Backround Education in ethics and professionalism should reflect the realities medical students encounter in the hospital and clinic. Method We performed content analyses on Case Observation and Assessments (COAs) written by third-year medical students about ethical and professional issues encountered during their internal medicine and paediatrics clinical clerkships. Results A cohort of 141 third-year medical students wrote 272 COAs. Content analyses identified 35 subcategories of ethical and professional issues within 7 major domains: decisions regarding treatment (31.4%), communication (21.4%), professional duties (...) (18.4%), justice (9.8%), student-specific issues (5.4%), quality of care (3.8%), and miscellaneous (9.8%). Conclusions Students encountered a wide variety of ethical and professional issues that can be used to guide pre-clinical and clinical education. Comparison of our findings with results from similar studies suggests that the wording of an assignment (specifying “ethical” issues, “professional” issues, or both) may influence the kinds of issues students identify in their experience-based clinical narratives. (shrink)

This book provides practical and research-based chapters that offer greater clarity about the particular kinds of teacher reflection that matter and avoids talking about teacher reflection generically, which implies that all kinds of reflection are of equal value.

Clicks, comments, transactions, and physical movements are being increasingly recorded and analyzed by Big Data processors who use this information to trace the sentiment and activities of markets and voters. While the benefits of Big Data have received considerable attention, it is the potential social costs of practices associated with Big Data that are of interest to us in this paper. Prior research has investigated the impact of Big Data on individual privacy rights, however, there is also growing recognition of (...) its capacity to be mobilized for surveillance purposes. Our paper delineates the underlying issues of privacy and surveillance and presents them as in tension with one another. We postulate that efforts at controlling Big Data may create a trade-off of risks rather than an overall improvement in data protection. We explore this idea in relation to the principles of the European Union’s General Data Protection Regulation as it arguably embodies the new ‘gold standard’ of cyber-laws. We posit that safeguards advocated by the law, anonymization and pseudonymization, while representing effective counter measures to privacy concerns, also incentivize the use, collection, and trade of behavioral and other forms of de-identified data. We consider the legal status of these ownerless forms of data, arguing that data protection techniques such as anonymization and pseudonymization raise significant concerns over the ownership of behavioral data and its potential use in the large-scale modification of activities and choices made both on and offline. (shrink)

In this paper, we reflect on our experience as science and technology studies researchers who were members of the working group that produced A Synthetic Biology Roadmap for the UK in 2012. We explore how this initiative sought to govern an uncertain future and describe how it was successfully used to mobilize public funds for synthetic biology from the UK government. We discuss our attempts to incorporate the insights and sensibilities of STS into the policy process and why we chose (...) to use the concept of responsible research and innovation to do so. We analyze how the roadmapping process, and the final report, narrowed and transformed our contributions to the roadmap. We show how difficult it is for STS researchers to influence policy when our ideas challenge deeply entrenched pervasive assumptions, framings, and narratives about how technological innovation necessarily leads to economic progress, about public reticence as a roadblock to that progress, and about the supposed separation between science and society. We end by reflecting on the constraints under which we were operating from the outset and on the challenges for STS in policy. (shrink)

How does creolization fare as a social-scientific concept? While Jane Gordon seeks to underscore the potential such a concept might have in the social sciences and philosophy, her discussants Gopal Guru, Kipton E. Jensen, Mickaella Perina, and Sundar Sarukkai draw attention to descriptive and normative issues that need to be addressed before arguments formulating and enacting creolization processes can be brought into domains of life from which they have been historically excluded.

The worldwide growth of franchising has been phenomenal during the past decade. At the same time there has been increased media attention to questionable business practices in franchising. Similar to some trade associations and professions, franchising has sought self-regulation by developing codes of conduct or ethics. This study examines the codes of ethics covering franchising activities in 21 countries. The results reveal that there is considerable variation in the activities/issues covered by the codes. Specifically, the codes cover most stages of (...) the franchising relationship, focus on a narrow set of stakeholders, are short on ethical guidance, and offer few enforcement provisions. The implications of these findings for international franchising and research are discussed. (shrink)

ABSTRACTThis is an account of the emancipatory struggle that faces agents who seek to change the oppressive social structures associated with neo-liberalism. We begin by ‘digging amongst the bones’ of the calls for resistance that have been declared dead or assimilated/co-opted by neoliberal theorists. This leads us to unearth, then utilize, Paulo Freire’s Pedagogy of the Oppressed, Steve Biko’s Black Consciousness and Shiv Visvanathan's ideas; which are examples of Roy Bhaskar’s transformative dialectic. We argue, using examples, that cognitive justice – (...) a concept common to each of our chosen theorists – is vital in enabling emancipatory social learning. By embracing cognitive justice, the agents gained confidence, which led to their increased ability to champion community and non-academic knowledge. It also uncovered structural tensions – attendant in neoliberalism – around privilege. By articulating these tensions, the participants were able to ‘come closer together’. Such processes, initiated by ensuring cognitive justice, are possible steps in achieving universal solidarity; which is likely to be a necessary step along the path of achieving emancipation. (shrink)

Breath is invisible and yet ever present and vital for living beings. The concept of invisibility in relation to breath operates in concrete and metaphorical ways to extend ideas about breath and breathlessness across disciplines, in clinical spaces and in life experience. Using a critical medical humanities approach, I demonstrate that the poverty of narrative accounts and language for breath outside the health context have had a crucial influence enabling clinically mediated interpretations and accounts to dominate. These third-person accounts are (...) important in the articulation of the ‘lived body’, but I balance this with a consideration of the subjective sensation of interoception, which has important implications for the visibility of breathlessness in both clinical and lay contexts. This article illustrates the rich potential of the subjects of breath and breathlessness within body studies and this special issue is a key step in making breath such an emergent topic. (shrink)

This article examines changes in men's attitudes toward the family provider role using data from the National Opinion Research Center, General Social Surveys for 1972 through 1989. Men's attitudes have become more egalitarian over this period; however, men approve more of sharing provider-role enactment than of sharing provider-role responsibility. Cohort succession was a more important source of change than change within cohorts. Differences among men in attitudes toward the provider role were associated with differences in men's provider-role experiences, although there (...) was a time lag between change in actual experience and change in attitudes. The findings suggest that structural change in the economy of the family that has changed men's experience as breadwinners is the major force altering gender expectations about family roles. Attitudes among some groups of men, those not directly affected by these changes and married men who gain privileges from the breadwinner status, however, continue to reflect past ideology. (shrink)

Over one-third of the white working class in America vote for Republicans. Some scholars argue that these voters support Republican economic policies, while others argue that these voters’ preferences on cultural and moral issues override their economic preferences. We draw on in-depth interviews with 120 white working-class voters to defend a broadly “economic” interpretation: for this segment of voters, moral and cultural appeals have an economic dimension, because these voters believe certain moral behaviors will help them prosper economically. Even the (...) very word “conservative” is understood as referencing not respect for tradition generally, but avoidance of debt and excessive consumption specifically. For many respondents, the need to focus on morality and personal responsibility as a means of prospering economically—what we call “walking the line”—accords with the rhetoric they associate with Republicans. Deindustrialization may have heightened the appeal of this rhetoric. (shrink)

Many mammals use scent marks to advertise territory ownership, but only recently have we started to understand the complexity of these scent signals and the types of information that they convey. Whilst attention has generally focused on volatile odorants as the main information molecules in scents, studies of the house mouse have now defined a role for a family of proteins termed major urinary proteins (MUPs) which are, of course, involatile. MUPs bind male signalling volatiles and control their release from (...) scent marks. These proteins are also highly polymorphic and the pattern of polymorphic variants provides a stable ownership signal that communicates genome‐derived information on the individual identity of the scent owner. Here we review the interaction between the chemical basis of mouse scents and the dynamics of their competitive scent marking behaviour, demonstrating how it is possible to provide reliable signals of the competitive ability and identity of individual males. BioEssays 26:1288–1298, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

This article argues that Maria Stewart is an underappreciated abolitionist, and a worthy exponent of the Black views of the 1830s. Her work is compared with that of David Walker, Charlotte Forten, and Anna Julia Cooper. A focal point of much of her work is her exhortation to the high moral ground—she remains concerned, throughout her career, about the temptations faced by many during the nineteenth century that might lead them to a non-Christian path. As is the case with Charlotte (...) Forten, who frequently moved for more formal education, Stewart worked ceaselessly to impel Black Americans to a worthy and virtuous life. (shrink)

This paper argues that public sector organizational failure may be best understood from a perspective of collective denial. The rise of this phenomenon is examined using testimony from a Public Inquiry into the downfall of a UK hospital, where falling organizational standards led to unethical decision making and an unacceptable number of patient deaths. In this paper, we show how collective denial, over time, became a process that resided within the fabric of organizational life. To explore the organizational processes associated (...) with collective denial, and how and why it occurs, we identify the influence of a ‘narrative of silence.’ This narrative allows ever more serious failings to be justified as organizational members lose contact with reality entering a downward spiral with no recovery. The combined impact of assumptions about leadership capability, enculturated professional identities, and organizational loyalty create an environment where a narrative of silence can develop. (shrink)

This paper argues that Murdoch’s views possess a structured ontology. As some of her critics note, her philosophical stance is one that must be gleaned from close readings of both her novels and her more straightforward essays. Given the complexities of her novels, the addition of her other work makes for a challenging task, but one that the reader can use. Murdoch’s work is valuable for the range of moral options it displays.

The work of Cox, Bales, Dingwaney, and others is cited in an effort to construct an argument about the special rights violations of contemporary slavery. It is contended that two forms, debt bondage and sexual slavery, are related and bear close examination.

The notion that plants, as well as animals, have a moral status is examined both in general, and with respect to the status of particularly rare plants that may be deemed to be lacking in general instrumentality, such as the Joshua tree. The work of Passmore, Singer and Santos is adduced, and several lines of argument revolving around preservation, sentiency and attractiveness to humans are constructed.

Central to the message of Christianity is the doctrine of suffering as redemptive; therefore, this doctrine must continue to occupy a central place in the discourse about human suffering. Narrative—like suffering itself—has a unique epistemic value and the power to exert a humanizing influence in this discourse. This presentation, though neither strictly systematic nor exhaustive, illustrates narrative’s illuminative capacity in relation to the concepts and propositions that have been part of the discussion of redemptive suffering. Beginning with the present context, (...) it provides justification for the use of narrative, discusses narrative’s place in the Catholic tradition, and then offers three narrative portraits accompanied by brief reflections on the various propositions that each narrative elucidates. (shrink)

The following is a defense of Jurgen Habermas' argumentational consensual procedure against Keith Lehrer and Carl Wagner's weighted averaging consensual procedure (and, I tentatively claim, against any weighted averaging consensual procedure). The argument is twofold: if Lehrer and Wagner intend, implicity, to replace what is for Habermas the metatheoretical stage of a discussion with the aggregation of judgments of respect, then their procedure fails to make use of all available information and the participants are not committed to the weighted average (...) position on these grounds; if, on the other hand, they do not intend to replace metatheoretical discussion by aggregation, then the conditions under which the discussion could conceivably have come to a halt are such as to provide no support for the claim that it is rational to aggregate, rather than to consider the discussion unresolved until more information is available. (shrink)

In mainstream discussion, violent crimes against women frequently are presented as inexplicable and their perpetrators as social deviants. Feminists have argued for an awareness of the sexually political and conformist nature of such crimes and have invented the word gynocide to name the range of systematic violence against women by men. I look at the issues raised by three recent manifestations of gynocide in the United States: the battering of Hedda Nussbaum and murder of Lisa Steinberg by Joel Steinberg, the (...) execution of serial killer Ted Bundy, and a series of murders of “prestigeless” women. (shrink)

The pervasive use of contracts in healthcare is a source of unease for many healthcare ethicists and patient advocates. This commentary examines the use of such contracts with individuals in rehabilitation settings who have complex medical and behavioural issues. The goals of this paper are to examine the many factors that can lead to contract use, to discuss some legal and ethical implications of contract use, and to assess contract use in light of concerns about health equity. The paper concludes (...) with some practical alternatives to the use of such contracts, and refers specifically to tools that might be borrowed from the field of behavioural therapy. (shrink)