Patient noncompliance with physician prescriptions, especially in nonsymptomatic chronic diseases, is frequently characterized in the literature as harmful and economically costly (Miller 1997).1 Nancy Houston Miller views patient noncompliance as harmful because noncompliance can result in continued or new health problems leading to hospital admissions. Further, she places the annual monetary cost of noncompliance at $100 billion.Patient noncompliance with prescribed treatment is considered the least understood form of health behavior (Coons 2001). Despite the plethora of attention in journal articles, the (...) issue of noncompliance remains unresolved even in terms of understanding the main correlates to .. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Invention of Greek Ethnography from Homer to Herodotusby Joseph E. SkinnerRebecca F. KennedyJ osephE. S kinner. The Invention of Greek Ethnography from Homer to Herodotus. Greeks Overseas. Oxford: Oxford University Press, 2012. xii + 343 pp. Numerous black-and-white figs. Cloth, $85.In his welcome book on the invention of ethnography, Skinner challenges the focus in mainstream scholarship on the Greek prose genre that was first defined by (...) Jacoby in his influential Die Fragmente der griechischen Historiker(discussed in detail, 30–34) and on a notion that the “Greekness” the genre embodies was [End Page 287]supposedly invented in the fifth century as a response to the Persian wars. Skinner also advocates a break from the structuralist frameworks favored by scholars such as F. Hartog and E. Hall. Thus, the book has two distinct focuses. First, Skinner seeks to demonstrate that the origins of the prose genre can be found in other literary genres, sub-literary engagements, and material artifacts that should be considered as part of the “thought-world from which the early prose accounts emerged” (17). Second, Skinner shows that structuralist binaries are not the best method for understanding ethnographic thinking and frames his study instead with the discourse theories found in the works of historian J. Clifford and anthropologist/sociologist P. Bourdieu that emphasize “practice” and process. Skinner argues that the genre of Greek ethnography is not synonymous with the practice of Greek identity nor can any functional, homogenous Greek identity claim to be embedded within the genre (18). Rather, he emphasizes the “ethnographic concerns” of the Greeks and attempts to contextualize the emergence of the prose genre by exploring evidence of ethnographic “practice” in the material of everyday life. Ethnographic thought is further defined as positioning in relation to both non-Greeks and other Greeks. Although the title of the book suggests that the timeframe of the study includes evidence from Homer down to the time of Herodotus’ Histories(ca. 430 b.c.e.), most of the evidence he musters comes from the archaic period with occasional recourse to Pindar and the historical fragments of the post–Persian war period. This fits in with a secondary aim of the book to show that the Persian wars did not serve as the impetus for ethnographic thinking or for the emergence of a notion of “Greekness,” a position emphasized most vigorously by J. Hall.Chapter 1 is a long and dense explanation of Skinner’s theoretical approach and the debates among which Skinner situates his study. Despite a number of scholarly efforts over the last decade or so in rethinking identity and ethnicity in antiquity, it is still necessary to combat the ghosts of Jacoby and the structuralists, and Skinner musters a theoretically equipped army for the battle. He finds inherently problematic Jacoby’s “invention” of genres and our adherence to them (a legacy from the earlier academic enterprise, especially in Germany, of prioritizing and ranking ancient cultures based on their “firsts”). Structuralist views are represented by Edith Hall’s Inventing the Barbarian(Oxford 1989), one of the most influential voices in the study of ancient ethnicity. Although she is prominent throughout the book, Skinner ironically never addresses the fact that Hall’s own evidence is the performative, public practice of Athenian drama. Hall herself, although a structuralist, reflects in choice of evidence the type of discursive practice Skinner himself wishes to invoke (in fact, he entirely excludes drama from his evidence). Skinner’s theoretical apparatus is complex and rarely appears explicitly in later chapters (except in the conclusion).In “Populating the Imaginaire” (chap. 2), Skinner catalogues some foreign and/or mythical peoples whom the Greeks deployed in their texts and art as part of their process of self-identification. The peoples discussed are, as Skinner admits, selective, but I could not find a principle behind the selection. The discussion of the Cyclopes is restricted to Homer, and the Arimaspians make a brief appearance. [End Page 288]The Scythians, Amazons, Lydians, Egyptians, and Ethiopians receive extensive treatment in text and iconography (although his presentation of Archaic literary representations of Thrace is slightly abbreviated). Also included are the Pelasgians and peoples of... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 10.1 (2000) 103-108 [Access article in PDF] Letters "Small Sacrifices" in Stem Cell Research Madam: I agree with Professors McGee and Caplan (in their article "The Ethics and Politics of Small Sacrifices in Stem Cell Research," KIEJ, June 1999) that the question of the nature and status of the source of stem cells must be addressed. However, in their eagerness to convince us (...) of the smallness of the sacrifices, I think the authors use some unfortunate rhetorical devices and move much too quickly over some necessary distinctions.The rhetorical display is unfortunate if the article is intended to be a fair and rational development of an argument--e.g., those who hold a position in opposition to the authors do not argue they "inveigh." The section on the political area of the controversy seems particularly dismissive of other's positions.However, I will focus on just two areas where I think a more nuanced consideration would make the question of the moral legitimacy of the "small sacrifices" of embryos less obvious than the authors' rhetoric would suggest.First, they claim that opponents of such research assume some sort of "super status" for an embryo. The rights generally conceded to born human beings may not be as "weak" as they characterize. But even considering only the "negative right against unwarranted violence," I think the authors misdescribe the situation. Contrary to their assertion, I do not know when "adults and even children are... forced to give life... in the defense or at least interest of the community's highest ideals and most pressing interests" (p. 153). Could they be speaking of capital punishment, justified in the name of protecting the community? But then why mention children?It is true that not everyone can be guaranteed every means to preserving and enhancing life. But this limitation on positive rights is not a "forced giving." Adults may be compelled to risk life--e.g. in a draft for the sake of a war. But, again, the more or less justifiable imposition of a risk is not the same as selecting out one particular individual or class to be directly killed. Neither adults nor born children are compelled to be killed for the sake of organ "donation," even if a greater number might be saved. If one grants equivalent status to the embryo (as the authors seem to do here for the sake of argument), opponents do not have to claim a "super status" for embryos, just the ordinary human right not to be killed even for "compassionate" motives.A second area where I think the authors move too quickly is in their impoverished definition of the essential humanity of the early embryo as exhaustively represented by the physical structure of its DNA. The authors seem to recognize [End Page 103] that, ordinarily, there is more to personhood than sheer physical structure. For example, they mention memories and habits (p. 154). They could also speak of relationships, attitudes, and the like. Since an early embryo has no such components of personality as we experience it, the authors hold that its identity could only be contained in its DNA. Since this DNA is preserved, even spread far and wide, by the use of stem cells, it almost seems as if we are doing the early embryo a favor by breaking it up.However, just because the embryo does not have any conscious memories or other attributes of character or personality, that does not mean its identity is constituted only by its physical structure described statically. The early embryo is not just a bundle of discrete structures, and its DNA is not just an inert lump made up of certain smaller lumps. Both the embryo and its DNA are active. Thus the identity of even an early embryo includes both its current processes and the innate potential for further activity and development. Although lacking a conscious will, the early embryo is already in a sense an agent, already doing things--growing, changing, and heading toward something that... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Aelius Théon: ProgymnasmataGeorge A. KennedyMichel Patillon, ed., avec l'assistance pour l'Arménien de Giancarlo Bolognesi. Aelius Théon: Progymnasmata. Paris: Les Belles Lettres, 1997. clvii + 229 pp. ( 1-120 double). Price not stated. (Editions Budé)Progymnasmata, handbooks of preliminary exercises in composition, are important sources for understanding Greek and Roman education and rhetoric and equally important in that the exercises they describe, including narrative, [End Page 476]fable, chria, encomium, ekphrasis, (...) synkrisis, prosopopoeia, and others, provided topics for literary genres in prose and poetry. Of the four surviving Greek treatises on progymnasmata, by or attributed to Theon, Hermogenes, Aphthonius, and Nicolaus, Pseudo-Hermogenes and Aphthonius were the most influential. There are good editions of them by Hugo Rabe and of Nicolaus by Joseph Felton, all in the Teubner series. Theon's work is the earliest treatment and in some ways the most interesting, for it shows the system of rhetorical education in a developing stage and, since it is addressed to teachers rather than to students, it has much to say about pedagogical method. It has, however, been available only in reprints of Leonard Spengel's Rhetores Graeci(II 59-130), originally published in 1854, and in copies of a dissertation by James R. Butts (Claremont Graduate School, 1986). The new Budé Theon, with its lengthy introduction, French translation, and extensive learned notes, at last makes the work accessible to scholars in its full form.The Greek manuscripts of Theon's treatise break off abruptly in the discussion of the exercise for and against a law and lack chapters at the end where Theon discussed reading aloud, listening, paraphrase, elaboration, and contradiction. In addition, the original order of chapters was altered by some editor in late antiquity to conform better to what is found in Pseudo-Hermogenes and Aphthonius. Forty years ago Italo Lana projected a new edition, restoring the original sequence, and published a valuable study of the Greek textual tradition (Turin 1959), but he never completed the edition. The probable reason is that about that time the existence of a full translation of the work into classical Armenian had come to be known from two manuscripts in the State Library in Erivan, Armenia. Butts was aware of the existence of the Armenian translation but had no direct access to the contents.The Armenian translation was made from a Greek text before the rearrangement of the chapters and before the loss of the concluding pedagogical chapters. Patillon, in collaboration with Bolognesi, has reconstructed the Greek text on which the translation was based. It was so literal as to be almost incomprehensible in itself, but by comparison with the Greek in the large part of the work where both survive it has proved possible to reconstruct the Greek original with some probability. Patillon makes much use of this reconstruction throughout his text and apparatus and prints the Armenian text of the otherwise lost chapters, with French translation but without the Greek reconstruction.On the basis of a notice in the SoudaTheon is probably to be identified with Aelius Theon of Alexandria. There is reference in a newly discovered part of the text (Patillon, p. 106) to Dionysius of Halicarnassus, which gives us a date after the first century B.C., and a possible reference to Theon in Quintilian (9.3.76), suggesting Theon may have been writing in the first century after Christ. The name Aelius might indicate a Hadrianic date but probably came into use in Egypt after the prefecture of Aelius Gallus in the Augustan period. [End Page 477]In any event, the work is clearly the earliest of the four major progymnasmatic treatises and has similarities to the Latin discussions of the exercises by Quintilian (1.9) and in Suetonius' De Grammaticis et Rhetoribus.Although there is much that deserves attention in the introduction and notes of this edition, readers will perhaps most want to know about passages where new readings in the Greek make a difference to the meaning and interpretation of passages, and also about the contents of the chapters that survive only in Armenian, here published for the first time. References are to page and line... (shrink)

Approaches to clinical ethics dilemmas that rely on basic principles or rules are difficult to apply because of vagueness and conflict among basic values. In response, casuistry rejects the use of basic values, and specification produces a large set of specified rules that are presumably easily applicable. Balancing is a method employed to weigh the relative importance of different and conflicting values in application. We argue against casuistry and specification, claiming that balancing is superior partly because it most clearly exhibits (...) the reasoning behind moral decision-making. Hence, balancing may be most effective in teaching bioethics to medical professionals. (shrink)

Some bioethicists have argued in favor of a sliding scale notion of competence, paternalistically requiring greater competence in relation to more significant risk. I argue against a sliding scale notion, taking issue with the positions of Allen E. Buchanan and Dan W. Brock, Ian Wilkes, and Joel Feinberg. Rejecting arguments that a sliding scale is supported by legal cases, by ordinary usage, and by fallible judgments about competence, I argue in favor of greater evidence of competence when risk is greater. (...) Two clinical cases are examined, both involving amputation, to show that my fixed concept of competence, with a requirement of clearer evidence of competence when risk is high, better accounts for good moral decisions in bioethics. (shrink)

This is the first book to offer the best essays, articles, and speeches on ethics and intelligence that demonstrate the complex moral dilemmas in intelligence collection, analysis, and operations. Some are recently declassified and never before published, and all are written by authors whose backgrounds are as varied as their insights, including Robert M. Gates, former Director of the Central Intelligence Agency; John P. Langan, the Joseph Cardinal Bernardin Professor of Catholic Social Thought at the Kennedy Institute of (...) Ethics, Georgetown University; and Loch K. Johnson, Regents Professor of Political Science at the University of Georgia and recipient of the Owens Award for contributions to the understanding of U.S. intelligence activities. Creating the foundation for the study of ethics and intelligence by filling in the gap between warfare and philosophy, this is a valuable collection of literature for building an ethical code that is not dependent on any specific agency, department, or country. (shrink)

This article seeks to develop the Marxist conception of social structure by incorporating developments within critical realist philosophy. It rejects forms of economic determinism such as the base-superstructure model and those reconstructions—like Cohen’s—that attribute primacy to productive forces in explaining history and society. It argues instead that society is the product of complex, often contradictory combinations of many different structures and mechanisms. They form a structural ensemble, hierarchically arranged, but where each element has its own dynamics and emergent powers. It (...) concludes that society is best understood through critical realist conceptions of stratification, emergence, transformation, and overdetermination. (shrink)

Self-confidence is associated with many positive outcomes, and training programs routinely seek to build participants’ self-efficacy. In this article, however, we consider whether self-confidence increases unethical behavior. In a series of studies, we explore the relationship between negotiator self-efficacy—an individual’s confidence in his or her negotiation ability—and the use of deception. We find that individuals high in negotiator self-efficacy are more likely to use deception than individuals low in negotiator self-efficacy. We also find that perceptions of the risk of deception (...) mediate this relationship. By identifying negotiator self-efficacy as an antecedent to unethical behavior, our findings offer important theoretical and empirical insights into the use of deception, the role of individual differences in ethical decision making, and the broader consequences of self-confidence in business and society. (shrink)

Prior studies report that the business group structure and the associated intra-group capital flows are prone to conflicts of interest between controlling shareholders and minority investors. Yet business group is a prevalent and stable structure around the globe, particularly where capital markets are underdeveloped. Using data from China, this paper empirically studies the trade-off between the negative and positive roles played by intra-group capital flows and tests the efficiency implications of such trade-off. We find that from the perspective of the (...) whole group, intra-group capital flows are most efficient when the groups are least subject to conflicts of interest between controlling shareholders and minority shareholders and when they face strong external financing constraints. (shrink)

Filmmakers use continuity editing to engender a sense of situational continuity or discontinuity at editing boundaries. The goal of this study was to assess the impact of continuity editing on how people perceive the structure of events in a narrative film and to identify brain networks that are associated with the processing of different types of continuity editing boundaries. Participants viewed a commercially produced film and segmented it into meaningful events, while brain activity was recorded with functional magnetic resonance imaging (...) (MRI). We identified three degrees of continuity that can occur at editing locations: edits that are continuous in space, time, and action; edits that are discontinuous in space or time but continuous in action; and edits that are discontinuous in action as well as space or time. Discontinuities in action had the biggest impact on behavioral event segmentation, and discontinuities in space and time had minor effects. Edits were associated with large transient increases in early visual areas. Spatial-temporal changes and action changes produced strikingly different patterns of transient change, and they provided evidence that specialized mechanisms in higher order perceptual processing regions are engaged to maintain continuity of action in the face of spatiotemporal discontinuities. These results suggest that commercial film editing is shaped to support the comprehension of meaningful events that bridge breaks in low-level visual continuity, and even breaks in continuity of spatial and temporal location. (shrink)

Clinical ethics consultants should show bold moral courage in discharging their duties to patients, families, and healthcare providers. Given the corrosive impact on trust, and on the appropriate d...

Environmental philosophers tend to be particularly wary of the language of “transcendence.” From Heidegger to contemporary feminism, we find the idea that the failure to respect nature is grounded in Platonism and Abrahamic religion. The denial of earth began, we are told, with the separation of the intelligible form from the actual thing, or, even worse, of the creator from the created. From this point of view what we need is a restored pantheistic sense, a new and revitalized paganism. I (...) counter this assertion by a reading of Plato’s Phaedrus that shows that respect itself is grounded in the recognition of transcendence. With the Bookof Job, I maintain that the voice of the transcendent God is what enables Job not only to see past his sufferings but for the first time to encounter the beauty of nature. Overcoming anthropocentrism requires a relationship to transcendence as such. (shrink)

According to agent-based approaches to virtue ethics, the rightness of an action is a function of the motives which prompted that action. If those motives were morally praiseworthy, then the action was right; if they were morally blameworthy, the action was wrong. Many critics find this approach problematically insensitive to an act’s consequences, and claim that agent-basing fails to preserve the intuitive distinction between agent- and act-evaluation. In this article I show how an agent-based account of right action can be (...) made sensitive to an act’s consequences. According to the approach which I defend, an action is right just in case it realizes an agent’s morally praiseworthy motive. Conversely, an action is wrong just in case it realizes a morally blameworthy motive. Specifying act-evaluation in terms of the realization, rather than the expression, of an agent’s motives allows an agent-based approach to distinguish between agent- and act-evaluation. This is because an agent may act from a morally praiseworthy motive, but fail to realize that motive. Her action will therefore not have been the right one, despite its being the expression of morally praiseworthy motives. (shrink)

Susan D. McCammon and Nicole M. Piemonte offer a thoughtful and thorough commentary on our manuscript entitled “Expanding the use of Continuous Sedation Until Death.” In this reply we attempt to clarify and further defend our position. We show how continuous sedation until death is not a “first resort” but rather a legitimate option among many that should available to terminally ill patients whose life expectancy is less than six months. We also attempt to show that we do not equivocate (...) the meaning of palliative care as the commentators suggested. We argue that the traditional notion of palliative care should move beyond relief of “experienced suffering” to relief of potential suffering for those whose life expectancy is less than six months. Lastly, we challenge the commentator’s position that the realm of ordinary medicine” should be the guide to care, by showing how the notion of ordinary medicine has been successfully challenged in both bioethical scholarship and the courts in a way that shows ordinary medicine to be an evolving concept rather than a static, universal guide. (shrink)

Utilitarians take an uncritical attitude toward the sort of individual claims they seek to aggregate. In this way they cannot account for an individual's valid claim against a policy which actually maximizes aggregate satisfaction. We thus claim that utilitarianism properly functions only after conflicting claims have been adjudicated; consequently, Utilitarianism properly maximizes the satisfaction of claims judged to be valid. In such a program, Utilitarianism ceases to be considered a part of ethics, But is seen as maintaining a principle of (...) feasibility and efficiency. Finally, We briefly suggest the methods we believe to be most effective in the resolution of ethical conflict. (shrink)

The philosophical relation between Martin Heidegger and Jean-Paul Sartre is important, partly because of the considerable influence of Heidegger on Sartre, and partly because of their critiques of each other.

The Soviet Union's moderate and creative policy toward Africa's wars of liberation will go far in winning allies in the conflict of capitalistic and socialistic ideologies.

In this paper, I argue that care ethics should be understood as a form of value pluralism. Writers on the ethics of care tend not explicitly to address issues in the theory of value, although much of what has been written about care ethics may be taken to suggest that it endorses some form of value monism. I argue against this conception of care ethics by showing that the practical reality of caregiving is more accurately represented by a pluralist account (...) of value. Practices of care are plausibly guided by a number of distinct and potentially conflicting values. These include quality of life, autonomy, dignity, personal development, and the value of nurturant relationships. Whilst caring takes each of these values to be important in its own right, they are not always jointly realisable, and carers are sometimes forced to promote one such value at the expense of another. The possibility of conflict between values is, of course, precisely what a pluralist conception of value tells us to expect. In this respect, then, value pluralism more faithfully reflects the reality of caregiving than does value monism, and care ethicists ought for this reason to endorse it. (shrink)

In order for a moral theory to support application it must be able to provide determinate answers to actual moral problems or, at the least, to significantly narrow acceptable options. It must also support the development of a genuine consensus, one that is disinterested, reasonable, and unbiased. I argue that theories concentrating on principles, or on rules, or on particular cases fail to meet these standards. A full coherence theory, taking into account principles, rules, practices, and judgments holds the greatest (...) promise for successful application. I present a detailed outline of a full coherence theory that is principled, pluralistic, and comprehensive. This coherence theory includes three basic principles (expressed both negatively and positively), but binds these, in terms of their explication and application, to rules and practices. This theory respects current practices but also directs us to change practices and institutions and even the interpretation of basic moral principles. The theory includes ways to determine which aspect of moral experience should take precedence in given circumstances, ways to determine who has particular obligations, and how — by means of a mutuality principle — value may be enhanced under conditions of value conflict. (shrink)

Available for the first time in English, this is the definitive account of the practice of sexual slavery the Japanese military perpetrated during World War II by the researcher principally responsible for exposing the Japanese government's responsibility for these atrocities. The large scale imprisonment and rape of thousands of women, who were euphemistically called "comfort women" by the Japanese military, first seized public attention in 1991 when three Korean women filed suit in a Toyko District Court stating that they had (...) been forced into sexual servitude and demanding compensation. Since then the comfort stations and their significance have been the subject of ongoing debate and intense activism in Japan, much if it inspired by Yoshimi's investigations. How large a role did the military, and by extension the government, play in setting up and administering these camps? What type of compensation, if any, are the victimized women due? These issues figure prominently in the current Japanese focus on public memory and arguments about the teaching and writing of history and are central to efforts to transform Japanese ways of remembering the war. Yoshimi Yoshiaki provides a wealth of documentation and testimony to prove the existence of some 2,000 centers where as many as 200,000 Korean, Filipina, Taiwanese, Indonesian, Burmese, Dutch, Australian, and some Japanese women were restrained for months and forced to engage in sexual activity with Japanese military personnel. Many of the women were teenagers, some as young as fourteen. To date, the Japanese government has neither admitted responsibility for creating the comfort station system nor given compensation directly to former comfort women. This English edition updates the Japanese edition originally published in 1995 and includes introductions by both the author and the translator placing the story in context for American readers. (shrink)