Health disparities are primarily driven by structural inequality including systemic racism. Medical educators, led by the AAMC, have tended to minimize these core drivers of health disparities. Ins...

Although ethics is increasingly integrated in the curriculum of U.S. medical schools, it remains not well integrated with system issues, and social and structural contexts of illness. Moreover, ethical analysis is not often taught as a clinical skill. To address these issues, an outcomes driven course in Social Sciences, Humanities, Ethics and Professionalism (SHEP) was created. Within the course, a web-based concept mapping device, SHEP Case Analysis Tool (SCAT), was created which schematizes the structure and flow of clinical cases from (...) diagnosis to treatment options, to shared decision making to outcome, and includes key stakeholders, influences, and structural features of the health system. In the course, each student analyzes a case in which they were directly involved using SCAT and presents their analysis to faculty and peers. This exercise 1) reinforces knowledge-based portions of the course pedagogy, 2) supports meta-cognition and critical thinking through concept mapping, 3) applies multidimensional analysis to identify ethical, social, and system issues that impact patient-care. 4) develops problem solving skills, 5) counters the hidden curriculum/support professional identity formation, and 6) develops skills in reflective discourse. This paper outlines the development and use of this concept mapping case analysis tool in an undergraduate medical education curriculum. (shrink)

Skeletal muscle formation is studied in vitro with myogenic cell lines and primary muscle cell cultures, and in vivo with embryos of several species. We review several of the notable advances obtained from studies of cultured cells, including the recognition of myoblast diversity, isolation of the MyoD family of muscle regulatory factors, and identification of promoter elements required for muscle‐specific gene expression. These studies have led to the ideas that myoblast diversity underlies the formation of the multiple types of fast (...) and slow muscle fibers, and that myogenesis is controlled by a combination of ubiquitous and muscle‐specific transcriptional regulators that may be different for each gene. We further review some unexpected results that have been obtained when ideas from work in culture have been tested in developing animals. The studies in vivo point to additional molecular and cellular mechanisms that regulate muscle formation in the animal. (shrink)

Volume 20, Issue 7, July 2020, Page 112-114.

The health system is, in particular ways, a microcosm of society and both reflects and contributes to its ills of racism, inequities, and disparities. As such, the house of medicine is obligated to...

A MAJOR THESIS OF CONTEMPORARY LIBERAL PHILOSOPHY is that its theory of justice, which incorporates strong rights to negative liberty, must be prior to and independent of a theory of the good. This priority is necessary, according to liberal theorists, in view of the requirement that any adequate theory accommodate a plurality of contending views of the good, no one of which is capable of eliciting public assent to it. Recent critics of liberalism have disputed this thesis, maintaining instead that (...) there is indeed an objective good, rather than a plurality of contending goods, which at least seriously compromises and possibly undermines the negative liberty with which liberals traditionally associated their theories. Variously called communitarians, virtue theorists, or republicans, these critics have presented an important challenge to contemporary liberalism whether of the individualist or welfare state variety. (shrink)

Conservation can occur anywhere regardless of scale, political jurisdiction, or landownership. We present a framework to help managers at protected areas practice conservation at the scale of relationships. We focus on relationships between stakeholders and protected areas and between managers and other stakeholders. We provide a synthesis of key natural resources literature and present a case example to support our premise and recommendations. The purpose is 4-fold: 1) discuss challenges and threats to conservation and protected areas; 2) outline a relationship-scale (...) approach to address conservation threats; 3) describe the tools and techniques that can be used to implement this approach; and 4) present a case example from rural Alaska, USA, to illustrate relationship-scale conservation. Our case example illustrates how aspects of this approach to conservation were applied to address a wildlife population decline. Tools needed to implement relationship-scale conservation include 1) collecting and documenting narratives of place; 2) measuring and monitoring trust and commitment; and 3) identifying and mitigating threats. We recommend that planners and managers, working with their research partners, redefine and refocus their goals and objectives to include these practices. Doing so will enable them to gain substantial applied knowledge about their stakeholders and foster and maintain place relationships as desired outcomes of conservation. The ultimate outcome is a better prognosis for long-term global survival of protected areas and biodiversity. Published 2014. This article is a U.S. Government work and is in the public domain in the USA. (shrink)

The essays in this volume examine the nature of human flourishing and its relationship to a variety of other key concepts in moral theory. Some of them trace the link between flourishing and human nature, asking whether a theory of human nature can allow us to develop an objective list of goods that are of value to all agents, regardless of their individual purposes or aims. Some essays look at the role of friendships or parent-child relationships in a good life, (...) or seek to determine whether an ethical theory based on human flourishing can accommodate concern for others for their own sake. Other essays analyze the function of families or other social-political institutions in promoting the flourishing of individuals. Still others explore the implications of flourishing for political theory, asking whether considerations of human flourishing can help us to derive principles of social justice. (shrink)

In 1988, the control of the American Psychological Association shifted to those advocating the interests of professional practice and a substantial segment of the scientific community in psychology seceded to form the American Psychological Society, devoted to scientific psychology and scientific-based practice. In this climate, it has become increasingly difficult for scientists and practitioners to maintain analytical discussions of the philosophical and methodological issues that divide these two groups. For over 25 years, the authors have been fortunate to have the (...) professional and intellectual luxury of just such a discussion, and present here a dialogue that attempts to capture their initial stark differences in perspective and the process by which differences have been clarified, and areas of agreement established. 2012 APA, all rights reserved). (shrink)

BackgroundPrenatal and early postnatal choline supplementation reduces cognitive and behavioral deficits in animal models of Fetal Alcohol Spectrum Disorder. In a previously published 9-month clinical trial of choline supplementation in children with FASD, we reported that postnatal choline was associated with improved performance on a hippocampal-dependent recognition memory task. The current paper describes the neurophysiological correlates of that memory performance for trial completers.MethodsChildren with FASD who were enrolled in a clinical trial of choline supplementation were followed for 9 months. Delayed (...) recall on a 9-step elicited imitation task served as the behavioral measure of recognition memory. Neurophysiological correlates of memory were assessed via event-related potentials.ResultsDelayed recall on EI was correlated with two ERP components commonly associated with recognition memory in young children: middle latency negative component and positive slow wave. No significant ERP differences were observed between the choline and placebo groups at the conclusion of the trial.ConclusionAlthough the small sample size limits the ability to draw clear conclusions about the treatment effect of choline on ERP, the results suggest a relationship between memory performance and underlying neurophysiological status in FASD. This trial was registered.1. (shrink)

The notion of obligation of what an agent owes to himself, to others, or to society generally occupies a central place in morality. But what are the sources of our moral obligations and what are their limits? To what extent do obligations vary in their stringency and severity, and does it make sense to talk about imperfect obligations, that is, obligations that leave the individual with a broad range of freedom to determine how and when to fulfil them? The twelve (...) essays in this volume address these and other questions and explore related issues. Some of them discuss broad theoretical questions, some essays look at moral reasons for action. Others discuss specific moral obligations or the tensions that may exist between our obligations and our other concerns. (shrink)

These essays explore the history and justification of the welfare state and examine private alternatives to the public provision of aid. Essays focus on the nature of personal responsibility, the impact of identity politics on the welfare state, and the various strategies that have been proposed to deal with the problem of poverty. Others assess the success or failure of public housing, government assistance to veterans, or other specific programmes, suggesting ways of reforming, expanding, or replacing them.

Divisions abound as to whether politics should be held responsible to a higher moral standard or whether pragmatic considerations, or realpolitik, should prevail. The two poles are represented most conspicuously by Aristotle (for whom the proper aim of politics is moral virtue) and Machiavelli (whose prince exalted political pragmatism over morality). The fourteen contributions to this volume address perennial concerns in political and moral theory. They underscore the rekindled yearning of many to hold the political realm to a higher standard (...) despite the skepticism of dissenters who question the likelihood, or even the desirability, of success. (shrink)

A central idea in moral and political philosophy, 'autonomy' is generally understood as some form of self-governance or self-direction. Certain Stoics, modern philosophers such as Spinoza, and most importantly, Immanuel Kant, are among the great philosophers who have offered important insights on the concept. Some theorists analyze autonomy in terms of the self being moved by its higher-order desires. Others argue that autonomy must be understood in terms of acting from reason or from a sense of moral duty independent of (...) the passions. Autonomy seems closely related to the notion of freedom, but in what sense: freedom from coercion, freedom from psychological constraints, or freedom from material necessity? Various approaches to these and similar questions yield different implications for public policy. Is capitalism, social democracy or socialism more favorable to autonomy? The essays in this volume address these important questions. (shrink)

Any comprehensive discussion of property must draw on a range of disciplines - philosophy, politics, economics, and legal theory - and must address a number of fundamental questions: What is the nature of ownership, and should there be limits on the rights that attend it? Should property be held privately or in common, or should some combination of these two types of ownership prevail? To what extent does the legitimacy of a system of property depend on considerations of economic efficiency (...) or distributive justice? The essays in this volume examine these questions, as well as other important issues, from a variety of perspectives. Some explore the theory of original acquisition; others deal with the concept of self-ownership; still others look at legal or constitutional issues. (shrink)

Philosophers since ancient times have pondered how we can know whether moral claims are true or false. The first half of the twentieth century witnessed widespread skepticism concerning the possibility of moral knowledge. Indeed, some argued that moral statements lacked cognitive content altogether, because they were not susceptible to empirical verification. The British philosopher A. J. Ayer contends that 'They are pure expressions of feeling and as such do not come under the category of truth and falsehood. They are unverifiable (...) … because they do not express genuine propositions.' The second half of the twentieth century brought a revival of interest among philosophers in moral and political questions. Whether or not ethics can be founded upon a rational basis continues to preoccupy the philosophical community even now. (shrink)

This collection of essays is dedicated to the memory of the late Harvard philosopher Robert Nozick, who died in 2002. The publication of Nozick's Anarchy, State, and Utopia in 1974 revived serious interest in natural rights liberalism, which, beginning in the latter half of the eighteenth century, had been eclipsed by a succession of antithetical political theories including utilitarianism, progressivism, and various egalitarian and collectivist ideologies. Some of our contributors critique Nozick's political philosophy. Other contributors examine earlier figures in the (...) liberal tradition, most notably John Locke, whose Second Treatise of Government, published in the late seventeenth century, profoundly influenced the American founders. The remaining authors analyze natural rights liberalism's central doctrines. (shrink)

What is a person? What makes me the same person today that I was yesterday or will be tomorrow? Philosophers have long pondered these questions. In Plato's Symposium, Socrates observed that all of us are constantly undergoing change: we experience physical changes to our bodies, as well as changes in our 'manners, customs, opinions, desires, pleasures, pains, [and] fears'. Aristotle theorized that there must be some underlying 'substratum' that remains the same even as we undergo these changes. John Locke rejected (...) Aristotle's view and reformulated the problem of personal identity in his own way: is a person a physical organism that persists through time, or is a person identified by the persistence of psychological states, by memory? These essays - written by prominent philosophers and legal and economic theorists - offer valuable insights into the nature of personal identity and its implications for morality and public policy. (shrink)

Recent and ongoing developments in science and technology - such as the prevention and treatment of disease through genetics and the development of increasingly sophisticated computer systems with wide-ranging applications - hold out the promise of vastly improving the quality of human life, but they can also raise serious ethical, legal, and public policy questions. The thirteen essays in this volume address these questions and related issues from a variety of perspectives. Written by prominent philosophers, economists, and legal theorists, these (...) essays offer valuable insights into the nature of scientific innovation and its implications for our social policies and practices. (shrink)

The essays in this volume examine the nature of human flourishing and its relationship to a variety of other key concepts in moral theory. Some of them trace the link between flourishing and human nature, asking whether a theory of human nature can allow us to develop an objective list of goods that are of value to all agents, regardless of their individual purposes or aims. Some essays look at the role of friendships or parent-child relationships in a good life, (...) or seek to determine whether an ethical theory based on human flourishing can accommodate concern for others for their own sake. Other essays analyze the function of families or other social-political institutions in promoting the flourishing of individuals. Still others explore the implications of flourishing for political theory, asking whether considerations of human flourishing can help us to derive principles of social justice. (shrink)

In this collection, thirteen prominent philosophers and political scientists address the nature of liberalism, its origins, and its meaning and proper interpretation. Some essays examine the writings of liberalism's earliest defenders, like John Locke and Adam Smith, or the influence of classical liberalism on the American founders. Some focus on the Progressive movement and the rise of the administrative state, while others defend particular conceptions of liberalism or examine liberal theories of justice, including those of John Rawls and Robert Nozick. (...) Several essays discuss the U.S. Constitution, seeking to determine whether it is best viewed as empowering the federal government to achieve certain ends, or as strictly limiting its power to ensure the broadest freedom for individuals to pursue their own ends. Other essays address the limits of economic freedom or focus on the nature and extent of property rights and the government's power of eminent domain. (shrink)

What is the good life? This question captured the attention of ancient philosophers and it remains with us today, because it compels us to consider what it is to be human. To inquire about the good life is to ask, not about the proper conduct in one specific situation, but about the proper course of an entire life. It is to ask what we ought to make of ourselves as moral beings, what standards we ought to follow, and what goals (...) we ought to aspire to. But does it make sense to talk about the good life or the human good, or are there many human goods and many ways of living a good life? If there are many goods, then ow are they related, and how are we to determine whether one good outweighs another? Does living one's own life well leave room for concern for the well-being of others? Are there other non-moral concerns that may sometimes take precedence over living a good life? These are a few of the questions that will be addressed by the essays in this issue. (shrink)

These essays represent the latest research of a number of prominent political theorists. The essays explore the role of government, the nature of public discourse and the obligations of citizens. Some examine the sources of our need for government, asking what form of government we should establish and whether a single form can be suitable for all societies. Some seek to discover the proper aims of government - asking, for example, whether government should promote equality among its citizens or whether (...) it should allow inequalities in the hope of raising everyone's level of well-being. Others explore government's role in ensuring citizens' autonomy and in protecting their rights to pursue their own interests and projects. Still others examine the processes through which policies are formulated and debated, asking what forms of public deliberation are likely to produce the best results. (shrink)

Philosophers since ancient times have pondered how we can know whether moral claims are true or false. The first half of the twentieth century witnessed widespread skepticism concerning the possibility of moral knowledge. Indeed, some argued that moral statements lacked cognitive content altogether, because they were not susceptible to empirical verification. The British philosopher A. J. Ayer contends that 'They are pure expressions of feeling and as such do not come under the category of truth and falsehood. They are unverifiable (...) ... because they do not express genuine propositions.' The second half of the twentieth century brought a revival of interest among philosophers in moral and political questions. Whether or not ethics can be founded upon a rational basis continues to preoccupy the philosophical community even now. (shrink)

The Securities and Exchange Commission requires publicly held US corporations to disclose all information, whether it is positive or negative, that might be relevant to an investor's decision to buy, sell, or hold a company's securities. The decisions made by corporate managers to disclose such information can significantly affect the judgments and decisions of investors. This paper examines academic accounting research on corporate managers' voluntary disclosures of earnings forecasts and non-GAAP earnings measures. Much of the evidence from this research indicates (...) that some managers engage in opportunistic disclosure behavior that often benefits one group (managers and shareholders) at the expense of other groups (often other investors). The paper concludes by discussing the ethical implications of this behavior. (shrink)

A central idea in moral and political philosophy, 'autonomy' is generally understood as some form of self-governance or self-direction. Certain Stoics, modern philosophers such as Spinoza, and most importantly, Immanuel Kant, are among the great philosophers who have offered important insights on the concept. Some theorists analyze autonomy in terms of the self being moved by its higher-order desires. Others argue that autonomy must be understood in terms of acting from reason or from a sense of moral duty independent of (...) the passions. Autonomy seems closely related to the notion of freedom, but in what sense: freedom from coercion, freedom from psychological constraints, or freedom from material necessity? Various approaches to these and similar questions yield different implications for public policy. Is capitalism, social democracy or socialism more favorable to autonomy? The essays in this volume address these important questions. (shrink)

The thirteen essays in this volume approach the liberal-communitarian debate from a variety of perspectives. Some discuss disagreements between liberals and communitarians over the nature of moral agency and the proper functions of government. Some examine alternative ways of conceiving liberalism or community, or challenge widely held beliefs about the harmful effects of capitalism on community, or about the value of traditional practices as guides to judicial reasoning. Other essays seek to determine whether it makes sense to think of societies (...) as having and pursuing a common good, or whether culturally diverse societies can ever hope to achieve social unity. Still others examine the role of states in promoting citizens' civic education and their participation in the voluntary associations and institutions of civil society. (shrink)

What constitutes a just tax system, and what are its moral foundations? Should a society's tax regime be designed to achieve a just distribution of wealth among its citizens, or should such a regime be designed to promote economic growth, rising standards of living, and increasing levels of employment? Are these two goals compatible or incompatible? Why should justice not require, or at least lead to, an increase in general prosperity? The essays in this volume examine the history of tax (...) policies and the normative principles that have informed the selection of various types of taxes and tax regimes; economic data to discover which tax policies lead to economic growth; particular theories of justice or property rights regarding the design of tax systems; and other essays propose specific tax reforms. Still others challenge traditional theories of taxation, offering new ways of understanding the fiscal relationship between governments and their citizens. (shrink)

Confronting crucial and difficult issues, the ten authors whose essays appear in this volume offer fresh perspectives on the nature and value of altruism. This collection of essays on moral philosophy deal with the balance to be struck between egoism and altruism - that is, between pursuing one's own interests and serving the interest of others - and with related issues. Contributions examine the relationship between altruism and rationality; consider cases in which one's personal needs and goals may legitimately be (...) given priority over the needs of others; question whether, and under what conditions, we may properly be forced to serve others' interests; and examine the role government should play in regulating our interactions. (shrink)

Modern industrial societies have achieved a level of economic prosperity undreamed of in earlier times, but in the view of the contemporary environmental movement, the prosperity has come at the cost of serious degradations to the natural world. For environmental advocates, problems such as resource depletion, air and water pollution, global warming and the loss of biodiversity represent due threats to the well-being of human societies and the planet itself. But just how serious are these threats and how should we (...) go about confronting them? Do environmental problems call for more extensive government controls over industrial activity, energy policy and the like, or is it possible to find solutions by harnessing the incentives of the free market? The essays in this collection address these questions and explore related issues. (shrink)

Technological innovations and social developments have led to dramatic changes in the practice of medicine and in the way that scientists conduct medical research. Change has brought beneficial consequences, yet these gains have come at a cost, for many modern medical practices raise troubling ethical questions: Should life be sustained mechanically when the brain's functions have ceased? Should potential parents be permitted to manipulate the genetic characteristics of their embryos? Should society ration medical care to control costs? Should fetal stem (...) cells be experimented upon in an effort to eventually palliate or cure debilitating diseases? Bioethicists analyze and assess moral dilemmas raised by medical research and innovative treatments; they also counsel healthcare practitioners, patients, and their families. In this anthology, fifteen philosophers, social scientists, and academic lawyers assess various aspects of this field. (shrink)

Whether free speech is defended as a fundamental right that inheres in each individual, or as a guarantee that all of society's members will have a voice in democratic decision-making, the central role of expressive freedom in liberating the human spirit is undeniable. Freedom of expression will, as the essays in this volume illuminate, encounter new and continuing controversies in the twenty-first century. Advances in digital technology raise pressing questions regarding freedom of speech and, with it, intellectual property and privacy (...) rights. Campaign finance reform limits the formerly sacrosanct category of 'political speech'. Expressive liberties may face their greatest challenge from government efforts to thwart terrorism. The twelve legal scholars and philosophers whose work appears in this volume examine the history of free speech doctrine, its relevance to other social and personal values, and the radical critiques it has withstood in recent years. (shrink)

Since the end of the Cold War, there has been increasing interest in the global dimensions of a host of public policy issues - issues involving war and peace, terrorism, international law, regulation of commerce, environmental protection, and disparities of wealth, income, and access to medical care. Especially pressing is the question of whether it is possible to formulate principles of justice that are valid not merely within a single society but across national borders. The thirteen essays in this volume (...) explore a range of issues that are central to contemporary discussions of global politics. Written by prominent philosophers, political scientists, economists, and legal theorists, they offer valuable contributions to current debates over the nature of justice and its implications for the development of international law and international institutions. (shrink)

What are the core values of liberalism and how can they best be promoted? Liberals in the classical tradition championed individual freedom, limited government and a capitalist economic system with strong rights to private property. Contemporary liberals, in contrast, embrace more egalitarian values and allow for a far more prominent role for government intervention in the market to reduce inequality, redistribute wealth and regulate economic activity. What accounts for these very disparate liberal views of property rights and economic freedom? How (...) should we understand the transition from the classical view of liberalism to its more egalitarian modern version? And what, ideally, should the relationship be between the central values of liberalism and the economic institutions of capitalism? The eleven essays in this volume address these questions and examine related issues. (shrink)

In 1776, the American Declaration of Independence appealed to "the Laws of nature and of Nature's God" and affirmed "these Truths to be self-evident, that all Men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the Pursuit of Happiness...." In 1935, John Dewey, professor of philosophy at Columbia University, declared, "Natural rights and natural liberties exist only in the kingdom of mythological social zoology." These opposing pronouncements on (...) natural rights represent two separate and antithetical American political traditions: natural rights individualism, the original Lockean tradition of the Founding; and Progressivism, the collectivist reaction to individualism which arose initially in the newly established universities in the decades following the Civil War. (shrink)

The institution of private property lies at the heart of contemporary Western societies. However, what are the limits of property ownership? Do principles of justice require some measure of governmental redistribution of property in order to relieve poverty or to promote greater equality among citizens? And what do principles of justice have to say about individuals' ownership of their own talents and the products of their labor, and about the initial acquisition of land and natural resources? The essays in this (...) volume, written by eleven prominent political and moral philosophers, address these questions and explore related issues. A number of them consider the theoretical foundations of property ownership, asking how the rights of individuals to acquire property can be justified, and how extensive these rights are. Some focus on the concept of self-ownership, discussing how the individual's right to control their own mind, body and actions relates to their right to gain control over extrapersonal objects and resources. Others look at connections between property ownership and various values, including democratic political participation and equality of wealth and opportunity. (shrink)

These essays assess market liberal or libertarian political theory. They provide insights into the limits of government, develop market-oriented solutions to pressing social problems, and explore some defects in traditional libertarian theory and practice. Some of the essays deal with crucial theoretical issues, asking whether the promotion of citizens' welfare can serve as the justification for the establishment of government, or inquiring into the constraints on individual behavior that exist in a liberal social order. Some essays explore market liberal or (...) libertarian positions on specific public policy issues, such as affirmative action, ownership of the airwaves, the provision of healthcare, or the regulation of food and drugs. Other essays look at property rights, the morality of profit-making, or the provision of public goods. Still others address libertarianism as a political movement, suggesting ways in which libertarians can reach out to those who do not share their views. (shrink)

The essays in this volume address questions about responsibility that arise in moral philosophy and legal theory. Some analyse different theories of causality, asking which theory offers the best account of human agency and the most satisfactory resolution of troubling controversies about free will and determinism. Some essays look at responsibility in the legal realm, seeking to determine how the law should assign liability for negligence, or whether the courts should allow defendants to offer excuses for their wrongdoing or to (...) claim some form of 'diminished responsibility'. Other essays explore libertarian views about political freedom and accountability, asking whether libertarian positions on consent, contract law, and responsibility are consistent, or whether restitution is superior to retribution or deterrence as a basis for a theory of corrective justice. Still others examine the notion of partial or divided responsibility, or the relationship between responsibility and the emotions. (shrink)

The essays in this volume--written by prominent philosophers, political scientists, and legal scholars--address these questions and explore related issues.