The concept of the Golden Mean, which has been accepted as a behavioral guideline of human beings for thousands of years, is briefly reviewed. Several empirical studies in the field of organizational behavior are summarized as evidence that the concept has practical management applications. Based on the Golden Mean concept and its management empirical evidence, the authors propose a model of “Reasoned Responses” and its practical application to the decision-making process.

The concept of the Golden Mean, which has been accepted as a behavioral guideline of human beings for thousands of years, is briefly reviewed. Several empirical studies in the field of organizational behavior are summarized as evidence that the concept has practical management applications. Based on the Golden Mean concept and its management empirical evidence, the authors propose a model of Reasoned Responses and its practical application to the decision-making process.

Phenomenology is one of the most popular qualitative research methodologies used in nursing research. Although interpretive phenomenology is often a logical choice to address the concerns of nursing, the vast number of methods of phenomenology means choosing an appropriate method can be daunting, especially for novice researchers. It is critical that nurse researchers select a phenomenological method that fits the research problem and the skill and world view of the researcher; doing so will result in a research experience that resonates (...) with and excites the researcher. The interpretive phenomenological methodologies of Benner, Munhall, and Conroy each offer unique methods of phenomenological inquiry. However, to date, we are not aware of any literature that explores and compares the methodological approaches of these nurses. In this paper, the origins and influence of phenomenology as both a philosophy and methodology on nurse researchers will be explored, followed by a critical analysis and comparison of these three nurses. By highlighting the distinctive differences and attributes of each method, this paper provides an analysis and comparison of the approaches of these prominent nurses. In doing so, we aim to aid the researcher in their methodological selection, thereby resulting in a successful and rewarding research endeavor. (shrink)

Volume 25, Issue 3, March 2025, Page 38-39.

Nursing knowledge development and application are influenced by numerous factors within the context of science and practice. The prevailing culture of science along with an evolving context of increasingly technological environments and rationalization within health care impacts both the generation of nursing knowledge and the practice of nursing. The effects of the culture of science and the context of nursing practice may negatively impact the structure and application of nursing knowledge, how nurses practice, and how nurses understand the patients and (...) families for whom they care. Specifically, the nature of critical care and its highly technical environment make critical care nursing especially vulnerable to these potentially negative influences. The influences of the culture of science and the increasingly technical practice context may result in an overreliance on the natural sciences to guide critical care nursing actions and an associated marginalization of the caring relationship in critical care nursing practice. Within this environment, nursing philosophy may not be foundational to nursing actions; rather, the dominant culture of science and the rationalization of health care may be informing nursing practice. As such, the ideology and goals of nursing may not be central to the practice of critical care nursing. The purpose of this paper is to explore the influence of the culture of science on the development of nursing knowledge and theory. Further, we aim to describe the value of using conceptual frameworks, such as Roy's Adaptation Model, as a nursing philosophy to influence the development of person‐centred nursing knowledge and theory to inform critical care nursing practice as it related to the care of patients and families. In doing so, nursing philosophy is situated as foundational for nursing actions. (shrink)

BackgroundMoral distress (MD) is an emotional and psychological response to morally challenging dilemmas. Moral distress is experienced frequently by nurses in the intensive care unit (ICU) and can result in emotional anguish, work dissatisfaction, poor patient outcomes, and high levels of nurse turnover. Opportunities to discuss ethically challenging situations may lessen MD and its associated sequela.ObjectiveThe purpose of this project was to develop, implement, and evaluate the impact of nursing ethics huddles on participants’ MD, clinical ethics knowledge, work satisfaction, and (...) patient care among ICU nurses.Sample and SettingThe sample, 32 nurses from three ICU settings in an 800-bed tertiary academic medical center, participated in six nursing ethics huddles over a two-month period.MethodsAlvita K. Nathaniel’s Theory of Moral Reckoning guided development of the nursing ethics huddle process.1 The Moral Distress Thermometer was administered at three data points: baseline level of MD, and pre- and post-huddle to determine changes in the subjects’ level of MD.2 Focused content analysis was used to analyze qualitative responses from questionnaires about the subjects’ perception of the effect of the huddles on work satisfaction and patient care. Knowledge attainment was evaluated via open-ended short-answer questions.ResultsOverall, use of nurse-ethicist-led nursing ethics huddles was associated with improved quality of work life, patient care, and clinical ethics knowledge. The change in pre- and post-nursing ethics huddles MD scores was statistically significant (p < 0.0001). (shrink)

We explore the various ethical challenges that arise during the practical implementation of an emergency resource allocation protocol. We argue that to implement an allocation plan in a crisis, a hospital system must complete five tasks: (1) formulate a set of general principles for allocation, (2) apply those principles to the disease at hand to create a concrete protocol, (3) collect the data required to apply the protocol, (4) construct a system to implement triage decisions with those data, and (5) (...) create a system for managing the consequences of implementing the protocol, including the effects on those who must carry out the plan, the medical staff, and the general public. Here we illustrate the complexities of each task and provide tentative solutions, by describing the experiences of the Coronavirus Ethics Response Group, an interdisciplinary team formed to address the ethical issues in pandemic resource planning at the University of Rochester Medical Center. While the plan was never put into operation, the process of preparing for emergency implementation exposed ethical issues that require attention. (shrink)

Recently ethical implications of human resource management have intensified the focus on care perspectives in management and organization studies. Appeals have also been made for the concept of organizational care to be grounded in philosophies of care rather than business theories. Care perspectives see individuals, especially women, as primarily relational and view work as a means by which people can increase in self-esteem, self-develop and be fulfilled. The ethic of care has received attention in feminist ethics and is often socially (...) construed as a feminine ethic. Although well developed in the caring professions there remains no model or definition of the care ethic in management literature with little care research undertaken. This paper develops the concept of the care ethic using Heidegger’s philosophy, namely, care is fundamental to human being. To show Heideggerian care, an individual notices, pays attention to another and responds in ways to empower and enable. In a study which aimed to analyze women’s lived experience of career, we applied the philosophically grounded methodology hermeneutic phenomenology. Findings revealed the power of Heideggerian care, Sorge, as a key factor in creating meaning. From this, we propose that care has potential as a theoretical and philosophically based construct with strong practical implications. It provides a way of understanding the care ethic, lies at the heart of our being, and is essential to meaning in our grelationships and undertakings. Crucially, it can provide reprieve from the existential angst that trademarks our being. (shrink)

Organisations that design and deploy artificial intelligence (AI) systems increasingly commit themselves to high-level, ethical principles. However, there still exists a gap between principles and practices in AI ethics. One major obstacle organisations face when attempting to operationalise AI Ethics is the lack of a well-defined material scope. Put differently, the question to which systems and processes AI ethics principles ought to apply remains unanswered. Of course, there exists no universally accepted definition of AI, and different systems pose different ethical (...) challenges. Nevertheless, pragmatic problem-solving demands that things should be sorted so that their grouping will promote successful actions for some specific end. In this article, we review and compare previous attempts to classify AI systems for the purpose of implementing AI governance in practice. We find that attempts to classify AI systems proposed in previous literature use one of three mental models: _the Switch_, i.e., a binary approach according to which systems either are or are not considered AI systems depending on their characteristics; _the Ladder_, i.e., a risk-based approach that classifies systems according to the ethical risks they pose; and _the Matrix_, i.e., a multi-dimensional classification of systems that take various aspects into account, such as context, input data, and decision-model. Each of these models for classifying AI systems comes with its own set of strengths and weaknesses. By conceptualising different ways of classifying AI systems into simple mental models, we hope to provide organisations that design, deploy, or regulate AI systems with the vocabulary needed to demarcate the material scope of their AI governance frameworks. (shrink)

Qualitative and quantitative research on the impact of medical and health humanities teaching in baccalaureate education is sparse. This paper reviews recent studies of the impact of medical and health humanities coursework in pre-health professions education and describes a pilot study of baccalaureate students who completed semester-long medical humanities courses in the Division of Medical Humanities & Bioethics at the University of Rochester. The study format was an email survey. All participants were current or former baccalaureate students who had taken (...) one or more courses in literature and narrative in medicine, bioethics, history of medicine, and/or visual arts and healthcare during the past four years. The survey gathered numerical data in several areas: demographic information, career plans, self-reported influence of coursework on educational and career plans, and self-reported influence of coursework on intellectual skills and abilities. It also gathered narrative commentary that elaborated on students’ responses to the numerically-based questions. Notable findings from preliminary analysis of the data include higher scores of self-reported impact of the coursework on specific habits of mind and on preparedness for intended career rather than on gaining admission to future educational programs. Discussion of the results focuses on several potential future directions this type of study might take, including multi-center, longitudinal, and sequential approaches. (shrink)

Even appropriate, ethically sound recommendations can generate angst. In this case, the principal investigator is concerned about the ethics consult recommendation to not inform the participan...

In organ transplantation, there is a lack of ethical discussion about the recipient’s right not to receive a transplant. Using the current situation of living organ transplantation and deceased organ transplantation in Japan as an example, we prospectively discussed to what extent the recipient’s right not to receive a transplant is ethically acceptable. In directed transplantation from a living donor, a recipient may refuse organ donation from a particular donor. It is preferable that a recipient’s request for organ donation from (...) a donor occurs as part of a transparent process. In nondirected transplantation from a deceased donor, refusal of transplantation from a particular type of donor appears potentially justifiable. There are both moral and pragmatic considerations. Certain refusals based solely on belief are morally unacceptable, and refusal to transplant a recipient based on the donor’s age jeopardizes the entire transplant system. When religious beliefs affect mental and physical health, individualized measures are required for transplant rejection. We also deductively developed a prospective argument based on the current status of donor–recipient communication in living organ transplantation in Japan and the 2010 amendment of the law allowing relatives to be given priority in organ transplantation from deceased donors. (shrink)

McInerney, Patrick Nostra Aetate is Vatican II's ground-breaking document on the Catholic Church's relation with people of other religions. The two previous Popes have called it 'the Magna Carta' of the Church's new direction in interreligious dialogue. For centuries church teaching and practice in regard to other religions had been encapsulated in the axiom extra ecclesiam nulla salus. Nostra Aetate represents a 'radically new understanding of the relations of the church to the other great world religions.'.

McInerney, Patrick Review of: World Christianity encounters world religions: A summa of interfaith dialogue, by Edmund Kee-Fook Chia, pp. 272, US$29.95.

This paper examines the ethical aspects of organ transplant surgery in which a donor heart is transplanted from a first recipient, following determination of death by neurologic criteria, to a second recipient. Retransplantation in this sense differs from that in which one recipient undergoes repeat heart transplantation of a newly donated organ, and is thus referred to here as “reuse cardiac organ transplantation.” Medical, legal, and ethical analysis, with a main focus on ethical analysis. From the medical perspective, it is (...) critical to ensure the quality and safety of reused organs, but we lack sufficient empirical data pertaining to medical risk. From the legal perspective, a comparative examination of laws in the United States and Japan affirms no illegality, but legal scholars disagree on the appropriate analysis of the issues, including whether or not property rights apply to transplanted organs. Ethical arguments supporting the reuse of organs include the analogous nature of donation to gifts, the value of donations as inheritance property, and the public property theory as it pertains to organs. Meanwhile, ethical arguments such as those that address organ recycling and identity issues challenge organ reuse. We conclude that organ reuse is not only ethically permissible, but even ethically desirable. Furthermore, we suggest changes to be implemented in the informed consent process prior to organ transplantation. The organ transplant community worldwide should engage in wider and deeper discussions, in hopes that such efforts will lead to the timely preparation of guidelines to implement reuse cardiac organ transplantation as well as reuse transplantation of other organs such as kidney and liver. (shrink)

Nielsen Busch and Mjaaland (2023) argue that controlled donation after circulatory death does not violate the dead donor rule because the dead donor rule “merely requires that procurement of organs...

This book is the only contemporary, systematic study of the relationship of time and conscious experience. Peter K. Mclnerney examines three tightly interconnected issues: how we are able to be conscious of time and temporal entities, whether time exists independently of conscious experience, and whether the conscious experiencer exists in time in the same way that ordinary natural objects are thought to exist in time. Insight is drawn from the views of major phenomenological and existential thinkers on these issues. Building (...) on a detailed explication and critique of the views of Kant, Husserl, Heidegger, and Sartre, Mclnerney develops and defends his own positions. He argues that a revised version of Husserl’s three-feature theory of time-consciousness provides the best explanation of our awareness of temporal features, but that an independently real time is necessary to explain our experience of temporal passage. He also shows that human existence has some special temporal features in addition to those it shares with other entities. Time-consciousness, the conscious exercise of powers, and personal identity through time require that any temporal part of human existence be defined by and "reach across" to earlier and later parts. (shrink)

This study considers the relations between James Mill's _The_ _History of British India_ and Enlightenment historiography, especially William Robertson's _Historical Disquisition Concerning the Knowledge the Ancients had of India_. David McInerney argues that it was in _The History of British India_ that Mill first published his theory of government, which appears there in his account of 'Oriental despotism' and his criticisms of Robertson's account of the caste system, and that, contrary to the opinion of certain critics, Mill's usage of (...) 'history' in _The History of British India_ is not rationalist but rather entails a distinctively empiricist conception of the relationship between historical records and the improvement of government. (shrink)

Tracing the deep connections between philosophy and education, Ryan McInerney argues that we must use philosophy to reflect on the significance of educational practice to all human endeavour. He uses a broad approach which takes in the relationships governing philosophy, education, and language, to reveal education's fundamental achievements and metaphysical significance. The realization of educational ideals and policies are read alongside growing skepticism regarding the theoretical and practical significance of philosophical thinking, and the emphasis on resource efficiency and measurable (...) outcomes which characterise schooling today. It is from this context that McInerney defends the value inherent to the philosophy of education. Drawing upon contemporary continental and analytic thinkers including Nietzsche, Gadamer, and Wittgenstein, McInerney charts the role of education in shaping the child's metaphysical transformation through language acquisition. Connecting early years and primary school education, McInerney pinpoints rationality as the crucial factor which produces critical, thinking beings. He presents the pursuit of philosophically minded education as a rational pursuit which enables us to philosophise and educate others in turn, dispensing with the epistemological and conceptual foundationalisms of the past. (shrink)

The Norman Rockwell image of the American physician who fixed the broken arm of a child, treated the father for hypertension, and brought an unborn child into this world is now almost nonexistent. Since the time of the Rockwell portrait, a highly technical medical industry has evolved. Now two-thirds of physicians are board certified in subspecialties, and patients visit an average of 3–4 different physicians per year. Today's physicians see themselves less as “benevolent and wise counselors overseeing the patient's welfare (...) and more as objective scientists applying the latest technical methods to bring about the desired end.” The intimate patient-physician relationship that was once the norm in our society is rapidly disappearing. (shrink)

In everyday life people frequently recognize that a person at a time may be more or less strongly motivated to carry out an intentional action and that “trying harder” frequently affects the successful completion of an intentional action. In “Rational Choice and Action Omnipotence,” John Pollock provides an original account of rational choice in which “trying to do an action” is a basic factor. This paper argues that Pollock’s “expected-utility optimality prescription” is deficient because it lacks a parameter for intensity (...) of trying. The paper also indicates specific ways in which this deficiency could be corrected. (shrink)

Planctomycetes, Verrucomicrobia and Chlamydia are prokaryotic phyla, sometimes grouped together as the PVC superphylum of eubacteria. Some PVC species possess interesting attributes, in particular, internal membranes that superficially resemble eukaryotic endomembranes. Some biologists now claim that PVC bacteria are nucleus‐bearing prokaryotes and are considered evolutionary intermediates in the transition from prokaryote to eukaryote. PVC prokaryotes do not possess a nucleus and are not intermediates in the prokaryote‐to‐eukaryote transition. Here we summarise the evidence that shows why all of the PVC traits (...) that are currently cited as evidence for aspiring eukaryoticity are either analogous (the result of convergent evolution), not homologous, to eukaryotic traits; or else they are the result of horizontal gene transfers. (shrink)

Many technologies in our everyday lives are expressions of deliberate and protracted political struggles among interested groups. While some technologies are inherently political, other technologies become politicized through competition among different groups and organizations. How do seemingly apolitical technologies become politicized? In this article, the author examines the case of the “circuit riders,” a progressive technology movement in the United States that promotes information technology use among nonprofit and grassroots organizations, to show how a particular technology is politicized through field-level (...) interactions. Applying and contributing to actor—network theory, the author finds that translation takes place as an organizational process by which actors associate the ideals of the technology in question with their political ideals and then attempt to enroll other actors to accept the resultant associations. Successful association depends on both discursive and organizational practices. (shrink)

BackgroundAlthough patient advocates have developed templates for standard consent forms, evaluating patient preferences for first in human (FIH) and window of opportunity (Window) trial consent forms is critical due to their unique risks. FIH trials are the initial use of a novel compound in study participants. In contrast, Window trials give an investigational agent over a fixed duration to treatment naïve patients in the time between diagnosis and standard of care (SOC) surgery. Our goal was to determine the patient-preferred presentation (...) of important information in consent forms for these trials.MethodsThe study consisted of two phases: (1) analyses of oncology FIH and Window consents; (2) interviews of trial participants. FIH consent forms were analyzed for the location(s) of information stating that the study drug has not been tested in humans (FIH information); Window consents were analyzed for the location(s) of information stating the trial may delay SOC surgery (delay information). Participants were asked about their preferred placement of the information in their own trial’s consent form. The location of information in the consent forms was compared to the participants’ suggestions for placement. Results34 [17 FIH; 17 Window] of 42(81%) cancer patients approached participated. 25 consents [20 FIH; 5 Window] were analyzed. 19/20 FIH consent forms included FIH information, and 4/5 Window consent forms included delay information. 19/20(95%) FIH consent forms contained FIH information in the risks section 12/17(71%) patients preferred the same. Fourteen (82%) patients wanted FIH information in the purpose, but only 5(25%) consents mentioned it there. 9/17(53%) Window patients preferred delay information to be located early in the consent, before the “Risks” section. 3/5(60%) consents did this.ConclusionsDesigning consents that reflect patient preferences more accurately is essential for ethical informed consent; however, a one-size fits all approach will not accurately capture patient preferences. We found that preferences differed for FIH and Window trial consents, though for both, patients preferred key risk information early in the consent. Next steps include determining if FIH and Window consent templates improve understanding. (shrink)

If a transformation in medicine occurs in the wake of the Human Genome Project, its likely focus will be prevention, a logical extension of the lessons of variation and individuality inherent in molecular genetics. The transformation of medicine will require a transformation in genetics education as well, focusing on the development of genetic literacy that allows patient and provider to collaborate as partners in health promotion and disease prevention. The components of genetic literacy include new views of genetics and of (...) disease, and attention to the nature of science, the principles of technology, and ethical, legal, and social implications of genetic medicine. (shrink)

The thousands of funerary inscriptions from the city of Rome published in CIL VI are a rich source of demographic data but are also the subject of serious debate regarding the epigraphic habit of the Romans. Do the inscriptions represent a cross-section of Roman society or are they largely the creation of the lower classes? Fixing the milieu from which the inscriptions come is difficult, because the exact status of more than 50 % of the commemorating population is unstated. The (...) first section of the paper lays out the criteria according to which individuals, both those of certain status and those of uncertain status, may be classified as freeborn, freed or servile. The second section tabulates the results and argues that the practice of commemoration by modest titulus was overwhelmingly a phenomenon of the milieu of the freed. Since this is not a self-perpetuating population, the prevalence of freedmen in the tituli shows it was among those families in transition from slavery to liberty that titular commemoration was most common. The freed drew attention to their own freedom, and even more proudly advertised the freeborn status of their children. (shrink)

The HarperCollins College Outline series summarizes an area of study in a format that assures easy comprehension for students as well as the general reader. INTRODUCTION TO PHILOSOPHY covers areas ranging from the Nature of God to Theories of Personal Identity Through Time to Feminism and Purposes of Government.