological processes. Current research demonstrates that nucleotide sequences inform not only development but also heredity and evolution, and they do so in all sorts of ways. Even though (...) they do not exhaust the varieties of biological information employed in these processes, I claim that the power of DNA sequences to inform these processes is richer and perhaps far greater than the conventional understanding of genetic information permits, indeed richer than what any of our images of simple linguistic codes or of senders and receivers permits. Rather than a tape in a Turing machine or a message or signal sent through the generations, DNA is first and foremost a physicochemical structure with a range of potential uses by the physicochemical arsenal of biological cells that is so large as to expose the poverty of our most familiar metaphors. Recognition of this fact leads us to conclude that DNA is both more and less than we thought—more because it carries both symbolic and non-symbolic information and less because accepting that fact undermines its radical distinction from other biological molecules. (shrink)

This book discusses the role of the trickster figure in contemporary film against the cultural imperatives and social issues of modernity and postmodernity, and argues that cinematic tricksters always reflect psychological, economic and social change in society. It covers a range of films, from Charlie Chaplin’s classics such as _Modern Times_ and _The Great Dictator_ to contemporary comedies and dramas with ‘trickster actors’ such as Jim Carrey, Sacha Baron-Cohen, Andy Kaufman and Jack Nicholson. _The Trickster in Contemporary Film_ offers a (...) fresh perspective on the trickster figure not only in cinema but in Western culture in general. Alongside original film analyses, it touches upon a number of psychosocial issues including sovereignty of the individual, tricksterish qualities of the media, and human relationships in the mercurial digital age. Further topics of discussion include: common motifs in trickster narratives the trickster and personal relationships gonzo-trickster and the art of comic insurrection. Employing a number of complementary approaches such as Jungian psychology, film semiotics, narrative structure theories, Victor Turner’s concept of liminality and Mikhail Bakhtin’s theory of the carnivalesque, this book is essential reading for students and scholars of film, as well as anyone with an interest in analytical psychology and wider critical issues in contemporary culture. (shrink)

As evaluation of practitioners’ competence is largely based on self-report, accuracy in practitioners’ self-assessment is essential for ensuring high quality treatment-delivery. The aim of this study was to assess the relationship between independent observers’ ratings and practitioners’ self-reported treatment integrity ratings of Motivational interviewing. Practitioners were randomized to two types of supervision [i.e., regular institutional group supervision, or individual telephone supervision based on the MI Treatment Integrity code]. The mean age was 43.2 years, and 62.7 percent were females. All sessions (...) were recorded and evaluated with the MITI, and the MI skills were self-assessed with a questionnaire over a period of 12 months. The associations between self-reported and objectively assessed MI skills were overall weak, but increased slightly from baseline to the 12-months assessment. However, the self-ratings from the group that received monthly objective feedback were not more accurate than those participating in regular group supervision. These results expand findings from previous studies and have important implications for assessment of practitioners’ treatment fidelity: Practitioners may learn to improve the accuracy of self-assessment of competence, but to ensure that patients receive intended care, adherence and competence should be assessed objectively. (shrink)

In the Euthydemus, Socrates is presented as an eager student of seemingly trivial arts, earning derision both for desiring to master the peculiar art of Euthydemus and Dionysodorus and for studying the harp in his old age. I explain Socrates’ interest in these apparently trivial arts by way of a novel reading of the first protreptic argument, suggesting that the wisdom Socrates praises is complex in nature, securing the happiness of its possessor only insofar as it is composed of both (...) ordinary productive knowledge and ethically productive knowledge. This reading of the first protreptic makes sense of the otherwise perplexing second protreptic, explaining why Socrates is so keen to identify an art which makes what it uses. Wisdom acts as a reliable source of benefit only insofar as it is a complex composed of multiple different arts and types of knowledge. These arts, however, can only be acquired one at a time – if no single art is capable of combining the powers of both ordinary productive knowledge and ethically productive knowledge in the way that wisdom as a whole does, then the pursuit of wisdom will fail to offer reliable benefit despite the reliably beneficial nature of its possession. Thus, it is appropriate for the Euthydemus to conclude with Socrates telling Crito to take courage and pursue philosophy despite the seemingly harmful effects that its pursuit has had on others. Euthydemus and Dionysodorus represent the danger facing the aspiring philosopher, the possibility of being ruined by independent possession of the particular kind of ordinary productive knowledge on which philosophical activity depends – verbal mastery, the grasp of subtle conceptual distinctions needed both to argumentatively reveal reality and to argumentatively obscure it, to reliably equivocate and to reliably avoid equivocation. (shrink)

This study documents and characterizes a phenomenon in naturally‐occurring conversation which I have termed interactional reconstruction. Interactional reconstruction involves retroactive reinterpretation of an earlier utterance (or set of utterances) on the basis of a more recent utterance (or set of utterances). This work is meant to serve two functions: first, to enrich our theories of human communication; and second, to explore directions and implications for theories of meaning and discourse modeling within cognitive science.

The purpose of this study was to compare breast cancer patients' perceived partici pation in their own care with nurses' perceptions of such participation. Both groups reported that patients are able and willing to take part in their own care more actively than allowed under the present health care system. Nurses also reported that they do provide patients with opportunities for participation.

Semi-Post algebras have been introduced and investigated in [6]. This paper is devoted to semi-Post subalgebras and homomorphisms. Characterization of semi-Post subalgebras and homomorphisms, relationships between subalgebras and homomorphisms of semi-Post algebras and of generalized Post algebras are examined.

O objetivo do presente artigo é propor uma interpretação da filosofia sartriana para pensar o nossoatual contexto de isolamento, pandemia e agravamento de diferentes crises. Pretendo fazer isso pormeio de dois conceitos cunhados a partir do exame das obras Bariona, Cahiers pour une morale eCritique de la raison dialectique, são eles: esperança existencialista e solidariedade construída.

O objetivo do presente artigo é apresentar uma proposta de método de pesquisa da filosofia de Jean-Paul Sartre que considera como parte da manifestação do seu pensamento também as obras ficcionais de literatura e teatro e não somente as obras teóricas. Com o método de pesquisa que privilegia a perspectiva de conjunto da obra procuro demonstrar os ganhos teóricos e conceituais e a profundidade de discussão possíveis se nos dedicarmos a compreender como o pensamento sartriano acontece também pelas vias da (...) literatura e do teatro. Para isso, o texto promove a reflexão em torno das relações entre Filosofia e Literatura ao longo da produção sartriana, rebatendo a interpretação tradicional de que as obras ficcionais de Sartre são pièces à these, i. é, de que a ficção funcionaria como uma exemplificação para a filosofia.AbstractThe aim of this article is to present a proposal of a method of research of the philosophy of Jean-Paul Sartre. This method considers as part of the manifestation of his thought also the fictional works of literature and theater and not only the theoretical works. With the method of research that privileges the perspective of the entire work I will try to show the theoretical and conceptual gains and the depth of discussion possible if we try to understand how the Sartrian thought also manifests through the paths of literature and theater. For this, this paper wants to promote the reflection on the relations between Philosophy and Literature throughout the Sartrian work, debating the traditional interpretation about the fictional works as pièces à these, ie, that fictional work should be seen as an exemplification for philosophy. (shrink)

RESUME Jean-Paul Sartre débute comme dramaturge durant la Seconde Guerre mondiale alors qu'il est prisonnier de guerre en Allemagne, dans un camp de 25.000 détenus. Durant sa captivité, le philosophe écrit une pièce de théâtre réunissant des victimes et leurs bourreaux, des juifs, des prisonniers et des allemands. Bariona est la toute première pièce de Sartre et elle restera une référence pour le théâtre de situations que l'auteur ne cessera de réaliser pendant toute sa vie. Traditionnellement la pensée sartrienne est (...) analysée, dans un premier temps, sous le prisme de la philosophie abstraite et individualiste dont L'être et le néant est l'expression fondamentale, puis, dans un second temps, après la Seconde Guerre mondiale, à travers le marxisme dont la Critique de la raison dialectique serait le principal ouvrage. L'objectif essentiel de cet article est de mettre à l'épreuve cette idée en analysant les concepts de l'homme seul et de la collectivité dans la première pièce dramaturgique de Sartre. On verra que l'interprétation que divise la pensée de Sartre en deux n'est pas si juste. RESUMO Jean-Paul Sartre estreia como dramaturgo durante a Segunda Guerra Mundial, quando é feito prisioneiro de guerra na Alemanha em um campo de concentração com outras 25 mil pessoas. Durante seu cárcere, o filósofo escreve uma peça de teatro reunindo vítimas e seus algozes, judeus e alemães. Bariona é a primeira peça de Sartre e permanecerá a referência do teatro de situações que o autor continuará a perseguir por toda a vida. Tradicionalmente, o pensamento sartriano é considerado, em um primeiro momento, sob o prisma da filosofia abstrata e individualista, que teria na obra O ser e o nada a expressão fundamental; em seguida, em um segundo momento, depois da Segunda Guerra Mundial, o é por meio do marxismo, do qual a Crítica da razão dialética seria a obra principal. O objetivo fundamental do presente artigo é o de colocar à prova essa ideia, analisando os conceitos de homem solitário e de coletividade na primeira peça de teatro de Sartre. Veremos que a interpretação que divide o pensamento de Sartre em dois não é, com efeito, justa. (shrink)

This paper brings a developmental perspective to the discussion of a longstanding issue surrounding the proper characterization of presuppositions. On an influential view (Stalnaker in Synthese 22(1–2):272–289, 1970; Stalnaker, in Milton, Unger (eds) Semantics and philosophy, New York University Press, New York, 1974; Karttunen in Theor Linguist 1:181–194, 1974), formal presuppositions reflect admittance conditions: an utterance of a sentence which presupposes _p_ is admitted by a conversational context _c_ only if _p_ is common ground in _c_. The theory distinguishes two (...) modes of satisfying this formal requirement: (i) presuppositions may have common ground status prior to utterance, or (ii) they may achieve common ground status post hoc, via accommodation, an adjustment of the common ground by cooperative listeners so as to meet the requirements of an uttered sentence. While intuitive and general, the theory has been criticized (among other things) on methodological grounds (see e.g. Gazdar in Pragmatics: implicature, presupposition and logical form, Academic Press, New York, 1979): the availability of accommodation makes it difficult to empirically examine the notion of presupposition as admittance conditions because a central tenet—pragmatic infelicity results whenever _c_ does not entail _p_—may be masked due to the pragmatic sophistication of language users. In this paper, we argue that child language presents an opportunity to avoid this intrinsic difficulty. In a series of behavioral experiments, we show that young children generate a default expectation that the presuppositions of an asserted sentence have common ground status prior to utterance. Furthermore and more tellingly, we also find that even when accommodation is the preferred option for adults, children fail to accommodate presuppositions in an adult-like manner. This pattern of behavior, we argue, is expected under the admittance theory: in a population where the interference from accommodation is reduced, the impact of failing to satisfy the formal admittance conditions becomes directly observable. (shrink)

Intensional logic (IL) and its application to natural language, which the present monograph addresses, was first developed by Richard Montague in the late 1960s (e.g., Montague 1970a, 1970b). Through the efforts of (especially) Barbara Partee (e.g., Partee 1975, 1976), and Richmond Thomason, who edited the posthumous collection of Montague’s works (Thomason 1974), this became the main framework for those who aspired to a formal semantic theory for natural language, and these included computational linguists as early as Jerry Hobbs in the (...) late 1970s (e.g., Hobbs and Rosenschein 1977). In fact, until the advent of the current interest in statistical linguistics with its own conception of what semantics is, IL, or some variant of it, was perhaps the main theory of semantics within computational linguistics generally. And within current computational semantics it still is. But over the years, philosophers, linguists, and computational linguists have noted a variety of shortcomings in Montague’s version of IL. Montague defined intensions as functions from possible worlds to extensions in that world. But this had the effect of making logically equivalent expressions have the same intension, thus leading to the problem of “logical omniscience” (believing/knowing all the logical consequences of what is believed/known). Montague had based his IL on Church’s simple theory of types (Church 1940), supplemented with intensions of each type. But this implies that each natural language item accepts only arguments of some one fixed type. However, this is not true for natural language, where conjunctions, verbs, and pretty much any functional term that accepts arguments at all can accept arguments of different types. (For example, and can accept arguments that are of the sentence type, of the verb phrase type, of the adjective type, etc.; and indeed, it can accept arguments of differing types in its different argument.. (shrink)