We surveyed 1005 postdoctoral fellows by questionnaire about ethical matters related to biomedical research and publishing; 33% responded. About 18% of respondents said they had taken a course in research ethics, and about 31% said they had had a course that devoted some time to research ethics. A substantial majority stated willingness to grant other investigators, except competitors, access to their data before publication and to share research materials. Respondents’ opinions about contributions justifying authorship of research papers were mainly consistent (...) but at variance with those of many biomedical journal editors. More than half said they had observed what they considered unethical research practices. To increase the chances of getting a grant funded, 27% said they were willing to select or omit data to improve their results; to make publication of their work more likely or to benefit their career, 15% would select or omit data and 32% would list an undeserving author. Of respondents who thought they had been unfairly denied authorship on a paper, or been listed with or asked to list an undeserving author, 75% said they would be willing to list an undeserving author (P<0.001). Having taken a course dealing with research ethics had no effect on stated willingness to select or omit data or to fabricate data in the future, but was positively associated with willingness to grant undeserved authorship (P<0.04). Although these results do not controvert research demonstrating the effectiveness of ethics courses during professional education, they indicate that the research environment is a powerful component of a trainee’s experience and ethical development. (shrink)

Background: The Clinical Ethics Residency for Nurses was offered selectively to nurses affiliated with two academic medical centers to increase confidence in ethical decision-making. Research Question/Aim: To discover how effective the participants perceived the program and if their goals of participation had been met. Research design: A total of 65 end-of-course essays (from three cohorts) were analyzed using modified directed content analysis. In-depth and recursive readings of the essays by faculty were guided by six questions that had been posed to (...) graduates. Ethical considerations: Institutional review board approval was granted for the duration of the program and its reporting period. Confidentiality was maintained via the use of codes for all evaluations including the essays and potentially identifying content redacted. Findings: An umbrella theme emerged: participants had developed ethical knowledge and skills that provided a “moral compass to navigate the many gray areas of decision-making that confront them in daily practice.” Six major themes corresponding to questions posed to the participants included the ability to advocate for good patient care; to support and empower colleagues, patients, and families; they experienced personal and professional transformation; they valued the multimodal nature of the program; and were using their new knowledge and skills in practice. However, they also recognized that their development as moral agents was an ongoing process. Discussion: Findings support that enhancing nurse confidence in their moral agency with a multimodal educational approach that includes mentored practice in ethical decision-making, enhancing communication skills and role-play can mitigate moral distress. A majority found the program personally and professionally transformative. However, they recognized that ongoing ethics discussion involvement and supportive environments would be important in their continued development of ethical agency. Conclusion: Multimodal ethics education programs have potential to be transformative and enhance nurse confidence in their ethical decision-making. (shrink)

Almost 160 years after the American Civil War, where the Union defeated the Confederacy and ended slavery in the United States, approximately 1,910 tributes remain to Confederate military leaders located on public property in the 11 original Confederate states, particularly in cities with an exceptionally high density of Black residents. To Blacks, this iconography delivers a clear message of White supremacy. Six states have enacted laws to protect and preserve these memorials, making it almost impossible to use the court system (...) to move them to private property. This paper explores connections between support for a myth called the Lost Cause, which is a revisionist history intended to spread misinformation about the true cause of the American Civil War, and attitudes toward placement of Confederate symbols on public land. We show that there is significant belief in the Lost-Cause myth among many White U.S. Southerners. Furthermore, we find those who believe most in the myth are the least likely to want to move the monuments or end taxpayer support for their maintenance. (shrink)

This article examines factors related to husbands' contribution to housework when their wives become newly impaired. Data are from a sample of 319 married couples who participated in the National Survey of Families and Households, and in which wives developed physical limitations between baseline and five-year follow-up interviews. Using ordinary least squares regression, we found that husbands who have egalitarian attitudes toward marital roles and are happy in their marriage at baseline do more housework at follow-up than husbands who are (...) traditional and/or are less happy. Given the slow rate of change in household division of labor, the lack of public policies to support people with impairment and family caregiving disproportionately burdens women. (shrink)

One antidote to moral distress is stronger moral agency—that is, an enhanced ability to act to bring about change. The Clinical Ethics Residency for Nurses, an educational program developed and run in two large northeastern academic medical centers with funding from the Health Resources and Services Administration, intended to strengthen nurses’ moral agency. Drawing on Improving Competencies in Clinical Ethics Consultation: An Education Guide, by the American Society for Bioethics and Humanities, and on the goals of the nursing profession, CERN (...) sought to change attitudes, increase knowledge, and develop skills to act on one's knowledge. One of the key insights the faculty members brought to the design of this program is that knowledge of clinical ethics is not enough to develop moral agency. In addition to lecture‐style classes, CERN employed a variety of methods based in adult learning theory, such as active application of ethics knowledge to patient scenarios in classroom discussion, simulation, and the clinical practicum. Overwhelmingly, the feedback from the participants (sixty‐seven over three years of the program) indicated that CERN achieved transformative learning. (shrink)

Online gaming creates unique public spaces of interaction. These spaces are both highly controlled but also able to slip through the regulatory net, as domestic legislation struggles to respond to fast-changing interjurisdictional environments. Inter- and transdisciplinary research hold potential to respond to questions surrounding the regulation of these online spaces, by exploring multiple perspectives. The authors of this paper each come from a unique starting point in their exploration of these issues. The paper will examine three spaces of regulation in (...) online game world environments. It will look at (1) rules and regulations that governs online interaction in virtual spaces, (2) the ‘code’ that controls behaviour through game architecture, and (3) the laws that are developed by players inside the game world. The first part will analyse whether domestic law can be adequate to regulate a space that is not geographically fixed. The second will discuss how the coding of the game and its architecture regulate behaviours within the space. The last is a “bottom-up” regulatory system, originating within the gaming community. Where do these three layers of regulation interact with each other? What are the unique languages of these spaces? This paper is a starting point for further investigation into the regulation of online behaviours through interwoven rule systems. (shrink)

Pamela had, throughout her life, an ambivalent relationship with the church. She wanted her work to make a difference to it and she was committed to being a feminist philosopher of religion. There are many recurrent themes in her work that clearly relate to her background in the church, and particularly in the Lutheran church of her upbringing. Her challenge to the patriarchy of what she called “hyper-traditional” Christianity is clear, but also her critique of some forms of forgiveness (...) and her search for new understandings of love and vulnerability. Her work presents significant challenges to the church, but does not abandon it, instead offering new ways of connecting with some of its most profound and important teachings and themes. Her work encourages us women in the church to value our own life experience as a source of knowledge, to re-frame our vulnerabilities and to find love in ways that offer freedom and hope. Pamela saw her work as her own contribution to the community of the church. It remains important that her voice, even and especially with its “speaker vulnerability,” is heard in that place. (shrink)

The Monographs produced by the International Agency for Research on Cancer (IARC) apply rigorous procedures for the scientific review and evaluation of carcinogenic hazards by independent experts. The Preamble to the IARC Monographs, which outlines these procedures, was updated in 2019, following recommendations of a 2018 expert Advisory Group. This article presents the key features of the updated Preamble, a major milestone that will enable IARC to take advantage of recent scientific and procedural advances made during the 12 years since (...) the last Preamble amendments. The updated Preamble formalizes important developments already being pioneered in the Monographs Programme. These developments were taken forward in a clarified and strengthened process for identifying, reviewing, evaluating and integrating evidence to identify causes of human cancer. The advancements adopted include strengthening of systematic review methodologies; greater emphasis on mechanistic evidence, based on key characteristics of carcinogens; greater consideration of quality and informativeness in the critical evaluation of epidemiological studies, including their exposure assessment methods; improved harmonization of evaluation criteria for the different evidence streams; and a single-step process of integrating evidence on cancer in humans, cancer in experimental animals and mechanisms for reaching overall evaluations. In all, the updated Preamble underpins a stronger and more transparent method for the identification of carcinogenic hazards, the essential first step in cancer prevention. (shrink)

Philosophising, as Spinoza conceives it, is the project of learning to live joyfully. This in turn is a matter of learning to live together, and the most obvious test of philosophical insight is our capacity to sustain a harmonious way of life. Susan James defends this interpretation and explores Spinoza's influence on contemporary debates.

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

Many philosophers have been persuaded that if we don’t create our own characters, we cannot be responsible for acts that flow from our characters; they also raise doubts about whether acts that do not flow from our characters can fairly be attributed to us. Both these concerns, however, reflect a simplistic and implausible conception of character and of its relation to our actions and our selves. I suggest a different relationship between character and responsibility: We can be responsible for acts (...) that are in character and also for acts that are out of character, but to be capable of being responsible at all is closely related to the capacity to have a character. I relate this capacity to the exercise of active intelligence—a capacity that is manifested in actions in or out of character, but not in the display of many psychological conditions or disorders. (shrink)

Background Dynamic consent has been proposed as a process through which participants and patients can gain more control over how their data and samples, donated for biomedical research, are used, resulting in greater trust in researchers. It is also a way to respond to evolving data protection frameworks and new legislation. Others argue that the broad consent currently used in biobank research is ethically robust. Little empirical research with cohort study participants has been published. This research investigated the participants’ opinions (...) of adding a dynamic consent interface to their existing study. Methods Adult participants in the Extended Cohort for E-health, Environment and DNA longitudinal cohort study who are members of the EXCEED Public and Participant Engagement Group were recruited. Four focus groups were conducted and analysed for thematic content. Discussion topics were derived from a review of the current literature on dynamic consent. Results Participants were in favour of many aspects of a dynamic consent interface, such as being able to update their information, add additional data to their records and choose withdrawal options. They were supportive provided it was simple to use and not intrusive. Participants expressed a markedly high level of trust in the study and its investigators and were unanimously happy with their current participation. No strong support was found for adding a dynamic consent interface to EXCEED. Conclusions Trust in the study researchers was the strongest theme found. Openness and good data security were needed to retain their trust. While happy to discuss dynamic consent, participants were satisfied with the current study arrangements. There were indications that changing the study might unnecessarily disturb their trust. This raised the question of whether there are contexts where dynamic consent is more appropriate than others. This study was limited by the small number of participants who were committed to the study and biased towards it. More research is needed to fully understand the potential impact of adding a dynamic consent interface to an existing cohort study. (shrink)

situation is one in which all are in great peril and someone must be sacrificed lest all perish. In such situations, it is permissible to do things which would be considered wrong under less drastic circumstances. Proponents of animal rights such as Tom Regan agree that in such circumstances it may be necessary to sacrifice a dog in order to save human life. Is such an admission consistent with calling for the abolition of all scientific research on animals? That is, (...) is scientific research a ‘lifeboat’? The analogy is tempting but flawed. The demand for abolition of animal research is not marred by consistency on this score. Keywords: abolition, animal research, animal rights, lifeboat cases, Tom Regan CiteULike Connotea Del.icio.us What's this? (shrink)

I offer a novel interdisciplinary approach to understanding the communicative task of listening, which is under-theorised compared to its more conspicuous counterpart, speech. By correlating a Rylean view of mental actions with a virtue ethical framework, I show listeners’ internal activity as a morally relevant feature of how they treat people. The listener employs a policy of responsiveness in managing the extent to which they allow a speaker's voice to be centred within their more effortful, engaged attention. A just listener's (...) policy of responsiveness avoids unwarrantedly dismissing speakers’ messages on the basis of peripheral attention alone. (shrink)

Charles Peirce, Mikhail Bakhtin and Thomas Sebeok all develop original research itineraries around the sign and, despite terminological differences, canbe related with reference to the concept of dialogism and modelling. Jakob von Uexküll’s biosemiosic “functional cycle”, a model for semiosic processes, is alsoimplied in the relation between dialogue and communication.Biological models which describe communication as a self-referential, autopoietic and semiotically closed system (e.g., the models proposed by Maturana,Varela, and Thure von Uexküll) contrast with both the linear (Shannon and Weaver) and (...) the circular (Saussure) paradigms. The theory of autopoietic systems is only incompatible with dialogism if reference is to a linear causal model which describes communication as developing from source to destination, or to the conversation model governed by the turning around together rule. Dialogism understood in biosemiotic terms overlaps with the concepts of interconnectivity,interrelation, intercorporeity and presupposes the otherness relation.As Uexküll says, the relation with the umwelt in nonhuman living beings is stable and concerns the species; on the contrary, in human beings it is, changeableand concerns the single individual, which is at once an advantage and a disadvantage. Thanks to “syntactics”, human beings can construct, deconstruct and reconstruct an infinite number of worlds from a finite number of elements. This distinguishes human beings from other animals and determines their capacity for posing problems and asking questions. The human being not only produces his or her own world, but can also endanger it, and even destroy it to the point of causing the extinction of all other life forms on Earth. The unique capacity for reflection on signs makes human beings responsible for life across the planet, both human and nonhuman. Such reflections shift semiotic research in the direction of semioethics. (shrink)

For years, moral language has been the province of the Right, as the Left has consoled itself with rudderless pragmatism. In this profound and powerful book, Susan Neiman reclaims the vocabulary of morality--good and evil, heroism and nobility--as a lingua franca for the twenty-first century. In constructing a framework for taking responsible action on today's urgent questions, Neiman reaches back to the eighteenth century, retrieving a series of values--happiness, reason, reverence, and hope--held high by Enlightenment thinkers. In this thoroughly (...) updated edition, Neiman reflects on how the moral language of the 2008 presidential campaign has opened up new political and cultural possibilities in America and beyond. (shrink)

Re-consent in research, the asking for a new consent if there is a change in protocol or to confirm the expectations of participants in case of change, is an under-explored issue. There is little clarity as to what changes should trigger re-consent and what impact a re-consent exercise has on participants and the research project. This article examines applicable policy statements and literature for the prevailing arguments for and against re-consent in relation to longitudinal cohort studies, tissue banks and biobanks. (...) Examples of re-consent exercises are presented, triggers and non-triggers for re-consent discussed and the conflicting attitudes of commentators, participants and researchers highlighted. We acknowledge current practice and argue for a greater emphasis on ‘responsive autonomy,’ that goes beyond a one-time consent and encourages greater communication between the parties involved. A balance is needed between respecting participants' wishes on how they want their data and samples used and enabling effective research to proceed. (shrink)

The Republic’s political discussion begins with the construction of two contrasting cities: a ‘healthy’ city and a ‘city with a fever’; one defined by environmentally sustainable subsistence practices and the other by ‘luxurious’ over consumption that exceeds the carrying capacity of its land. Plato’s characters proceed to cure the inflamed city of its fever, resulting in the delineation of the ideal political constitution, the Kallipolis, which recovers the virtues of the original, healthy city in an altered form. This paper develops (...) an ecological reading of the Republic, highlighting Plato’s optimism regarding humans’ ability to limit their material consumption in accordance with the limits of the natural world. The conventional interpretation of the Republic’s first city, known as ‘the city of pigs’, is reconsidered in light of new socio-ecological research on traditional resource management systems. (shrink)

Volume 20, Issue 7, July 2020, Page 6-8.

Volume 19, Issue 1, February 2020, Page 78-88.

Background: Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses costing from $44,380 - $63,400 per nurse—an estimated $4.21 to $6.02 million financial loss annually for hospitals in the United States of America. Attrition of all nurses is costly. Most past research has focused on the new graduate nurse with little focus on the mid-career nurse. Attrition of mid-career nurses is a loss for the profession now and into the future. Research objective: The purpose of the study was (...) to explore relationships of professional values orientation, career development, job satisfaction, and intent to stay in recently hired mid-career and early-career nurses in a large hospital system. Research design: A descriptive correlational study of personal and professional factors on job satisfaction and retention was conducted. Participants and research context: A convenience sample of nurses from a mid-sized hospital in a metropolitan area in the Southwestern United States was recruited via in-house email. Sixty-seven nurses met the eligibility criteria and completed survey documents. Ethical considerations: Institutional Review Board approval was obtained from both the university and hospital system. Findings: Findings indicated a strong correlation between professional values and career development and that both job satisfaction and career development correlated positively with retention. Discussion: Newly hired mid-career nurses scored higher on job satisfaction and planned to remain in their jobs. This is important because their expertise and leadership are necessary to sustain the profession into the future. Conclusion: Nurse managers should be aware that when nurses perceive value conflicts, retention might be adversely affected. The practice environment stimulates nurses to consider whether to remain on the job or look for other opportunities. (shrink)

_The Incident at Antioch_ is a key play marking Alain Badiou's transition from classical Marxism to a "politics of subtraction" far removed from party and state. Written with striking eloquence and extraordinary poetic richness, and shifting from highly serious emotional and intellectual drama to surreal comic interlude, the work features statesmen, workers, and revolutionaries struggling to reconcile the nature and practice of politics. This bilingual edition presents _L'Incident d'Antioche_ in its original French and, on facing pages, an expertly executed English (...) translation. Badiou adds a special preface, and an introduction by the scholar Kenneth Reinhard connects the play to Paul Claudel's _The City_, Saint Paul and the early history of the Church, and the innovative mathematical thinking of Paul Cohen. The translation includes Susan Spitzer's extensive notes clarifying allusions and quotations and hinting at Badiou's intentions. An interview with Badiou encompasses the play's settings, themes, and events, as well as his ongoing literary and conceptual experimentation on stage and off. (shrink)

The Covid‐19 pandemic has exposed four myths in bioethics. First, the flood of bioethics publications on how to allocate scarce resources in crisis conditions has assumed authorities would declare the onset of crisis standards of care, yet few have done so. This leaves guidelines in limbo and patients unprotected. Second, the pandemic's realities have exploded traditional boundaries between clinical, research, and public health ethics, requiring bioethics to face the interdigitation of learning, doing, and allocating. Third, without empirical research, the success (...) or failure of ethics guidelines remains unknown, demonstrating that crafting ethics guidance is only the start. And fourth, the pandemic's glaring health inequities require new commitment to learn from communities facing extraordinary challenges. Without that new learning, bioethics methods cannot succeed. The pandemic is a wake‐up call, and bioethics must rise to the challenge. (shrink)

Individuals with a variety of disabilities benefit greatly from the ADA provision of easy public access with their service dogs. However, the growing problem of non-disabled individuals passing off their pets as service dogs both threatens public safety and can result in denial of access for legitimate service dog teams. We argue that requiring certification of service dog teams and furnishing qualified teams with state-issued ID tags, following a process similar to that for obtaining accessible-parking placards, is the least intrusive (...) way to protect access for legitimate teams and protect public safety. While some consider a certification requirement for service dog teams to be burdensome, balanced against the harms posed by easy public access for untrained or inappropriate dogs, the mild burden is justified. (shrink)

The American Association of University Women (AAUW) is one of the nation's oldest and most influential voices for equality in education, the professions, and public life. Tracing the history of the AAUW, Susan Levine provides a new perspective on the meaning of feminism for women in mainstream liberal organizations. In so doing, she explores the problems that women confront and the strategies they have developed to achieve equal rights. Established in 1921 with the merging of two regional groups of (...) women college graduates, the AAUW has grown to become a vital resource center for educational policy and women's concerns. While not always favoring the label "feminist," AAUW has sought to end discrimination against women, providing fellowships for women to pursue higher education, lobbying for changes in public policy, and conducting groundbreaking research. From the beginning, however, both achievement and controversy have marked the organizations' efforts. The AAUW, self-identified as the voice of moderation and mainstream women, has also been bound by social convention of class and race. One result, a bitter conflict in the late 1940s over racial integration, forced AAUW to change its national policies. Yet the organization emerged stronger than ever and at present boasts over 135,000 members. By examining the experience of groups like AAUW, Levine suggests that feminism was not so much "reborn" in the 1970s as it was adopted by a rapidly growing constituency of college educated women demanding the realization of their goals. Author note: Susan Levine is Assistant Professor of History at East Carolina University and the author of Labor's True Woman: Carpet Weavers, Industrialization, and Labor Reform in the Gilded Age (Temple). (shrink)

This essay presents Genevieve Vaughan’s writings on language, communication and social praxis for social change. Mothering/being-mothered is thematized, in the framework of gift logic, as a core practice characterizing human relationships, shedding new light on the properly human in terms of gift economy values.