The philosophy of family‐centered care (FCC) promotes partnerships between families and staff to plan, deliver, and evaluate services for children and has been officially adopted by a majority of pediatric hospitals throughout North America. However, studies indicated that many parents have continued to be dissatisfied with their decision‐making roles in their child's care. This is particularly salient for parents of children with chronic ongoing complex health problems. These children are dependent upon medical technology and require frequent hospitalizations during which parents (...) must contribute to difficult decisions regarding their child's care. Given this clinical issue, an alternative theoretical perspective was explored to redress this problem. Pierre Bourdieu's theoretical concepts of field, capital, and habitus were used to analyze the hierarchical relationships in pediatric acute care hospitals and to design a briefing intervention aimed at improving parents' satisfaction with decision making in that health care setting. (shrink)

This article reports on the Boundaries in Practice (BIP) Scale developed to measure knowledge, comfort, ethical decision making, and experience. Few instruments used in studies conducted on professional/?client boundaries have been validated. The BIP demonstrated sound face, content and construct validity, and adequate internal consistency reliability. The BIP Scale provides the first reliable and valid means of investigating multiple boundary domains across health disciplines and teams. The sensitivity and complexity of boundary issues and the serious consequences of breaches highlight the (...) importance of a valid and reliable measure in building empirical knowledge in this field. (shrink)

Introduction Future HIV vaccine efficacy trials with adolescents will need to ensure that participants comprehend study concepts in order to confer true informed assent. A Hepatitis B vaccine trial with adolescents offers valuable opportunity to test youth understanding of vaccine trial requirements in general. Methods Youth reviewed a simplified assent form with study investigators and then completed a comprehension questionnaire. Once enrolled, all youth were tested for HIV and confirmed to be HIV-negative. Results 123 youth completed the questionnaire (mean age=15 (...) years; 63% male; 70% Hispanic). Overall, only 69 (56%) youth answered all six questions correctly. Conclusions Youth enrolled in a Hepatitis B vaccine trial demonstrated variable comprehension of the study design and various methodological concepts, such as treatment group masking. (shrink)

BackgroundStructured, systematic methods to formulate consensus recommendations, such as the Delphi process or nominal group technique, among others, provide the opportunity to harness the knowledge of experts to support clinical decision making in areas of uncertainty. They are widely used in biomedical research, in particular where disease characteristics or resource limitations mean that high-quality evidence generation is difficult. However, poor reporting of methods used to reach a consensus – for example, not clearly explaining the definition of consensus, or not stating (...) how consensus group panellists were selected – can potentially undermine confidence in this type of research and hinder reproducibility. Our objective is therefore to systematically develop a reporting guideline to help the biomedical research and clinical practice community describe the methods or techniques used to reach consensus in a complete, transparent, and consistent manner.MethodsThe ACCORD project will take place in five stages and follow the EQUATOR Network guidance for the development of reporting guidelines. In Stage 1, a multidisciplinary Steering Committee has been established to lead and coordinate the guideline development process. In Stage 2, a systematic literature review will identify evidence on the quality of the reporting of consensus methodology, to obtain potential items for a reporting checklist. In Stage 3, Delphi methodology will be used to reach consensus regarding the checklist items, first among the Steering Committee, and then among a broader Delphi panel comprising participants with a range of expertise, including patient representatives. In Stage 4, the reporting guideline will be finalised in a consensus meeting, along with the production of an Explanation and Elaboration document. In Stage 5, we plan to publish the reporting guideline and E&E document in open-access journals, supported by presentations at appropriate events. Dissemination of the reporting guideline, including a website linked to social media channels, is crucial for the document to be implemented in practice.DiscussionThe ACCORD reporting guideline will provide a set of minimum items that should be reported about methods used to achieve consensus, including approaches ranging from simple unstructured opinion gatherings to highly structured processes. (shrink)

Martin Heidegger's commitment to the idea that _Dasein_ is ultimately gender neutral, as well as several other major aspects of his thought, raises significant questions for feminist philosophers. The fourteen essays included in this volume clearly illustrate the ways in which feminist readings can deepen our understanding of his philosophy. They illuminate both the richness and the limitations of the resources his work can provide for feminist thought. This volume engages the full scope of Heidegger's writings from_ Being and Time (...) _through his latest work, from his readings of the ancient Greek poets to his critique of modern technology. At the same time, it reflects a wide range of contemporary feminist concerns: the significance of gender difference; the role of the body in philosophical thought; the relationship between philosophy and the natural world, and between philosophy and the domestic realm; and the aspiration to move forward into a new, more just, political world. Included in this volume are important new essays by Ellen Armour, Carol Bigwood, Jack Caputo, Tina Chanter, Trish Glazebrook, Jennifer Gosetti, Luce Irigaray, Dorothy Leland, Mechthild Nagel, Gail Stenstad, and the editors—as well as a valuable historical and theoretical Introduction by Patricia Huntington, the first of Jacques Derrida's "Geschlecht" articles, and an important 1997 essay by Iris Marion Young. (shrink)

In its treatment of the role of emotion in ethics the argument of the book outlines a new way of packing motivational force into moral meaning that allows for a ...

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)

The idea of a role in nursing that includes expertise in ethics has been around for more than 30 years. Whether or not one subscribes to the idea that nursing ethics is separate and distinct from bioethics, nursing practice has much to contribute to the ethical practice of healthcare, and with the strong grounding in ethics and aspiration for social justice considerations in nursing, there is no wonder that the specific role of the nurse ethicist has emerged. Nurse ethicists, expert (...) in nursing practice and the application of ethical theories and concepts, are well positioned to guide nurses through complex ethical challenges. However, there is limited discussion within the field regarding the specific job responsibilities that the nurse ethicist ought to have. The recent appearance of job postings with the title “nurse ethicist” suggest that some healthcare institutions have identified the value of a nurse in the practice of ethics and are actively recruiting. Discomfort about the possibility of others defining the role of the nurse ethicist inspired this paper (and special issue). If the nurse ethicist is to be seen as an integral part of addressing ethical dilemmas and ethical conflicts that arise in healthcare, then nurse ethicists ought to be at the forefront of defining this role. In this paper, we draw upon our own experiences as nurse ethicists in large academic healthcare systems to describe the essential elements that ought to be addressed in a job description for a nurse ethicist practicing in a clinical setting linked to academic programs. Drawing upon our experience and the literature, we describe how we perceive the nurse ethicist adds value to healthcare organizations and teams of professional ethicists. (shrink)

The area of services marketing is a highly crucial one for potential ethical violations. The services industry, which drives over two-thirds of our national economy, is about to experience severe changes due to increasing competition. The temptation to make ethical compromises will pose a dramatic threat to the business climate.We review conceptual approaches to the field of marketing ethics and conclude that existing models often lack an important component which affects ethical decision-making. That component includes the interorganizational variables: the primary (...) task environment, including immediate customers and suppliers to the buyer and seller; the secondary task environment, comprised of suppliers and customers to the immediate suppliers and customers, competitors, and regulatory agencies, and the macro-environment, those broader forces which impinge on the activities in the primary and secondary task environments. (shrink)

Although affective facial pictures are widely used in emotion research, standardised affective stimuli sets are rather scarce, and the existing sets have several limitations. We therefore conducted a validation study of 490 pictures of human facial expressions from the Karolinska Directed Emotional Faces database (KDEF). Pictures were evaluated on emotional content and were rated on an intensity and arousal scale. Results indicate that the database contains a valid set of affective facial pictures. Hit rates, intensity, and arousal of the 20 (...) best KDEF pictures for each basic emotion are provided in an appendix. (shrink)

This paper contributes to the contemporary business ethics narrative by proposing an approach to corporate ethical decision making (EDM) which serves as an alternative to the imposition of codes and standards to address the ethical consequences of grand challenges, like COVID-19, which are impacting today’s society. Our alternative approach to EDM embraces the concept of reflexive thinking and ethical consciousness among the individual agents who collectively are the corporation and who make ethical decisions, often in isolation, removed from the collocated (...) corporate setting. We draw on the teachings of the Canadian philosopher and theologian, Fr. Bernard Lonergan, to conceptualize an approach to EDM which focuses on the ethics of the corporate agent by nurturing the universal and invariant structure that is operational in all human beings. Embracing Lonergan’s dynamic cognitive structure of human knowing, and the structure of the human good, we advance a paradigm of EDM in business which emboldens authentic ethical thought, decision making, and action commensurate with virtuous living and germane to human flourishing. Lonergan’s philosophy guides us away from the imposition of over-arching corporate codes of ethics and inspires us, as individual agents, to attend to the data of our own consciousness in our ethical decision making. Such cognitional endowment leads us out of the ethics of the ‘timeless present’ (Islam and Greenwood in Journal of Business Ethics 170: 1–4, 2021) towards ethical authenticity in business, leaving us better placed to reflect upon and address the ethical issues emanating from grand challenges like COVID-19. (shrink)

I analyze the extent to which classical phase transitions, both first order and continuous, pose a challenge for intertheoretic reduction. My contention is that phase transitions are compatible with a notion of reduction that combines Nagelian reduction and what Thomas Nickles called Reduction2. I also argue that, even if the same approach to reduction applies to both types of phase transitions, there is a crucial difference in their physical treatment: in addition to the thermodynamic limit, in continuous phase transitions there (...) is a second infinite limit involved, which marks an important difference in the reduction of first-order and continuous phase transitions. (shrink)

This paper defends the view that Frege’s reduction of arithmetic to logic would, if successful, have shown that arithmetical knowledge is analytic in essentially Kant’s sense. It is argued, as against Paul Benacerraf, that Frege’s apparent acceptance of multiple reductions is compatible with this epistemological thesis. The importance of this defense is that (a) it clarifies the role of proof, definition, and analysis in Frege’s logicist works; and (b) it demonstrates that the Fregean style of reduction is a valuable tool (...) for those who would investigate the nature of arithmetical knowledge. (shrink)

As the world held its breath for news surrounding COVID-19 and hunkered down amidst stay-at-home orders, medical students across the U.S. wondered if they would be called to serve on the front lines of the pandemic. Medical school administrators faced the challenge of protecting learners while also minimizing harm to their medical education. This balancing act raised critical questions in medical education as institutions reacted to changing guidelines. COVID-19 has punctuated already contentious areas of medical education and has forced institutions (...) and organizations to take quick action. From the perspectives of a recent medical school graduate and current resident and a practicing clinician-educator, we examine the pandemic’s impact on undergraduate medical education through an ethical lens. First, we explore the value of medical education, what drives this value, and how COVID-19 may alter it. We next consider student choice and how shifts toward utilitarianism in healthcare during a pandemic may affect learning and career exploration. Then, we inquire how access to technology may impact the experience of medical students from diverse backgrounds and varied institutions during a rapid shift to socially distanced learning. We identify vulnerabilities for students at several phases of the journey: premedical, preclinical, clinical, and preparation for residency. Finally, we address the hidden curriculum of COVID-19, its potential erosion of empathy among current medical students, and possible long-term consequences for future physicians and patients. (shrink)

Patricia White; Friendship and Education, Journal of Philosophy of Education, Volume 24, Issue 1, 30 May 2006, Pages 81–92, https://doi.org/10.1111/j.1467-9752.

This paper focuses on the cognitive/computational and evolutionary levels. It describes three proposals to make cognition computationally tractable, namely: Resource Rationality, the Adaptive Toolbox and Massive Modularity. While each of these proposals appeals to evolutionary considerations to dissolve the intractability of cognition, Rich, Blokpoel, de Haan, and van Rooij argue that, in each case, the intractability challenge is not resolved, but just relocated to the level of evolution.

Empirically minded philosophers have raised questions about judgments and theories based on moral intuitions such as Rawls’s method of reflective equilibrium. But they work from the notion of intuitions assumed in empirical work, according to which intuitions are immediate assessments, as in psychologist Jonathan Haidt’s definition. Haidt himself regards such intuitions as an appropriate basis for moral judgment, arguing that normal agents do not reason prior to forming a judgment and afterwards just “confabulate” reasons in its defense. I argue, first, (...) that the notion of “considered intuitive judgment” that Rawls spells out when he first presents his method is pre-theoretical, but not at all pre-reflective, in the way Haidt’s definition supposes; it may rest on various forms of reasoning short of systematic derivation from theoretical principles. I go on to take issue with Haidt’s dismissal of ex post facto moral reasoning, arguing that it can play both a causal role in an individual’s later intuitions or judgments and a legitimate normative role, as required by moral competence in judging non-taboo cases. I suggest that the move from intuition to judgment and thence to ex post facto reasoning makes sense as a justificatory version of Peircean abduction, or what is now mainly called “inference to the best explanation.”. (shrink)

I agree with Dyck’s basic claim that Kant follows the methodology of Rational Psychology in setting up his critique of it: He starts as it starts, with an existential proposition ‘I think.’ On the other hand, I am not convinced of Dyck’s use of the Dreams essay in establishing a timeline for the development of Kant’s views on inner sense. That essay is evidence that Kant thinks that Schwendenborg’s metaphysics is ungrounded, because he has a crazy sort of inner sense, (...) but it does not show that Kant rejected a more standard internal sense at this time. I also suggest that some of Kant’s vacillation about inner sense depends on an unusual feature of his doctrine of the representations of space and time: They are composed of both sensory and a priori elements. My hypothesis is that the seeming vacillation about inner sense may be a reflection of whether whether he is considering it broadly, as a faculty that provides intuitions with a particular form, or whether he is restricting what it provides to what can be sensed. (shrink)

In this paper I focus on a use of an idea of evolution in transhumanist discussions about technologies, human enhancement, and a concept of posthuman. Charles Darwin’s evolutionary theory stands at the origin of transhumanist thought and provides a theoretical foundation for many contemporary transhumanists. However, in the paper I argue that the idea of evolution used by these writers mostly cannot be interpreted as direct continuation of Darwin’s notion of evolutionary theory. The text is divided into three sections. The (...) first section deals with Kurzweil’s term of evolution of our universe heading to the singularity. In the second section, I point out a metaphor which occurs in some transhumanist texts – the comparison of childhood and adulthood to natural and conscious evolution. The last section focuses on connection between the notions of progress, evolution, and human enhancement. (shrink)

This paper argues that Book 3 of Porphyry’s De abstinentia contains an overlooked argument in favor of vegetarianism for the sake of non-human animals themselves. The argument runs as follows: animals are essentially sentient creatures. Sentience (αἴσθησις) allows them to discern what is good for their survival and what is destructive to them, so that they can pursue the former and avoid the latter. As a result, animals (human and non-human) have preferences, desires, and hopes. Having purposeful strivings that can (...) be promoted or frustrated makes them recipients of justice and injustice. This means, for Porphyry, that animals, unlike plants, can be wronged since they are creatures that discern, and purposefully pursue, what is good or bad for them. This reading stands against interpretations that argue that Porphyry advocates vegetarianism only for our benefit, and not for the animals’ own sake. (shrink)

A challenge for cost-benefit analysis is that it ignores ethical values such as justice, fairness, and equity. One standard response is to regard CBA results as just one factor in a more complex decision-process where ethical and democratic factors are also considered. This paper considers an alternative response: extending CBA so that it takes into account not only self-interested input but also moral preferences such as a ‘taste’ for fairness. Drawing on existing research and the example of resource allocation, the (...) paper develops and analyzes objections to extended CBA. Evaluation of these objections, the paper shows, depends on how the original challenge is interpreted and how the problem of ‘ignoring’ ethical values is understood. While some interpretations lead to an impasse between defenders and critics of extended CBA, the paper proposes a novel interpretation – focused on political representationality – and showcases the limits of CBA as a coherent response. (shrink)

This paper develops and defends a conception of moral coherence that is suitable for use in contexts of principle pluralism. I argue that, as they are traditionally understood, coherence methods stack the deck against pluralist theories, by incorporating norms such as systematicity—that the principles of a theory should be as few and as simple as possible. I develop and defend an alternative, minimal, conception of coherence that focuses instead on consistency. It has been suggested that consistency in this context should (...) aim at the avoidance of conflict, but I argue against this: what matters is “case consistency,” or judging consistently from one case to another. This means judging in accordance with morally relevant similarities and differences. I defend my proposal of minimal coherence from objections having to do with complexity and arbitrariness. (shrink)

This paper attempts to determine what the.Characteristics of post-modernity, found within the work process, are, based on reflections on Latin America. In order to do this we look at post-modernity not as a context in and of itself, but as characteristics superimposed on these new forms of l..