Business and Society Review, Volume 127, Issue S1, Page 193-222, Spring 2022.

BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...) objective of this review was to identify and map the outcomes reported in primary studies of CEC. The secondary objective was to provide a comprehensive overview of CEC structures, processes, and roles to enhance understanding and to inform standardization.MethodsWe searched electronic databases to identify primary studies of CEC involving patients, substitute decision-makers and/or family members, clinicians, healthcare staff and leaders. Outcomes were mapped across five conceptual domains as identified a priori based on our clinical ethics experience and preliminary literature searches and revised based on our emerging interpretation of the data. These domains included personal factors, process factors, clinical factors, quality, and resource factors. ResultsForty-eight studies were included in the review. Studies were highly heterogeneous and varied considerably regarding format and process of ethical intervention, credentials of interventionist, population of study, outcomes reported, and measures employed. In addition, few studies used validated measurement tools. The top three outcome domains that studies reported on were quality, process factors, and clinical factors. The majority of studies examined multiple outcome domains. All five outcome domains were multidimensional and included a variety of subthemes.ConclusionsThis scoping review represents the initial phase of mapping the outcomes reported in primary studies of CEC and identifying gaps in the evidence. The confirmed lack of standardization represents a hindrance to the provision of high quality intervention and CEC scientific progress. Insights gained can inform the development of a core outcome set to standardize outcome measures in CEC evaluation research and enable scientifically rigorous efficacy trials of CEC. (shrink)

BackgroundThere is growing interest in the collection, storage and reuse of biological samples for future research. Storage and future use of biological samples raise ethical concerns and questions about approaches that safeguard the interests of participants. The situation is further complicated in Africa where there is a general lack of governing ethical frameworks that could guide the research community on appropriate approaches for sample storage and use. Furthermore, there is limited empirical data to guide development of such frameworks. A qualitative (...) study to address this gap was conducted with key stakeholders in Malawi to understand their experiences and perspectives regarding storage and usage of samples for future research.MethodsThis study conducted 13 in-depth interviews with ethics committee members, regulators and researchers, and five focus group discussions with community representatives and clinical trial participants in Malawi. Interviews and focus group discussions were audio-recorded, transcribed verbatim, and thematically analysed.ResultsOn the current regulatory guidelines that governs the collection, storage and reuse of samples in Malawi, participants highlighted their different understanding of it, with some indicating that it prohibited the reuse and sharing of samples, while others believed it permitted.Views on the informed consent model used in Malawi, some stakeholders expressed that the current model limited options for sample contributors regarding future use. Researchers supported storing samples for future use in order to maximize their value and reduce research costs. However, they expressed concern over the exportation of samples highlighting that it could lead to misuse and would not support the development of research capacity within Malawi. They recommended use of broad consent or tiered consent and establishment of biobanks to address these concerns.ConclusionsStudy findings highlighted the need for a review of the current regulatory guideline and the development of infrastructure to support the use of stored biological samples for future use among the research community in Malawi. At the moment, there are ethical and practical concerns arising from the collection, storage and secondary use of biological samples make it hard to reconcile scientific progress and the protection of participants. (shrink)

Alison Gopnik and her collaborators have recently proposed a bold and intriguing hypothesis about the relationship between scientific cognition and cognitive development in childhood. According to this view, the processes underlying cognitive development in infants and children and the processes underlying scientific cognition are _identical_. We argue that Gopnik’s bold hypothesis is untenable because it, along with much of cognitive science, neglects the many important ways in which human minds are designed to operate within a social environment. This leads to (...) a neglect of _norms_ and the processes of _social_ _transmission_ which have an important effect on scientific cognition and cognition more generally. (shrink)

Against the medical and social models of disability are two newer proposals. Elizabeth Barnes’ Minority Body proposes that it is the bodies which are advocated for and included in the disability rights movement which are rightfully called “disabled.” Savulescu and Kahane’s Welfarist approach proposes that disability is intrinsically tied to the effects of bodily states on welfare. They put the need for a consistent and relatively simple normative theory above accounting for standard case judgements about who is and is not (...) disabled or looking at all to membership of the disabled community. I argue that Barnes’ theory offers the best response to issues with the dominant models of disability. Further, I argue that the Welfarist theory operates in a space removed from the wishes and lived experiences of disabled people – separating ‘disability’ from activism entirely – to its detriment. Doing so compromises its explanatory power, over-generalizes the concept and prevents the insertion of meaningful boundaries. Barnes’ ‘solidarity thesis’ soundly conceptualizes disability whilst making room for activist voices. The centering of activist projects makes it stronger. (shrink)

Disturbing international inequalities in health abound. Life expectancy in Swaziland is half that in Japan. A child unfortunate enough to be born in Angola has 73 times as great a chance of dying before age 5 as a child born in Norway. A mother giving birth in southern sub-Saharan Africa has 100 times as great a chance of dying from her labor as one birthing in an industrialized country. For every mile one travels outward toward the Maryland suburbs from downtown (...) Washington, DC on its underground rail system, life expectancy rises by a year – reflecting the race and class inequities in American health. Are the glaring, even larger, international health inequalities also unjust? -/- All of us no doubt think they are grossly unfortunate. Many of us think they are unfair or unjust. Why should some people be at such a health disadvantage through no fault of their own, losers in a natural and social lottery assigning them birth in an unhealthy place? Others of us are troubled by the absence of the kinds of human relationships that ordinarily give rise to the claims of egalitarian justice that we make on each other – for example, being fellow citizens or even interacting in a cooperative scheme. Who has obligations of justice to reduce these international inequalities? And do those obligations hold regardless of how the inequalities came about? What institutions are accountable for addressing them? (shrink)

Many societies, and nearly all wealthy, developed countries, provide universal access to a broad range of public health and personal medical services. Is such access to health care a requirement of social justice, or is it simply a matter of social policy that some countries adopt and others do not? If it is a requirement of social justice, we should be clear about what kinds of care we owe people and how we determine what care is owed if we cannot (...) possibly meet every health need, as arguably no society can. We should be clear about what constitutes appropriate access to that care, given that there are diverse barriers to access. We must also be able to say why we owe these things as a matter of justice, and, of course, different accounts of social justice will bake and serve this cake in different ways. (shrink)

How should medical services be distributed within society? Who should pay for them? Is it right that large amounts should be spent on sophisticated technology and expensive operations, or would the resources be better employed in, for instance, less costly preventive measures? These and others are the questions addreses in this book. Norman Daniels examines some of the dilemmas thrown up by conflicting demands for medical attention, and goes on to advance a theory of justice in the distribution of (...) health care. The central argument is that health care, both preventive and acute, has a crucial effect on equality of opportunity, and that a principle guaranteeing equality of opportunity must underly the distribution of health-care services. Access to care, preventive measures, treatment of the elderly, and the obligations of doctors and medical administrations are fully discussed, and the theory is shown to underwrite various practical policies in the area. (shrink)

Upholding cooperative norms via punishment is of central importance in organizations. But what effect does punishing have on the reputation of the punisher? Although previous research shows third parties can garner reputational benefits for punishing transgressors who violate social norms, we proposed that such reputational benefits can vary based on the perceived motive for the punishment. In Studies 1 and 2, we found that individuals who endorsed a consequentialist (versus deontological) motive for punishing were seen as more trustworthy. In Study (...) 3, the results showed that when pitted against one another, a person who endorsed a consequentialist (versus deontological) motive for punishing was chosen more often as a partner in a Trust Game. In Study 4, we found that a manager who expressed a consequentialist reason for punishing an employee was seen as having less psychopathic tendencies, and this related to the manager being perceived as more trustworthy and a superior cooperation partner. Using a recall methodology, Study 5 results showed that employees who perceived their managers as having more consequentialist (versus deontological) motives for punishing also perceived their managers as being less psychopathic and more trustworthy. Theoretical and practical implications are discussed. (shrink)

The ever-growing acceptance and use of assisted human reproduction techniques has caused demand for “donated” sperm and eggs to outstrip supply. Medical professionals and others argue that monetary reward is the only way to recruit sufficient numbers of “donors”. Is this a clash between pragmatics and policy/ethics? Where monetary payments are the norm, alternative recruitment strategies used successfully elsewhere may not have been considered, nor the negative consequences of commercialism on all participants thought through. Considerations leading some countries to ban (...) the buying and selling of sperm, eggs and embryos are outlined and a case made that the collective welfare of all involved parties be the primary consideration in this, at times heated, debate. (shrink)

The treatment-enhancement distinction draws a line between services or interventions meant to prevent or cure conditions that we view as diseases or disabilities and interventions that improve a condition that we view as a normal function or feature of members of our species. The line drawn here is widely appealed to in medical practice and medical insurance contexts, as well as in our everyday thinking about the medical services we do and should assist people in obtaining.

Philosophical Investigations, Volume 45, Issue 2, Page 146-160, April 2022.

Hegel’s view of India is famously negative, and postcolonial scholarship has been largely dominated by a view of Hegel as little more than a chauvinist. This paper argues that this interpretation is one-sided and overly simplistic. Most approaches to Hegel on India focus on the well-known lectures on the philosophy of history, imposing an overly teleological reading upon Hegel’s view of cultural difference. In contrast, I demonstrate the ambiguity of Hegel’s conception of India through a close reading of Hegel’s little-known (...) essay on the Bhagavad-Gītā (Über die unter dem Namen Bhagavad-Gita bekannte Episode des Mahabharata von Wilhelm von Humboldt). Hegel believed that the Bhagavad-Gītā was India’s paradigmatic text, and he used this essay as a platform for discussing Indian thought in general. In distinction to Bradley Herling’s interpretation of the Gītā essay, I contend that here Hegel has an unexpectedly positive view of Indian thought, but only insofar as it appears to reflect his own. (shrink)

Endurantists have recently faced a mereological puzzle in various forms. Here I argue that, instead of presenting a genuine worry, the puzzle actually reveals a common misunderstanding about the endurantist ontology. Furthermore, through this discussion of the alleged problem and the misunderstanding which motivates it, I reveal metaphysical commitments the endurantist has that may not be widely recognized. For instance, she is committed to interesting and perhaps controversial views about shape and location. I highlight these commitments and what they mean (...) for the endurantist. (shrink)

Bioethics' traditional focus on clinical relationships and exotic technologies has led the field away from population health, health disparities, and issues of justice. The result: a myopic view that misses the institutional context in which clinical relationships operate and can overlook factors that affect health more broadly than do exotic technologies. A broader bioethics agenda would take up unresolved questions about the distribution of health and the development of fair policies that affect health distribution.

People tend to contribute more—and think they have stronger obligations to contribute more—to rescuing an identified victim rather than a statistical one. Indeed, they are often disposed to contribute more to rescuing a single identified victim than a greater number of statistical ones. By an “identified victim,” I mean Terry Q., lying injured in the passenger seat of the wrecked automobile on the corner of Main Street and Broadway, or Jessica McClure, the child who fell into the Texas well in (...) 1987 and whose family was sent $700,000 in donations for her. We need not know their names, however, and we can accept a very minimal form of identification. By a “statistical victim,” I mean the person who, extrapolating from traffic records, will be in a similar, serious car accident tomorrow (and may then be identified), or the children who will fall into wells next year if we do not cap them better than we did the well that trapped Jessica. Does this disposition (or perceived obligation) have any normative force? I initially thought there could be no such normative force, but consequentialist and nonconsequentialist arguments, pro and con, have convinced me that reasonable people can disagree with each other. This disagreement poses a problem for political philosophy: how should policy choices take such disagreement into account? (shrink)

The rapidly increasing numbers of elderly people in our society have raised some important moral questions: How should we distribute social resources among different age groups? What does justice require from both the young and the old? In this book, Norman Daniels offers the first systematic philosophical discussion of these urgent questions, advocating what he calls a "lifespan" approach to the problem: Since, as they age, people pass through a variety of institutions, the challenge of caring for the elderly (...) becomes the prudent allocation of public resources among the various stages of people's lives. Using this philosophical approach, Daniels addresses specific public policy issues such as the allocation of medical funds, the adequacy of long-term care, current Medicare cost-containment measures, and the equitable distribution of income support over the lifespan and between generations. (shrink)

I argue that David Lewis’s philosophically dominant conception of time travel cannot straightforwardly handle what we might call cases of relativistic time travel—that is, the sort of time travel which could only plausibly occur in a relativistic setting. I evaluate whether or not the Lewisian account can be successfully adapted such that it would able to analyse potential cases of relativistic time travel satisfactorily while still being employable in the analysis of those cases that make no mention of physics or (...) the structure of spacetime. This is primarily an analytical and explanatory exercise, rather than a polemical one. (shrink)

We introduce new leader humility scales capturing a theoretically rich conceptualization of leader-expressed humility aligned with traditional and ethically-grounded philosophies. These scales draw from recent inductive research (Oc et al., 2015) identifying nine dimensions of leader-expressed humility: (1) having an accurate view of self, (2) recognizing follower strengths and achievements, (3) modeling teachability and being correctable, (4) leading by example, (5) showing modesty, (6) working together for the collective good, (7) empathy and approachability, (8) showing mutual respect and fairness, and (...) (9) mentoring and coaching. The first three dimensions overlap with the most prominent conceptualization of leader-expressed humility in the literature (i.e., Owens et al., 2013). However, the latter six dimensions are unique and represent an expanded understanding of the humble behaviors of leaders, which have implications for leaders and their ethical behavior in organizations. We conducted three studies resulting in two versions of the leader-expressed humility measure: 1) a 27-item scale with the nine dimensions (i.e., the “Leader-Expressed Humility” [LEH] scale) and 2) a 9-item brief scale (i.e., the “Brief LEH” scale) comprised of one item from each of the nine dimensions. As an initial step, we generated a pool of items that reflected each dimension. Next, we validated the LEH and Brief LEH scales in Study 1 and cross-validated the Brief LEH scale in Study 2 with two samples of subordinates in Singapore. As a final step, in Study 3, we cross-validated the Brief LEH scale with a sample of subordinates in the United States. (shrink)

Healthcare (including public health) is special because it protects normal functioning, which in turn protects the range of opportunities open to individuals. I extend this account in two ways. First, since the distribution of goods other than healthcare affect population health and its distribution, I claim that Rawls's principles of justice describe a fair distribution of the social determinants of health, giving a partial account of when health inequalities are unjust. Second, I supplement a principled account of justice for health (...) and healthcare with an account of fair process for setting limits or rationing care. This account is provided by three conditions that comprise "accountability for reasonableness.". (shrink)

In this book by the award-winning author of Just Healthcare, Norman Daniels develops a comprehensive theory of justice for health that answers three key questions: what is the special moral importance of health? When are health inequalities unjust? How can we meet health needs fairly when we cannot meet them all? Daniels' theory has implications for national and global health policy: can we meet health needs fairly in ageing societies? Or protect health in the workplace while respecting individual (...) liberty? Or meet professional obligations and obligations of justice without conflict? When is an effort to reduce health disparities, or to set priorities in realising a human right to health, fair? What do richer, healthier societies owe poorer, sicker societies? Just Health: Meeting Health Needs Fairly explores the many ways that social justice is good for the health of populations in developed and developing countries. (shrink)

A moral right to health or health care is a special instance of a right to fair equality of opportunity. Nation-states generally have the capabilities to specify the entitlements of such a right and to raise the resources needed to satisfy those entitlements. Can these functions be replicated globally, as a global right to health or health care requires? The suggestion that “better global governance” is needed if such a global right is to be claimed requires that these two central (...) capabilities be present. It is unlikely that nation-states would concede these two functions to a form of global governance, for doing so would seriously compromise the authority that is generally included in sovereignty. This claim is a specification of what is often recognized as the “sovereignty problem.” The argument of this paper is not an “impossibility” claim, but a best guess about whether the necessary conditions for better global governance that supports a global right to health or health care can be achieved. (shrink)

The Routledge Classic Edition of Daniels’ influential 2001 text _Vygotsky and Pedagogy_ explores the growing interest in Vygotsky and the pedagogic implications of the body of work that is developing under the influence of his theories. With a new preface from Harry Daniels this book explores the growing interest in Vygotsky and the pedagogic implications of the body of work that is developing under the influence of his theories. It provides an overview of the ways in which the (...) original writing has been extended and identifies areas for future development. The author considers how these developments are creating new and important possibilities for the practices of teaching and learning in school and beyond, and illustrates how Vygotskian theory can be applied in the classroom. The book is intended for students and academics in education and the social sciences and will be of interest to all those who wish to develop an analysis of pedagogic practice within and beyond the field of education. (shrink)

Background Non-violent resistance which has involved healthcare workers has been instrumental in securing a number of health-related gains and a force in opposing threats to health. Despite this, we know little about healthcare workers who have engaged in acts of non-violent resistance. Research aim Amongst a sample of healthcare workers who had engaged in acts of resistance this study sought to explore their understanding of non-violent resistance and how or whether they felt healthcare workers made a distinct contribution to such (...) action. Research design Cross-sectional survey Participants and research context Healthcare workers (doctors, nurses, academics and others) from the UK and Europe who had engaged in acts of non-violent resistance. Ethical considerations Ethical approval for this study was granted by the University of Greenwich Human Research Ethics Committee (UREC/20.5.6.11). Findings/results Most participants spoke about the nature of non-violent resistance, its oppositional, didactic and symbolic functions and the role of violence or harm. While most people understood non-violent resistance as a public, oppositional and collective act, many identified more subtle everyday acts in the workplace that undermined policy or procedures they saw as harmful. When asked about distinctions in non-violent resistance carried out by healthcare workers, most participants referred to their standing in society, noting that healthcare works were a trusted and authoritative source. Some identified an ethical imperative to act while others identified the risks that came with such action, noting their accountability and responsibility they had to patients. About a quarter of participants felt that such action was no different to others carrying out non-violent resistance or dependent on the issue or nature of the action. Conclusions These findings speak to the complex and multifaceted nature of non-violent resistance. Additionally our findings suggest healthcare workers have a distinct role to play in leading and supporting non-violent actions. (shrink)

BackgroundNational guidelines require programmes use subjective assessments of social support when determining transplant suitability, despite limited evidence linking it to outcomes. We examined how transplant providers weigh the importance of social support for kidney transplantation compared with other factors, and variation by clinical role and personal beliefs.MethodsThe National survey of the American Society of Transplant Surgeons and the Society of Transplant Social Work in 2016. Using a discrete choice approach, respondents compared two hypothetical patient profiles and selected one for transplantation. (...) Conditional logistic regression estimated the relative importance of each factor; results were stratified by clinical role and beliefs.ResultsFive hundred and eighy-four transplant providers completed the survey. Social support was the second most influential factor among transplant providers. Providers were most likely to choose a candidate who had social support, always adhered to a medical regimen, and had a 15 years life expectancy with transplant. Psychosocial providers were more influenced by adherence and quality of life compared with medical/surgical providers, who were more influenced by candidates' life expectancy with transplant. For providers concerned with avoiding organ waste, social support was the most influential factor, while it was the least influential for clinicians concerned with fairness.ConclusionsSocial support is highly influential in listing decisions and may exacerbate transplant disparities. Providers’ beliefs and reliance on social support in determining suitability vary considerably, raising concerns about transparency and justice. (shrink)

The current two-sample investigation explores the role of enactment as a boundary condition in the relationship between experienced incivility and workplace outcomes. We integrate the tenets of the transactional model of stress and sensemaking theory to explain why enactment is a psychological sensemaking capability that can neutralize the adverse effects of experienced incivility on workplace outcomes. The results across two samples of data supported the study hypotheses by demonstrating that experienced incivility had stronger adverse effects on employees’ job satisfaction, OCBs, (...) and turnover intent for employees who reported lower levels of enactment than employees who reported higher levels of enactment. This study’s results make three important contributions to theory and research. First, we make an empirical contribution by examining enactment as a psychological sensemaking capability that can neutralize the adverse effects of experienced incivility on workplace outcomes. Second, we make a theoretical contribution by integrating the tenets of the transactional model of stress and sensemaking theory in a novel way that explains why enactment is a psychological sensemaking capability that can neutralize the adverse effects of stress on strain. Third, we demonstrate that enactment is the boundary condition that explains why incivility does not have universally adverse effects on employees’ outcomes. (shrink)

Transpersonal Psychology concerns the study of those states and processes in which people experience a deeper sense of who they are, or a greater sense of connectedness with others, with nature, or the spiritual dimension. Pioneered by respected researchers such as Jung, Maslow and Tart, it has nonetheless struggled to find recognition among mainstream scientists. Now that is starting to change. Dr. Michael Daniels teaches the subject as part of a broadly-based psychology curriculum, and this book brings together the (...) fruits of his studies over recent years. It will be of special value to students, and its accessible style will appeal also to all who are interested in the spiritual dimension of human experience. The book includes a detailed 38-page glossary of terms and detailed indexes. (shrink)

This essay explores the relationship between nature and grace and the theological impact of this relationship on feminist anthropological debates. Engaging this debate through an examination and critique of Serene Jones’ ‘eschatological essentialism’, this essay suggests that Jones mistakenly characterizes constructivism, and thus turns too quickly to an essentialist paradigm without considering its risks. Using Judith Butler and Karl Barth, this essay proposes an account of identity that the author calls a ‘Christological constructivism’. Suggesting that the person and work of (...) Christ instantiates a grace that disrupts nature, Daniels argues for an account of identity as ‘more-than’, suggesting that this anthropology engenders healing for women, and men, within communities religious and otherwise. (shrink)

In a recent article, Don Marquis canvasses the arguments on both sides of the abortion controversy and then puts forward his own argument against abortion:A. To deprive someone of the value of his or her future is prima facie wrong.B. The future an adult has is included in the future of the fetus it developed from.C. Abortion deprives the fetus of the value of its future.D. Therefore, abortion is prima facie wrong.I wish to show that this reasoning in no way (...) settles the issue of whether abortion is wrong. Section 1 concerns premise B, Sections 2 and 3 C, and Section 4 A.Notes. (shrink)