This article examines the unique disadvantages experienced by Black people and other people of color with substance use disorder in health care, and argues that an intersectional approach to enforcing disability rights laws offer an opportunity to ameliorate some of the harms of oppression to this population.

Meat is a multi-billion-dollar industry that relies on people performing risky physical work inside meat-processing facilities over long shifts in close proximity. These workers are socially disempowered, and many are members of groups beset by historic and ongoing structural discrimination. The combination of working conditions and worker characteristics facilitate the spread of SARS-CoV-2, the virus that causes COVID-19. Workers have been expected to put their health and lives at risk during the pandemic because of government and industry pressures to keep (...) this “essential industry” producing. Numerous interventions can significantly reduce the risks to workers and their communities; however, the industry’s implementation has been sporadic and inconsistent. With a focus on the U.S. context, this paper offers an ethical framework for infection prevention and control recommendations grounded in public health values of health and safety, interdependence and solidarity, and health equity and justice, with particular attention to considerations of reciprocity, equitable burden sharing, harm reduction, and health promotion. Meat-processing workers are owed an approach that protects their health relative to the risks of harms to them, their families, and their communities. Sacrifices from businesses benefitting financially from essential industry status are ethically warranted and should acknowledge the risks assumed by workers in the context of existing structural inequities. (shrink)

Prescription opioid policies too often reflect over a century's worth of moralizing about the nature of opioid use disorder, the value of pain, and the meaning of suffering. The social and legal penalties to prescribers run in one direction—avoid overprescribing, however defined, at all costs. The lack of shared definitions is problematic for formulating and evaluating opioid policy. For example, the variant definitions of “misuse,” “abuse,” and “addiction” complicate estimates of morbidity. There are also no widely accepted definitions of misprescribing (...) and overprescribing. I offer here a modest attempt at the categorization of misprescribing: inadvertent overprescribing, corrupt overprescribing, qualitative overprescribing, quantitative overprescribing, multiclass overprescribing, and underprescribing. (shrink)

Earp et al. provide a robust justification for the decriminalization of drugs based on the systemic racism that fuels the “war on drugs” and the ongoing harms of drug policies to individuals...

An inordinate number of low wage workers in essential industries are Black, Hispanic, or Latino, immigrants or refugees — groups beset by centuries of discrimination and burdened with disproportionate but preventable harms during the COVID-19 pandemic.

In this paper, we assume that organ donation policy in the United States will continue to be based on an opt-in model, requiring express consent to donate, and that families will continue to have the prerogative to make donation decisions whenever the deceased person has not recorded his or her own preferences in advance. The limited question addressed here is what should be done when a potential donor dies unexpectedly, without any recorded expression of his or her wishes at hand, (...) while a family decision is being sought. (shrink)

In this essay, we consider a set of related questions concerning the role and nature of money, the working of markets, and the relationship between forms of social organization and money. Among other things, we speculate that efforts to purge the neo-classical theory of markets of the phenomenon of false trading have been misguided in the sense that they fail to grasp the dependence of a market system on the existence of some false trading.

Considers the social and political significance of Kristeva’s oeuvre.

As the term regenerative agriculture caught fire in public discourse around 2019, it was promptly labelled a buzzword. While the buzzword accusation tends to be regarded as negative, these widely used terms also reflect an important area of growing public interest. Exploring a buzzword can thus help us understand our current moment and offer insights to paths forward. In this study, we explored how and why different individuals and groups adopt certain key terms or buzzwords, in this case the term (...) “regenerative agriculture”. We used an interpretivist approach to understand how “regenerative agriculture” is being constructed, interpreted, understood, and employed, drawing from 19 semi-structured interviews conducted with farmers, researchers, private companies, and NGO/nonprofits. Several interviewees felt that regenerative agriculture is making an important societal shift in thinking towards addressing major issues like climate change and parity in our food and agricultural systems. However, farmers in particular felt that the term is being greenwashed, coopting the work they do, and even diluting the meaning. We also found that regenerative agriculture is being advanced as mobilizing “win-wins”—for farmers, for consumers, for society—but that this discourse may be veiling the political and economic agendas of the big companies using the term. Our findings further illustrated the debates over standardizing the term regenerative agriculture, with some contending that there should be room for “continuous improvement” but others felt it is meaningless without a definition. (shrink)

The medium of payment typically is defined as that which is generally accepted in payment for goods and services or in the settlement of debt. Perhaps because modern monetary systems function so well in providing media of payment, we seldom consider the question of why they enjoy the general acceptability by which they are identified. Yet, because monetary systems evolve and change, such basic questions warrant occasional re-examination to ensure that contemporary analysis does not, unwittingly, embody and foster the errors (...) of an earlier time. (shrink)

As the term regenerative agriculture caught fire in public discourse around 2019, it was promptly labelled a buzzword. While the buzzword accusation tends to be regarded as negative, these widely used terms also reflect an important area of growing public interest. Exploring a buzzword can thus help us understand our current moment and offer insights to paths forward. In this study, we explored how and why different individuals and groups adopt certain key terms or buzzwords, in this case the term (...) “regenerative agriculture”. We used an interpretivist approach to understand how “regenerative agriculture” is being constructed, interpreted, understood, and employed, drawing from 19 semi-structured interviews conducted with farmers, researchers, private companies, and NGO/nonprofits. Several interviewees felt that regenerative agriculture is making an important societal shift in thinking towards addressing major issues like climate change and parity in our food and agricultural systems. However, farmers in particular felt that the term is being greenwashed, coopting the work they do, and even diluting the meaning. We also found that regenerative agriculture is being advanced as mobilizing “win-wins”—for farmers, for consumers, for society—but that this discourse may be veiling the political and economic agendas of the big companies using the term. Our findings further illustrated the debates over standardizing the term regenerative agriculture, with some contending that there should be room for “continuous improvement” but others felt it is meaningless without a definition. (shrink)

This chapter contains sections titled: A Brave New (Sexual) World The Original Study “Let's get this party started”: How Friends with Benefits Relationships Were Established “Is this a good idea?” Motivations and Barriers to Friends with Benefits Relationships “How does it feel?” Emotions Associated with Friends with Benefits Relationships “Can we make this work?” Rules for Maintaining Friends with Benefits Relationships “Was it good for you?” Outcomes of Friends with Benefits Relationships “So, what do you think?” Friends' Reactions to Friends (...) with Benefits Relationships Friends with Benefits Relationships: The Good, the Bad, and the Ugly. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

The past two decades of psychoanalytic discourse have witnessed a marked transformation in the way we think about women and gender. The assignment of gender carries with it a host of assumptions, yet without it we can feel lost in a void, unmoored from the world of rationality, stability and meaning. The feminist analytic thinkers whose work is collected here confront the meaning established by the assignment of gender and the uncertainty created by its absence. The contributions brought together in (...) _Psychoanalytic Reflections on a Gender-free Case_ address a cross-section of significant issues that have both chronicled and facilitated the changes in feminist psychoanalysis since the mid 1980s. Difficult issues which have previously been ignored are considered first. The book goes on to address family perspectives as they interact and shape the child’s experience of growing up male or female. Other topics covered are the authority of personal agency as influenced by the language and theory of patriarchy, male-centred concepts that consistently define women as inferior, and the concept of gender as being co-constructed within a relationship. The gender-free case presented here will fascinate all psychoanalysts interested in exploring ways of grappling with the elusive nature of gender, as well as those studying gender studies. (shrink)

The Power of Teaching: Readings on the Philosophical, Theoretical, and Practical Issues Associated with Teaching and Learning provides preservice K-12 teachers with a collection of curated readings that help them prepare for their future in teaching. The reader is divided into five units, each addressing one broadly defined topic in education. The first unit introduces readers to the multiple complexities associated with learning to teach effectively. The second unit contains four articles that explore a variety of pedagogical perspectives. In the (...) third unit, readers are provided with a brief survey of a variety of purposes that shape the overarching mission of schools. The fourth unit features five readings that address the importance of creating a safe and nurturing learning environment for all students. The final unit posits a successful multicultural approach involves self-reflection, a deep understanding of culture, and respect for culturally and linguistically diverse families. Designed to educate and empower, The Power of Teaching is an ideal anthology for courses and programs in K-12 education. (shrink)

Many philosophers believe that there is a causal condition on perception, and that this condition is a conceptual truth about perception. A highly influential argument for this claim is based on intuitive responses to Gricean style thought experiments. Do the folk share the intuitions of philosophers? Roberts et al. (2016) presented participants with two kinds of cases: Blocker cases (similar to Grice’s case involving a mirror and a pillar) and Non-Blocker cases (similar to Grice’s case involving a clock and brain (...) stimulation). They found that a substantial minority agreed that seeing occurs in the Non-Blocker cases, and that in the Blocker cases significantly less agreed that seeing occurs. They thus hypothesized that folk intuitions better align with a no blocker condition than with a causal condition. This paper continues this line of enquiry with two new experiments. The paper investigates the generality and robustness of Roberts et al.’s findings by expanding the sense modalities tested from only vision to audition and olfaction as well. The paper also uses Gricean style thought experiments as a case study for investigating the “reflection defense” against the negative project in experimental philosophy. Our results replicate and extend Roberts et al.’s study and support their hypothesis that folk intuitions better align with a no blocker condition. They also provide an empirical reason to doubt the reflection defense. (shrink)

This article integrates research on gendered organizations and the work-family interface to investigate an innovative workplace initiative, the Results-Only Work Environment, implemented in the corporate headquarters of Best Buy, Inc. While flexible work policies common in other organizations “accommodate” individuals, this initiative attempts a broader and deeper critique of the organizational culture. We address two research questions: How does this initiative attempt to change the masculinized ideal worker norm? And what do women’s and men’s responses reveal about the persistent ways (...) that gender structures work and family life? Data demonstrate the ideal worker norm is pervasive and powerful, even as employees begin critically examining expectations regarding work time that have historically privileged men. Employees’ responses to ROWE are also gendered. Women are more enthusiastic, while men are more cautious. Ambivalence about and resistance to change is expressed in different ways depending on gender and occupational status. (shrink)

Background: The literature and research on nursing ethics and advocacy has shown that generally very few nurses and other clinicians will speak up about an issue they have witnessed regarding a patient advocacy concern and that often advocacy in nursing is not learned until after students have graduated and begun working. Objective: To evaluate the effectiveness of narrative pedagogy on the development of advocacy in student nurses, as measured by the Protective Nursing Advocacy Scale. Design: We tested the hypothesis that (...) use of a narrative pedagogy assignment related to ethics would improve student nurse’s perception of their advocacy role as measured by the Protective Nursing Advocacy Scale using a quasi-experimental nonrandomized study using a pre-test, intervention, post-test design. Data collection occurred during class time from October 2012 to December 2012. The Protective Nursing Advocacy Scale tool was administered to students in class to assess their baseline and was administered again at the completion of the educational intervention to assess whether narrative pedagogy was effective in developing the nursing student’s perception of their role as a patient advocate. Ethical considerations: Students were informed that their participation was voluntary and that the data collected would be anonymous and confidential. The survey was not a graded assignment, and students did not receive any incentive to participate. The institutional review board of the college determined the study to be exempt from review. Setting: School of Nursing at a small liberal arts college in the Northeastern United States. Participants: A consecutive, nonprobability sample of 44 senior-level nursing students enrolled in their final nursing semester was utilized. Findings: Results indicated significant differences in student nurse’s perception of their advocacy role related to environment and educational influences following an education intervention using an ethics digital story. Conclusion: Using the Protective Nursing Advocacy Scale, we were able to measure the effectiveness of narrative pedagogy on nursing student’s perception of the nurse’s advocacy role. (shrink)

Bioethicists currently working in the United Kingdom demonstrate—as indeed do the very best of their colleagues internationally—an eagerness to engage in two extremely different but complementary approaches to their subject. First, they readily become involved in discussions of concrete bioethical issues that are of great concern to the medical profession, legislators, and the wider U.K. public. Second, perhaps because they recognize the importance of the “first-order” questions that exercise the public imagination, they show themselves commendably willing to turn their critical (...) gaze onto the very methods and frameworks they use to address those questions. The first approach we can properly call “bioethical,” whereas we might term the second approach “metabioethical.”. (shrink)

Randomized controlled trial trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions, whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has grown substantially (...) in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. This increase has been accompanied by the onset of learning healthcare systems, as well as an increasing focus on patient-oriented research. However, pragmatic trials have ethical challenges that have not yet been identified or adequately characterized. The present study aims to explore the views of key stakeholders with respect to ethical issues raised by the design and conduct of pragmatic trials. It is embedded within a large, four-year project that seeks to develop guidance for the ethical design and conduct of pragmatic trials. As a first step, this study will address important gaps in the current empirical literature with respect to identifying a comprehensive range of ethical issues arising from the design and conduct of pragmatic trials. By opening up a broad range of topics for consideration within our parallel ethical analysis, we will extend the current debate, which has largely emphasized issues of consent, to the range of ethical considerations that may flow from specific design choices. Semi-structured interviews with key stakeholders, across multiple jurisdictions, identified based on their known experience and/or expertise with pragmatic trials. We expect that the study outputs will be of interest to a wide range of knowledge users including trialists, ethicists, research ethics committees, journal editors, regulators, healthcare policymakers, research funders and patient groups. All publications will adhere to the Tri-Agency Open Access Policy on Publications. (shrink)

The standard, non‐repeated prisoner's dilemma poses no true dilemma about rationality, we argue. What the prisoners ought rationally to do, unless they are selfless, depends on the relationship of trust that they have or lack with one another. This helps to diffuse the apparent conflict between individual and collective rationality. If the prisoners have reason to trust one another, pursuing a joint strategy would be rational for them. In the absence of trust, pursuing an individual strategy would be rational. The (...) solution that is supposed to be puzzling – because each prisoner confessing is worse for both than the alternative on which both remain silent – is simply the rational solution for persons who have no reason to trust one another. Philosophers have been misled by the apparent availability of the better alternative. Collective rationality is not relevant for persons who do not stand in a trusting relationship. When they do, there is no unresolved conflict between their individual and collective points of view.1. (shrink)

STAJDUHAR K, FUNK L, JAKOBSSON E and ÖHLÉN J. Nursing Inquiry 2010; 17: 221–230A critical analysis of health promotion and ‘empowerment’ in the context of palliative family care-givingTraditionally viewed as in opposition to palliative care, newer ideas about ‘health-promoting palliative care’ increasingly infuse the practices and philosophies of healthcare professionals, often invoking ideals of empowerment and participation in care and decision-making. The general tendency is to assume that empowerment, participation, and self-care are universally beneficial for and welcomed by all individuals. (...) But does this assumption hold for everyone, and do we fully understand the implications of health-promoting palliative care for family caregivers in particular? In this study, we draw on existing literature to highlight potential challenges arising from the application of ‘family empowerment’ strategies in palliative home-care nursing practice. In particular, there is a risk that empowerment may be operationalized as transferring technical and medical-care tasks to family caregivers at home. Yet, for some family caregivers, a sense of security and support, as well as trust in professionals, may be equally if not more important than empowerment. Relational and role concerns may also at times take precedence over a desire for empowerment. The potential implications of ‘family empowerment’ are explored in this regard. ‘Family empowerment’ approaches need to be accompanied by a strong understanding of how to best support individual palliative family caregivers. (shrink)

1The opinions contained in this article are those of the authors and should not be construed as policies of the American Medical Association.

This study focuses on a set of dreams related to the September 11, 2001 terrorist attacks and their aftermath, using content analysis and cognitive psychology to explore the interweaving of external public catastrophe and internal psychological processes. The study tests several recent claims in contemporary dream research, including the central image theory of Hartmann [Hartmann, E., & Basile, R. . Dream imagery becomes more intense after 9/11/01. Dreaming, 13, 61–66; Hartmann, E., & Brezler, T. . A systematic change in dreams (...) after 9/11/01. Sleep, 31, 213–218], the media exposure factor postulated by Propper [Propper, R. E., Stickgold, R., Keeley, R., & Christman, S. D. . Is television traumatic? Dreams, stress, and media exposure in the aftermath of September 11, 2001. Psychological Science, 18, 334–340], the continuity hypothesis of Domhoff [Domhoff, W. G. . Finding meaning in dreams: A quantitative approach. New York: Plenum], the cognitive and metacognitive approach of Kahan [Kahan, T. L. . Consciousness in dreaming: A metacognitive approach. In K. Bulkeley , Dreams: A reader on the religious, cultural, and psychological dimensions of dreaming . New York: Palgrave], and the threat simulation theory of Revonsuo [Revonsuo, A. . The reinterpretation of dreams: An evolutionary hypothesis of the function of dreaming. Behavioral and Brain Sciences, 23, 877–901]. Our findings suggest the terrorist attacks had a tangible impact on the content of many people’s dreams, but did not fundamentally alter the cognitive processing features of their dreaming. The 9/11 attacks affected what they dreamed about, but not the way they dreamed. (shrink)

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)

This chapter contains sections titled: * Introduction * The Demand for Evidence * Belief Begins with Trust * Reid on Human Cognitive Faculties * Reid and Rationality * The God Faculty * Reason and Belief in God * Conclusion * Notes * Bibliography.

It goes almost without saying that there are no academic bioethical debates that are unique to the United Kingdom. The debates in which U.K. bioethicists become involved take place in international journals and in books with a worldwide readership. The contributions of those from these shores are frequently made in response to work by academics from the United States, Australia, Scandinavia, and a whole host of other countries.