Since 2000, research within positive psychology has exploded, as reflected in dozens of meta-analyses of different interventions and targeted processes, including strength spotting, positive affect, meaning in life, mindfulness, gratitude, hope, and passion. Frequently, researchers treat positive psychology processes of change as distinct from each other and unrelated to processes in clinical psychology. This paper presents a comprehensive framework for positive psychology processes that crosses theoretical orientation, links coherently to clinical psychology and its more dominantly “negative” processes, and supports practitioners (...) in their efforts to personalize positive psychological interventions. We argue that a multi-dimensional and multi-level extended evolutionary approach can organize effective processes of change in psychosocial interventions, by focusing interventions on context-appropriate variation, selection, and retention of processes, arranged in terms of key biopsychosocial dimensions across psychological, biophysiological, and sociocultural levels of analysis. We review widely studied positive psychology constructs and programs and show how this evolutionary approach can readily accommodate them and provide a common language and framework for improving human and community flourishing. We conclude that Interventions should start with the person, not the protocol. (shrink)

International courts are an integral component of the international legal system. These courts have been proliferating over time and increasingly working to ensure state compliance with the rules of the international regulatory regimes they join. However, these courts face a fundamental challenge: while they can rule against governments in violation of the regime’s rules, they cannot enforce those decisions. Working from the first principle that the regulatory regime is designed to help resolve collective action problems among the signees, this Article (...) proposes a formal model of international court influence that helps to explain the extent and limits of international court influence on national government behavior. (shrink)

Steven Vogel and Albert Borgmann have much in common. Both thinkers agree we collectively and materially build our environment. Both also believe communal discussion is essential for constructing better environments. Yet Borgmann does not hesitate to speak of “eloquent things,” while Vogel insists on nature’s silence. This essay examines that disagreement, arguing Vogel’s position is made stronger by the inclusion of what Borgmann calls “deictic discourse.” Such discourse testifies to the goodness of things, but without being either straightforward first-person speech, (...) or the kind of ventriloquism that worries Vogel. Deictic discourse does not eschew responsibility; it accepts a deep responsibility not only for the practices it advocates, but for the wellbeing of its subject. The essay concludes by arguing deictic discourse plays a crucial and ineliminable role in the type of transparent conversations about practice Vogel promotes. (shrink)

A good therapeutic relationship in mental health services is a predictor of positive clinical outcomes for people who seek help for distressing experiences, such as voice hearing and paranoia. One factor that may affect the quality of the therapeutic relationship and raises further ethical issues is the impact of the clinical encounter on users’ sense of self, and in particular on their sense of agency. In the paper, we discuss some of the reasons why the sense of epistemic agency may (...) be especially fragile in young people with unusual experiences and beliefs. We argue that it is important to identify and avoid behaviours that can undermine young people’s contributions as epistemic agents in the clinical encounter. (shrink)

In this book, leading Christian political thinkers and practitioners critique the Rawlsian concepts of “justice as fairness” and “public reason” from the perspective of Christian political theory and practice. It provides a new level of analysis from Christian perspectives, including implications for such hot topics as the culture war.

_Foucault and Animals_ is the first collection to explore the relevance of Foucault’s thought for the animal question. Chrulew and Wadiwel bring together essays that open up his influential range of concepts and methods to new domains of human-animal relations.

Translating ethical theories into clinical practice presents a perennial challenge to educators. While many suggestions have been put forth to bridge the theory-practice gap, none have sufficiently remedied the problem. We believe the ascendance of hospital medicine, as a dominant new force in medical education and patient care, presents a unique opportunity that could redefine the way clinical ethics is taught. The field of hospital medicine in the United States is comprised of more than 50,000 hospitalists—specialists in inpatient medicine—representing the (...) fastest growing subspecialty in the history of medicine, and its members have emerged as a dominant new force around which medical education and patient care pivot. This evolution in medical education presents a unique opportunity for the clinical ethics community. Through their proximity to patients and trainees, hospitalists have the potential to teach medical ethics in real time on the wards, but most hospitalists have not received formal training in clinical ethics. We believe it is time to strengthen the ties between hospital medicine and medical ethics, and in this article we outline how clinical ethicists might collaborate with hospitalists to identify routine issues that do not rise to the level of an “ethics consult,” but nonetheless require an intellectual grounding in normative reasoning. We use a clinical vignette to explore how this approach might enhance and broaden the scope of medical education that occurs in the inpatient setting: A patient with an intra-abdominal abscess is admitted to the academic hospitalist teaching service for drainage of the fluid, hemodynamic support, and antimicrobial therapy. During the initial encounter with the hospitalist and his team of medical students and residents, the patient reports night sweats and asks if this symptom could be due to the abscess. How should the hospitalist approach this question? (shrink)

: This paper presents a method of moral problem solving in clinical practice that is inspired by the philosophy of John Dewey. This method, called "clinical pragmatism," integrates clinical and ethical decision making. Clinical pragmatism focuses on the interpersonal processes of assessment and consensus formation as well as the ethical analysis of relevant moral considerations. The steps in this method are delineated and then illustrated through a detailed case study. The implications of clinical pragmatism for the use of principles in (...) moral problem solving are discussed. (shrink)

There has been increasing interest in recent years in the development of approaches to estimate causal effects when the number of potential confounders is prohibitively large. This growth in interest has led to a number of potential estimators one could use in this setting. Each of these estimators has different operating characteristics, and it is unlikely that one estimator will outperform all others across all possible scenarios. Coupling this with the fact that an analyst can never know which approach is (...) best for their particular data, we propose a synthetic estimator that averages over a set of candidate estimators. Averaging is widely used in statistics for problems such as prediction, where there are many possible models, and averaging can improve performance and increase robustness to using incorrect models. We show that these ideas carry over into the estimation of causal effects in high-dimensional scenarios. We show theoretically that averaging provides robustness against choosing a bad model, and show empirically via simulation that the averaging estimator performs quite well, and in most cases nearly as well as the best among all possible candidate estimators. Finally, we illustrate these ideas in an environmental wide association study and see that averaging provides the largest benefit in the more difficult scenarios that have large numbers of confounders. (shrink)

: This response to Lynn Jansen's critique of clinical pragmatism concentrates on two themes: (1) contrasting approaches to moral epistemology and (2) the connection between theory and practice in clinical ethics. Particular attention is paid to the status of principles and the role of consensus, with some closing speculations on how Dewey might view the current state of bioethics.

Most philosophical defences of the state’s right to exclude immigrants derive their strength from the normative importance of self-determination. If nation-states are taken to be the political institutions of a people, then the state’s right to exclude is the people’s right to exclude – and a denial of this right constitutes an abridgement of self-determination. In this paper, I argue that this view of self-determination does not cohere with a group-agency view of nation-states. On the group-agency view that I defend, (...) a nation-state is the kind of group-agent that does not supervene on the intentionality of member/citizens. If we think that a nation-state is an intentional group-agent in its own right, then we should think that self-determination resides with the institutions of the state rather than with the citizens. If nation-states do not supervene on the intentionality of citizens, then it is unclear why citizens might have the right to control membership in the state as a feature of self-determination. (shrink)

A 47-year-old woman with a history of anxiety disorder is admitted to the hospital for shortness of breath. On the third day of hospitalization, she asks her physician for a copy of all documents pertaining to her care. What expectation should she have for full disclosure? Are there limits on her access to her medical records and do her physician's concerns about professional privilege matter?The virtues of transparency in medicine have been well described. As proponents of transparency, we favor patient (...) access to their medical records, but we are increasingly troubled by the ease and extent of disclosure in current practice as technology advances and... (shrink)

Are there natural kinds of things around which our theories cut? The essays in this volume offer reflections by a distinguished group of philosophers on a series of intertwined issues in the metaphysics and epistemology of classification.

The restructuring of the healthcare marketplace has exerted pressure directly and indirectly on clinical ethics programs. The fiscal orientation and emphasis on efficiency, outcome measures, and cost control have made it increasingly difficult to communicate arguments in support of the existence or growth of ethics programs. In the current marketplace, arguments that rely on the claim that ethics programs protect patient rights or assist in the professional formation of practitioners often result in minimal levels of funding and preclude program growth. (...) Where ethics programs could once sustain themselves on goodwill alone and values arguments in an expanding healthcare market they are now encountering—at least by anecdotal reports—cutbacks and even elimination. To respond to these challenges, we offer an economic model that can be used to demonstrate the “value” of an institutionally based ethics program. (shrink)

In this paper I propose a novel defence of political cosmopolitanism grounded in a familiar principle: universal moral equality. Critics of cosmopolitanism generally agree to universal moral equality, but disagree about what moral equality means politically. According to my argument, if we accept that all people are morally equal, then we ought to accept their equal moral standing. We should therefore prefer socio-political arrangements that reflect the equal moral standing of all people over those that reflect differentiated moral standing. A (...) reasonable cosmopolitanism need not preclude partialist attachment to co-nationals, or undermine the significance of self-determination, so long as political arrangements do not produce differentiated moral standing. As the political application of an uncontroversial moral principle, I defend reasonable cosmopolitanism against nationalism and statism. Neither of these, I argue, are suitable foundations for global justice in migration because they each conceive of justice as a local concern for insiders. (shrink)

A 28-year-old female-to-male transgender patient presents to the emergency room with one day of pleuritic chest pain and shortness of breath. The patient is found to have an acute pulmonary embolus and is admitted is to the academic hospitalist teaching service for further management.The transgender population is diverse in gender identity, expression, and sexual orientation. Although estimates vary, one study suggests that 0.3% of adults identify as transgender. The U.S. National Transgender Discrimination Survey revealed that 28% of transgender adults have (...) experienced harassment in medical settings, 19% reported being refused care, and 28% postponed care because of discrimination... (shrink)

Der folgende Artikel ist im Jahr 2003 unter dem Titel „Clinical Pragmatism: A Method of Moral Problem Solving“ in dem Sammelband „Pragmatic bioethics“ erschienen, welcher sich mit der Bedeutung der pragmatistischen Philosophie für die Praxis befasst. In dem vom Internisten und Bioethiker Joseph J. Fins, dem Thoraxchirurgen Matthew D. Bacchetta und dem Philosophen und Medizinethiker Franklin G. Miller verfassten Beitrag wird der pragmatistische Ansatz in der klinischen Ethik anhand eines Fallbeispiels gleichzeitig beschrieben, begründet und demonstriert. Obgleich die Denkrichtung (...) der pragmatistischen Philosophie sowohl wissenschaftstheoretisch wie praktisch hoch bedeutsam ist – ohne diese ist weder die heutige sozialwissenschaftliche Forschung noch die angewandte, insbesondere die klinische Ethik denkbar –, werden pragmatistische Ansätze im deutschsprachigen Raum bis heute eher rudimentär rezipiert. (shrink)

Urban Chinese today do not appear to trust foreign countries. Why are they so suspicious? Over the past quarter century, the Chinese Communist Party has utilized its educational and propaganda systems to produce historical narratives of imperial China's beneficence towards its East Asian neighbors, and of an early modern at the hands of foreign powers. Qualitative analysis of Chinese social media today suggests that these narratives are tied to widespread popular distrust of China's East Asian neighbors and the West today. (...) Interrogating a 2012 survey of urban Chinese, this paper explores the sources of international attitudes quantitatively. It first examines whether Chinese today do indeed distrust foreign countries. It then tests two hypotheses about the drivers of Chinese distrust towards the world today. A socialization hypothesis holds that political and/or social pressures shape the international attitudes of the Chinese people. A psychological hypothesis, by contrast, holds that individual differences like age and gender shape Chinese attitudes. We find substantial support for the former: more years of education are associated with levels of dis/trust in foreign countries in the socially or politically appropriate ways. However, we also find that individual differences in subjective interest in international affairs interact with socialization processes like education and media exposure in shaping the international attitudes of urban Chinese today. The prevalence of public discourses of distrust towards foreign countries does not bode well for Chinese foreign policy in the twenty-first century. (shrink)

Over the course of the last four decades, William Leon McBride has distinguished himself as one of the most esteemed and accomplished philosophers of his generation. This volume—which celebrates the occasion of his seventy-fifth birthday—includes contributions from colleagues, friends, and formers students and pays tribute to McBride’s considerable achievements as a teacher, mentor, and scholar.

What does it mean to consider the world of AI through a Christian lens? Rapid developments in AI continue to reshape society, raising new ethical questions and challenging our understanding of the human person. Encountering Artificial Intelligence draws on Pope Francis’ discussion of a culture of encounter and broader themes in Catholic social thought in order to examine how current AI applications affect human relationships in various social spheres and offers concrete recommendations for better implementation. The document also explores questions (...) regarding personhood, consciousness, and the kinds of relationships humans might have with even the most advanced AI. Through these discussions, this book investigates the theoretical and practical challenges to interpersonal encounter raised by the age of AI. (AI Research Group for the Centre for Digital Culture of the Dicastery of Culture and Education of the Holy See). (shrink)

Physical activity, and likely the motivation for it, varies throughout the day. The aim of this investigation was to create a short assessment (CRAVE: Cravings for Rest and Volitional Energy Expenditure) to measure motivation states (wants, desires, urges) for physical activity and sedentary behaviors. Five studies were conducted to develop and evaluate the construct validity and reliability of the scale, with 1,035 participants completing the scale a total of 1,697 times. In Study 1, 402 university students completed a questionnaire inquiring (...) about the want or desire to perform behaviors “at the present moment (right now).” Items related to physical activity (e.g., “move my body”) and sedentary behaviors (e.g., “do nothing active”). An exploratory structural equation model (ESEM) revealed that 10 items should be retained, loading onto two factors (5 each for Move and Rest). In Study 2, an independent sample (n= 444) confirmed these results and found that Move and Rest desires were associated with stage-of-change for exercise behavior. In Study 3, 127 community-residing participants completed the CRAVE at 6-month intervals over two years- two times each session. Across-session interclass correlations (ICC) for Move (ICC = 0.72–0.95) and Rest (ICC = 0.69–0.88) were higher than when they were measured across 24-months (Move: ICC = 0.53; Rest: ICC = 0.49), indicating wants/desires have state-like qualities. In Study 4, a maximal treadmill test was completed by 21 university students. The CRAVE was completed immediately pre and post. Move desires decreased 26% and Rest increased 74%. Changes in Move and Rest desires were moderately associated with changes in perceived physical fatigue and energy. In Study 5, 41 university students sat quietly during a 50-min lecture. They completed the CRAVE at 3 time points. Move increased 19.6% and Rest decreased 16.7%. Small correlations were detected between move and both perceived energy and tiredness, but not calmness or tension. In conclusion, the CRAVE scale has good psychometric properties. These data also support tenets of the WANT model of motivation states for movement and rest (Stults-Kolehmainen et al., 2020a). Future studies need to explore how desires to move/rest relate to dynamic changes in physical activity and sedentarism. (shrink)

Philosophical Pragmatism and International Relations bridges the gap between philosophical pragmatism and international relations, two disciplinary perspectives that together shed light on how to advance the study and conduct of foreign affairs. Authors in this collection discuss a broad range of issues, from policy relevance to peacekeeping operations, with an eye to understanding how this distinctly American philosophy, pragmatism, can improve both international relations research and foreign policy practice.

The importance of legal epidemiology in public health law research has undoubtedly grown over the last five years. Scholars and practitioners together have developed guidance on best practices for the field, including: placing emphasis on transdisciplinary collaborations; creating valid, reliable, and repeatable research; and publishing timely products for use in decision-making and change. Despite the energy and expertise researchers have brought to this important work, they name significant challenges in marshalling the diverse skill sets, quality controls, and funding to implement (...) legal epidemiology activities. The Centers for Disease Control and Prevention has worked to develop cross-cutting research and translation on issues of national priority in legal epidemiology, and has explored ways to overcome some of these challenges. As such, this article describes a case study of the use of law to characterize states' prior authorization policies regarding medication used to treat attention-deficit/hyperactivity disorder, a central component of a broader effort to improve behavior therapy options for young children with ADHD. This article highlights the types of legal epidemiology work we have undertaken, the application of this work to an emerging public health problem, and the lessons learned in creating impactful research for the field. (shrink)

In two studies, we tested how the expression of civic hope in narratives and the perceived authenticity of civic/political actions relate to civic/political engagement. In a cross-sectional study of undergraduates (N = 230), the expression of civic hope predicted the perceived authenticity of civic actions (e.g., voting), which in turn predicted the motivation to engage in them. In a longitudinal on-line study that began 8 weeks prior to the 2020 U.S. Presidential election (N = 308 MTurk workers), overall expressions of (...) civic hope positively predicted the perceived authenticity of voting and the motivation to vote. In addition, expressions of civic hope positively predicted the perceived authenticity of voting, which in turn positively predicted the likelihood of reporting that one did vote. These findings indicate that a sense of civic hope and the experience of authenticity in political contexts may be important for democratic engagement. (shrink)