Organizational ethics—defined as the alignment of an institution’s practices with its mission, vision, and values—is a growing field in health care not well characterized in empirical literature. To capture the scope and context of organizational ethics work in United States healthcare institutions, we conducted a nationwide convenience survey of ethicists regarding the scope of organizational ethics work, common challenges faced, and the organizational context in which this work is done. In this article, we report substantial variability in the structure of (...) organizational ethics programs and the settings in which it is conducted. Notable findings included disagreement about the activities that comprise organizational ethics and a lack of common metrics used to assess organizational ethics activities. A frequently cited barrier to full engagement in these activities was poor institution-wide understanding about the role and function of organizational ethics resources. These data suggest a tension in the trajectory of organizational ethics’ professionalization: while some variability is appropriate to the field’s relative youth, inadequate attention to definitions of organizational ethics practice and metrics for success can impede discussions about appropriate institutional support, leadership context, and training for practitioners. (shrink)

In September 2010 at the Johns Hopkins Hospital, one of the nation's elite academic hospitals located in East Baltimore, Maryland, Paul Warren Pardus entered the facility to visit his mother, a patient. During a discussion with her doctor in a hospital hallway, Pardus became “overwhelmed” about the care and condition of his mother, pulled a handgun from his waistband, and shot the doctor in the chest. Pardus then locked himself and his mother in her room, shot and killed her, and (...) committed suicide.Dr. Gabe Kelen, a national expert on emergency preparedness and director of the Johns Hopkins emergency department, admitted several years later that this tragic event “really got us thinking in a very serious way.” Together with colleagues at the Johns Hopkins Office of Critical Event Preparedness and Response, Kelen conducted research on the threat and impact of “active shooters” in health care settings. (shrink)

Obesity is the definitive epidemic of the modern era in the United States. Its well-documented public health impacts, especially related to children and adolescents, are horrific. Nearly one-third of American minors are overweight; over 50% of them are obese. Already, these kids suffer from multiple adverse physical and mental health conditions. Sadly, absent serious communal and individual interventions, their lives may be cut short compared to their own parents’ life expectancy. While recent surveillance suggests childhood obesity may be trending down (...) slightly in some populations, public health experts remain concerned about the threat obesity poses to the health of America's youth.The concurrent travesty underlying childhood obesity is the relative societal failure to slow and reverse its spread. (shrink)

Telling Our Lives explores how three working-class women-from Jewish, African-American, and Irish-American backgrounds connect across their differences through storytelling and conversation.

To better understand the available publications addressing ethical issues in rural health care we sought to identify the ethics literature that specifically focuses on rural America. We wanted to determine the extent to which the rural ethics literature was distributed between general commentaries, descriptive summaries of research, and original research publications. We identified 55 publications that specifically and substantively addressed rural health care ethics, published between 1966 and 2004. Only 7 (13%) of these publications were original research articles while (12) (...) 22% were descriptive summaries of research and 36 (65%) were general commentaries. The majority of publications examined (55%) were clinically focused while 27% addressed organizational ethics and 18% addressed ethical ramifications of rural health care policy at a national or community level. Our findings indicate that there are a limited number of publications focusing on rural health care ethics, suggesting a need for scholars and researchers to more rigorously address rural ethics issues. (shrink)

Nelson Goodman argues against those who, like Carnap, claim extensional identity is the criterion for correct constructional definition. Goodman argues that internal logical difficulties sink such a criterion, thus he proposes his own criterion of extensional isomorphism. We argue that Goodman's criterion itself falls prey to his own arguments or else extensional identity is not shown faulty.

Experiences of embodied remembering are familiar and diverse. We settle bodily into familiar chairs or find our way easily round familiar rooms. We inhabit our own kitchens or cars or workspaces effectively and comfortably, and feel disrupted when our habitual and accustomed objects or technologies change or break or are not available. Hearing a particular song can viscerally bring back either one conversation long ago, or just the urge to dance. Some people explicitly use their bodies to record, store, or (...) cue memories. Others can move skilfully, without stopping to think, in complex and changing environments thanks to the cumulative expertise accrued in their history of fighting fires, or dancing, or playing hockey. The forms of memory involved in these cases may be distinct, operating at different timescales and levels, and by way of different mechanisms and media, but they often cooperate in the many contexts of our practices of remembering. (shrink)

In this article we use a hybrid methodology to better understand the skilful performance of sports teams as an exemplar of distributed cognition. We highlight key differences between a team of individual experts and an expert team, and outline the kinds of shared characteristics likely to be found in an expert team. We focus on the way that shared knowledge contributes to expert team performance. In particular, we suggest that certain kinds of shared knowledge and shared skill, potentially developed through (...) a team’s history of playing and training together, facilitate successful coordination. These kinds of shared knowledge and skill may be less developed in a team of experts without a shared history. Exploring the expert performance of sports teams informs our understanding of distributed cognition and collaboration more generally and creates avenues for further philosophical and empirical investigation. (shrink)

The conceptual literature increasingly portrays corporate philanthropy (CP) as an old-fashioned and ineffective operationalization of a firm’s corporate social responsibility. In contrast, empirical research indicates that corporations of all sizes, and both in developed and emerging economies, actively practice CP. This disadvantaged status of the concept, and research, on CP, complicates the advancement of our knowledge about the topic. In a systematic review of the literature containing 122 journal articles on CP, we show that this business practice is loaded with (...) unique characteristics, strengths, and weaknesses, and both conceptual and practical challenges that require renewed attention. We identify six interrelated but distinctive research themes in the literature: concept, motives, determinants, practices, business outcomes, and social outcomes. Dividing the literature on CP into six research themes creates an insightful comprehensive map of this intellectual terrain. Moreover, we distinguish among the level at which CP is analyzed: individual, organizational, institutional, or any combination of these levels. The review reveals significant gaps in the knowledge on CP. Most importantly we find that the conceptualization is limited, the research is mostly quantitative, the effects of CP on society are severely under-researched, and there is a lack of multilevel analyses. A detailed future research agenda is offered, including specific suggestions for research designs and measurements. (shrink)

Being social creatures in a complex world, we do things together. We act jointly. While cooperation, in its broadest sense, can involve merely getting out of each other’s way, or refusing to deceive other people, it is also essential to human nature that it involves more active forms of collaboration and coordination (Tomasello 2009; Sterelny 2012). We collaborate with others in many ordinary activities which, though at times similar to those of other animals, take unique and diverse cultural and psychological (...) forms in human beings. But we also work closely and interactively with each other in more peculiar and flexible practices which are in distinctive ways both species-specific and culturally and historically contingent: from team sports to shared labour, from committee work to mass demonstrations, from dancing to reminiscing together about old times. (shrink)

The study of adhesion plaques in normal and transformed cells provides a series of phenotypic markers by which the process of transformation can be followed. Several proteins which are concentrated in adhesion plaques have now been identified; a few of these can act as targets for tyrosine kinase. In an attempt to characterize the relationship between tyrosine phosphorylation and cell transformation, the reactions of three such proteins – vinculin, talin and integrin – with a range of tyrosine kinase oncogene products (...) have been studied in detail. (shrink)

In biomedicine, practitioners often treat risk of disease as an illness in itself—suitable for monitoring and intervention. In some cases, increased diagnostics improve health outcomes by detecting problems early. Recently, however, science and technology studies scholars and medical practitioners have noted that the treatment of risk can also lead to unnecessary intervention and possible harm. Despite these findings, it is often hard to see changes in practice. Childbirth serves as an illuminating case because two models of health risk operate simultaneously—in (...) addition to the model valuing frequent intervention, there is another that seeks to mitigate risk by refusing medical surveillance. Based on interviews with birth providers and an analysis of professional documents, this article uses the case of fetal heart rate monitoring in American childbirth to demonstrate how some health providers are framing “intentional non-knowing” as a moral imperative to reduce medical risk. Studying the success and limitations of this “risk counterculture” illuminates how risk societies are changing in response to data suggesting that more information can have hurtful effects. This case integrates well-developed theories of knowledge production with less-developed theories of knowledge nonproduction, leading to a more fruitful discussion of the boundaries of responsible knowledge in risk management. (shrink)

In their article “Moral Hazards in Pediatrics” (2016), Brunnquell and Michaelson remind us that the child's perspective is of utmost importance when making health care decisions and express concern...

Tumor suppressor genes represent a broad class of genes that normally function in the negative regulation of cell proliferation. Loss‐of‐function mutations in these genes lead to unrestrained cell proliferation and tumor formation. A fundamental understanding of how tumor suppressor genes regulate cell proliferation and differentiation should reveal important aspects of signalling pathways and cell cycle control. A recent report describing the Drosophila tumor suppressor gene warts has implications in the study of the human myotonic dystrophy gene(1). These genes encode members (...) of a cyclic AMP‐dependent protein kinase subfamily that includes other plant and animal orthologues. (shrink)

Experiences of embodied remembering are familiar and diverse. We settle bodily into familiar chairs or find our way easily round familiar rooms. We inhabit our own kitchens or cars or workspaces effectively and comfortably, and feel disrupted when our habitual and accustomed objects or technologies change or break or are not available. Hearing a particular song can viscerally bring back either one conversation long ago, or just the urge to dance. Some people explicitly use their bodies to record, store, or (...) cue memories. Others can move skilfully, without stopping to think, in complex and changing environments thanks to the cumulative expertise accrued in their history of fighting fires, or dancing, or playing hockey. The forms of memory involved in these cases may be distinct, operating at different timescales and levels, and by way of different mechanisms and media, but they often cooperate in the many contexts of our practices of remembering. (shrink)

The common “human in the loop” narrative in artificial intelligence (AI) implementation is in critical need of analysis and explanation, as Salloch and Eriksen (2024) rightfully argue. Researchers...

This excellent volume from the series Oxford Studies in Philosophy and Literature, edited by Richard Eldridge, does an admirable job of examining Ulysses from a.

Social activism against companies has evolved in the 50 years since Rachel Carson first put the US chemical industry under pressure to halt the indiscriminate use of the chemical DDT. Many more companies have come under the spotlight of activist attention as the agenda social activists address has expanded, provoked in part by the internationalization of business. During the past fifteen years, companies have begun to formulate corporate responsibility (CR) policies and appointed management teams dedicated to CR, resulting in a (...) change in the way companies interact with social activists. This paper presents findings from a longitudinal case study of managerial responses to social activism targeted at a company with relatively well-advanced CR practices and reputation. The case describes the unfolding of the internal processes over an 8-year period, including the role played by different managers and the tensions in the decision-making processes. The findings emphasize how values and beliefs in the company interact with economic arguments and how those are mediated through functions and relationships in the company and beyond. The paper shows how critical managers’ understanding of the motivations of activists behind the campaign is in shaping their actions. It reveals the paradoxical outcomes that can result from social activism at the level of the firm, the industry, and the field. (shrink)

With this third edition of Nelson Goodman's The Structure of Appear ance, we are pleased to make available once more one of the most in fluential and important works in the philosophy of our times. Professor Geoffrey Hellman's introduction gives a sustained analysis and appreciation of the major themes and the thrust of the book, as well as an account of the ways in which many of Goodman's problems and projects have been picked up and developed by others. Hellman (...) also suggests how The Structure of Appearance introduces issues which Goodman later continues in his essays and in the Languages of Art. There remains the task of understanding Good man's project as a whole; to see the deep continuities of his thought, as it ranges from logic to epistemology, to science and art; to see it therefore as a complex yet coherent theory of human cognition and practice. What we can only hope to suggest, in this note, is the b. road Significance of Goodman's apparently technical work for philosophers, scientists and humanists. One may say of Nelson Goodman that his bite is worse than his bark. Behind what appears as a cool and methodical analysis of the conditions of the construction of systems, there lurks a radical and disturbing thesis: that the world is, in itself, no more one way than another, nor are we. It depends on the ways in which we take it, and on what we do. (shrink)

Catholic doctrine’s strict prohibition on abortion can lead clinicians or institutions to conscientiously refuse to provide abortion, although a legal duty to provide abortion would apply to anyone who refused. Conscientious refusals by clinicians to end a pregnancy can constitute murder or reckless homicide under American law if a woman dies as a result of such a refusal. Such refusals are not immunized from criminal liability by the constitutional right to the free exercise of religion or by statutes that confer (...) immunity from criminal homicide prosecution. Core principles of the rule of law require the state to protect the lives of all persons equally and to place the life and health of persons above any the interests of providers have in moral integrity or in respecting the moral status of prenatal humans. In some states criminal liability related to conscientious objection also applies to corporate hospital officials. (shrink)

In Bester’s article (2018) challenging the use of the harm principle and advocating sole reliance on the use of a best interest standard (BIS) in pediatric decision-making, we believe that the auth...

The unique context of the rural setting provides special challenges to furnishing ethical healthcare to its approximately 62 million inhabitants. Although rural communities are widely diverse, most have the following common features: limited economic resources, shared values, reduced health status, limited availability of and accessibility to healthcare services, overlapping professional–patient relationships and care giver stress. These rural features shape common healthcare ethical issues, including threats to confidentiality, boundary issues, professional–patient relationship and allocation of resources. To date, there exists a limited (...) focus on rural healthcare ethics shown by the scarcity of rural healthcare ethics literature, rural ethics committees, rural focused ethics training and research on rural ethics issues. An interdisciplinary group of rural healthcare ethicists with backgrounds in medicine, nursing and philosophy was convened to explore the need for a rural healthcare ethics agenda. At the meeting, the Coalition for Rural Health Care Ethics agreed to a definition of rural healthcare ethics and a broad-ranging rural ethics agenda with the ultimate goal of enhancing the quality of patient care in rural America. The proposed agenda calls for increasing awareness and understanding of rural healthcare ethics through the development of evidence—informed, rural-attuned research, scholarship and education in collaboration with rural healthcare professionals, healthcare institutions and the diverse rural population. (shrink)

Because it promises to benefit business and society simultaneously, strategic philanthropy might be characterized as a “happy marriage” of corporate social responsibility behavior and corporate financial performance. However, as evidence so far has been mostly anecdotal, it is important to understand to what extent empirics support the actual practice as well as value of a strategic approach, which creates both business and social impacts through corporate philanthropic activities. Utilizing data from the years 2006 to 2009 for a sample of the (...) Dow Jones Sustainability Index, which monitors the world’s most sustainable companies, the authors test a model of strategic philanthropy in which the dependent variable is evidence that a firm does or does not measure business and social impacts simultaneously. From the DJSI data, the authors find a proposed measure of overall corporate social performance to be the most important explanatory factor for engagement in strategic philanthropy. Moreover, this measure of CSP has a mediating effect on the relations between certain independent variables and strategic philanthropy. Other important findings provide support for the influence of the institutional factors industry and region on the likelihood that companies are practicing strategic philanthropy, but little effect of the business characteristics company size and profitability on that likelihood. (shrink)

Feminism, Science, and the Philosophy of Science brings together original essays by both feminist and mainstream philosophers of science that examine issues at the intersections of feminism, science, and the philosophy of science. Contributors explore parallels and tensions between feminist approaches to science and other approaches in the philosophy of science and more general science studies. In so doing, they explore notions at the heart of the philosophy of science, including the nature of objectivity, truth, evidence, cognitive agency, scientific method, (...) and the relationship between science and values. (shrink)

Dynamic Structure of Reality makes available in English some of the most mature thought of the modern Spanish philosopher Xavier Zubiri. He first presented this material as a set of 1968 public lectures in Madrid. They were collected, edited, and published in 1989 as Estructura dinámica de la realidad. In 1962 Zubiri had published Sobre la esencia, a work of metaphysics that was praised by critics with one qualification: its treatment of reality was too static. The 1968 course was devised (...) as a response to those critics. Dynamic Structure of Reality retraces the road Hegel traveled concerning the creation of a self and how that self is realized by an interplay between spirit and nature. Like his great predecessor José Ortega y Gasset, and like his great Jewish contemporary Emmanuel Levinas, Zubiri takes religion in all seriousness and locates its questions within the questions of modern philosophy. In harmony with science, he advances a new idea of becoming. Reality, not being, becomes. As reality’s traits are revealed, in different degrees, reality resembles God, the universal self-giver. Zubiri systematically touches on many disciplines to show the varieties of self-giving--throughout the universe--of structural dynamism. (shrink)

How much bacterial evolution occurs in our intestines and which factors control it are currently burning questions. The formation of new ecotypes, some of which capable of coexisting for long periods of time, is highly likely in our guts. Horizontal gene transfer driven by temperate phages that can perform lysogeny is also widespread in mammalian intestines. Yet, the roles of mutation and especially lysogeny as key drivers of gut bacterial adaptation remain poorly understood. The mammalian gut contains hundreds of bacterial (...) species, each with many strains and ecotypes, whose abundance varies along the lifetime of a host. A continuous high input of mutations and horizontal gene transfer events mediated by temperate phages drives that diversity. Future experiments to study the interaction between mutations that cause adaptation in microbiomes and lysogenic events with different costs and benefits will be key to understand the dynamic microbiomes of mammals. Also see the video abstract here: https://youtu.be/Zjqsiyb5Pk0. (shrink)