Background Shared decision-making in healthcare is a collaborative process where patients are supported to make informed decisions according to their preferences. Healthcare decisions affect patients' lives which necessitates patients to participate in decisions concerning their health. This study explored experiences and ethical issues related to shared decision-making in a rural healthcare setting. Methods An exploratory qualitative study was conducted at Budumba Health Centre III and Butaleja Health Centre III in rural Eastern Uganda. In this study, 23 in-depth interviews were conducted (...) among 12 healthcare providers and 11 patients. Data was analyzed thematically using NVivo-12 plus software. Results Four themes emerged which included: Paternalistic cultures of care, challenges, strategies for improvement, and ethical issues. Patients at both facilities expressed the need to be involved in decision-making processes. However, many stressed that they are not engaged in decision-making about their health. Many healthcare providers noted that shared decision-making could improve patient prognosis but are faced with challenges related to low male involvement and the influence of cultural and religious practices, including myths and patriarchal attitudes which impact effective patient engagement. Ethical issues identified include concerns about informed consent, privacy and confidentiality, deception, and harm. Conclusions This study highlighted the need for better sensitization of patients and comprehensive training for healthcare providers to minimize and resolve ethical issues that emerge during shared decision-making processes. Therefore, targeted interventions are needed to enhance decision-making processes in rural healthcare including but not limited to developing shared decision-making manual and continuous training of healthcare providers to ethically engage patients. Further research is needed to explore larger facilities with a bigger scope including patients under 18 years of age and and their surrogates. (shrink)

Here at the Center, we had the privilege of seeing how Dan Callahan lived out his last days and weeks. True to his nature, Dan never stopped thinking or writing. Indeed, his wife Sidney told me that he finished his last essay one day before his death, on July 16th, insisting that she help him get to the computer so he could discuss it with a colleague. “It's my last one,” he told her with his characteristic self‐awareness. Dan also chose (...) the last topic he would focus on: climate change. At a December 2018 board meeting, Dan presented his desire to develop a workshop to explore the ways in which bioethics in general, and The Hastings Center in particular, might be able to make a valuable contribution to addressing the problem of global warming. (shrink)

Since the early 20th century, bioethics in South Africa has moved through several stages, responding to the same forces and developments as elsewhere, for example in the United Kingdom and United States. In addition, some unique developments in South Africa, for example the death of Steve Biko, the HIV/AIDS pandemic, and a peaceful transition to democracy with increased focus on human rights have given bioethics in South Africa its own dimension. Bioethics in South Africa reflects the general concerns of the (...) field elsewhere, but it also stands at the intersection of the concerns of both developed and developing worlds. Thus, issues such as resource allocation, HIV/AIDS, and medical research take on an urgency and character that reflect South Africa's particular historical, geographical, and social conditions. (shrink)

In December 1927, Alan Gregg,Associate Director of the RockefellerFoundation's Division of Medical Education, setoff from Paris on an exploratory mission toRussia. After a seventeen-day visit, Greggreturned firmly committed to improvingrelations. What did Gregg `see' in the field?Using the briefing book prepared for Gregg, histravel diaries, and his final report, thispaper analyses the social and cognitivedynamics of what became an exercise inFoundation bridge-building.

For the last forty years, two claims have been at the core of disputes about scientific change: that scientists reason rationally and that science is progressive. For most of this time discussions were polarized between philosophers, who defended traditional Enlightenment ideas about rationality and progress, and sociologists, who espoused relativism and constructivism. Recently, creative new ideas going beyond the polarized positions have come from the history of science, feminist criticism of science, psychology of science, and anthropology of science. Addressing the (...) traditional arguments as well as building on these new ideas, Miriam Solomon constructs a new epistemology of science. After discussions of the nature of empirical success and its relation to truth, Solomon offers a new, social account of scientific rationality. She shows that the pursuit of empirical success and truth can be consistent with both dissent and consensus, and that the distinction between dissent and consensus is of little epistemic significance. In building this social epistemology of science, she shows that scientific communities are not merely the locus of distributed expert knowledge and a resource for criticism but also the site of distributed decision making. Throughout, she illustrates her ideas with case studies from late-nineteenth- and twentieth-century physical and life sciences. Replacing the traditional focus on methods and heuristics to be applied by individual scientists, Solomon emphasizes science funding, administration, and policy. One of her goals is to have a positive influence on scientific decision making through practical social recommendations. (shrink)

✤ It is the characterization of those forms of reasoning that lead invariably from true sentences to true sentences, independently of the subject matter.

Using questionnaires, case studies, and problem-solving exercises, Robert C. Solomon shows corporations, employees, and students of business how to explore their own ethical principles and integrity. He illustrates how a workable ethical program can save a company when disaster strikes, as in the case of Johnson & Johnson's handling of the Tylenol poisonings, and how the lack of one can ensure the death of a good reputation, as in the case of Nestle's slow response to the protest they met (...) with they began marketing baby formula in third-world countries. Originally published as It's Good Business, this book has been extensively revised and updated to address ethical issues of the 1990s. The new edition includes new or expanded chapters on quality management, the customer, America and Japan, the environment, sexual harassment, and the glass ceiling for women and minorities. (shrink)

This text argues that justice is a virtue which everyone shares - a function of personal character and not just of government or economic planning. It uses examples from Plato to Ivan Boesky, to document how we live and how we feel.

The Greek philosopher Aristotle, writing over two thousand years before Wall Street, called people who engaged in activities which did not contribute to society "parasites." In his latest work, renowned scholar Robert C. Solomon asserts that though capitalism may require capital, but it does not require, much less should it be defined by the parasites it inevitably attracts. Capitalism has succeeded not with brute strength or because it has made people rich, but because it has produced responsible citizens and--however (...) unevenly--prosperous communities. It cannot tolerate a conception of business that focuses solely on income and vulgarity while ignoring traditional virtues of responsibility, community, and integrity. Many feel that there is too much lip-service and not enough understanding of the importance of cooperation and integrity in corporate life. This book rejects the myths and metaphors of war-like competition that cloud business thinking and develops an "Aristotelean" theory of business. The author's approach emphasizes several core concepts: the corporation as community, the search for excellence, the importance of integrity and sound judgment, as well as a more cooperative and humane vision of business. Solomon stresses the virtues of honesty, trust, fairness, and compassion in the competitive business world, and confronts the problem of "moral mazes" and what he posits as its solution--moral courage. (shrink)

ABOVE THE BOTTOM LINE focuses on the issues of the individual in the business environment, rather than focusing on large-scale, ethical decision making. Business is defended as a necessary and valuable component of contemporary life, a range of entrepreneurial ventures that should be approached in a principled, thoughtful, and honest manner. Looking at the importance of corporate culture, students are given direction in making personal and professional decisions at work, relating these to the concepts of social responsibility, employer and employee (...) rights, whistle-blowing, corporate governance, bankruptcy, and many other timely business issues. This text explores moral choices within the business environment, and considers current business policy issues. It is also a guide on how to think about business and a life in business, using vignettes from history and bits of literature and anthropology to broaden the students' outlook on commercial endeavors. (shrink)

Is it possible to be spiritual and yet not believe in the supernatural? Can a person be spiritual without belonging to a religious group or organization? In Spirituality for the Skeptic, philosopher Robert Solomon explores what it means to be spiritual in today's pluralistic world. Based on Solomon's own struggles to reconcile philosophy with religion, this book offers a model of a vibrant, fulfilling spirituality that embraces the complexities of human existence and acknowledges the joys and tragedies of (...) life. Solomon has forged an enlightened new path that synthesizes spirituality with emotions, intellect, science, and common sense. His new paradigm, "naturalized" spirituality, establishes as its cornerstone the "thoughtful love of life"--a passionate concern for the here-and-now, and not the by-and-by. Being spiritual doesn't mean being holed up as a recluse, spending hours in meditation and contemplation, Solomon argues. It demands involvement and emotional engagement with others in the struggle to find meaning in our lives. As such, this modern-day spirituality encompasses a passionate enthusiasm for the world, the transformation of self, cosmic trust and rationality, coming to terms with fate, and viewing life as a gift, all of which are explored in depth throughout this book. Spirituality for the Skeptic answers the need for a non-institutional, non-dogmatic spirituality that leads to personal fulfillment and satisfaction. By examining the ideas of great thinkers from Socrates and Nietzsche to Buddha to Kafka, Solomon arrives at a practical vision of spirituality that should appeal to many seekers looking to make sense of the human condition. (shrink)

In this collection of essays written over a period of twenty years, Solomon Feferman explains advanced results in modern logic and employs them to cast light on significant problems in the foundations of mathematics. Most troubling among these is the revolutionary way in which Georg Cantor elaborated the nature of the infinite, and in doing so helped transform the face of twentieth-century mathematics. Feferman details the development of Cantorian concepts and the foundational difficulties they engendered. He argues that the (...) freedom provided by Cantorian set theory was purchased at a heavy philosophical price, namely adherence to a form of mathematical platonism that is difficult to support. -/- Beginning with a previously unpublished lecture for a general audience, Deciding the Undecidable, Feferman examines the famous list of twenty-three mathematical problems posed by David Hilbert, concentrating on three problems that have most to do with logic. Other chapters are devoted to the work and thought of Kurt Gödel, whose stunning results in the 1930s on the incompleteness of formal systems and the consistency of Cantors continuum hypothesis have been of utmost importance to all subsequent work in logic. Though Gödel has been identified as the leading defender of set-theoretical platonism, surprisingly even he at one point regarded it as unacceptable. -/- In his concluding chapters, Feferman uses tools from the special part of logic called proof theory to explain how the vast part--if not all--of scientifically applicable mathematics can be justified on the basis of purely arithmetical principles. At least to that extent, the question raised in two of the essays of the volume, Is Cantor Necessary?, is answered with a resounding no. -/- This volume of important and influential work by one of the leading figures in logic and the foundations of mathematics is essential reading for anyone interested in these subjects. (shrink)