The aim of the present study was to investigate the association between work-related moral stress, moral climate and moral sensitivity in mental health nursing. By means of the three scales Hospital Ethical Climate Survey, Moral Sensitivity Questionnaire and Work-Related Moral Stress, 49 participants’ experiences were assessed. The results of linear regression analysis indicated that moral stress was determined to a degree by the work place’s moral climate as well as by two aspects of the mental health staff’s moral sensitivity. The (...) nurses’ experience of ‘moral burden’ or ‘moral support’ increased or decreased their experience of moral stress. Their work-related moral stress was determined by the job-associated moral climate and two aspects of moral sensitivity. Our findings showed an association between three concepts: moral sensitivity, moral climate and moral stress. Despite being a small study, the findings seem relevant for future research leading to theory development and conceptual clarity. We suggest that more attention be given to methodological issues and developing designs that allow for comparative research in other disciplines, as well as in-depth knowledge of moral agency. Copyright © 2011 by SAGE Publications. (shrink)

Identity construction — the process of creating and building a new future self — is an integral part of a person’s professional career development. However, at present we have little understanding of the psychological mechanisms that underpin this process. Likewise, we have little understanding of the barriers that obstruct it, and which thus may contribute to inequality in career outcomes. Using a social identity lens, and particularly the Social Identity Model of Identity Change (SIMIC), we explore the process of academic (...) identity construction among doctoral students. Through thematic analysis of semi-structured interviews with 22 PhD candidates, we observe that the identity construction process relies on a person’s perception of a navigable pathway between their current self and their future self. Importantly, participants who were able to access multiple identity resources were more likely to perceive a navigable pathway to a future professional self (e.g., as an academic), unless they perceived these identities to be incompatible with those held by leading members of the profession (e.g., their supervisors). This research suggests that the identities that people are able to access as they progress in their careers may play an important role in their ongoing professional identity construction and career success. (shrink)

Robust technology infrastructure is needed to enable learning health care systems to improve quality, access, and cost. Such infrastructure relies on the trust and confidence of individuals to share their health data for healthcare and research. Few studies have addressed consumers’ views on electronic data sharing and fewer still have explored the dual purposes of healthcare and research together. The objective of the study is to explore factors that affect consumers’ willingness to share electronic health information for healthcare and research. (...) This study involved a random-digit dial telephone survey of 800 adult Californians conducted in English and Spanish. Logistic regression was performed using backward selection to test for significant associations of each explanatory variable with the outcome variable. The odds of consent for electronic data sharing for healthcare decreased as Likert scale ratings for EHR impact on privacy worsened, odds ratio = 0.74, 95% CI [0.60, 0.90]; security, OR = 0.80, 95% CI [0.66, 0.98]; and quality, OR = 0.59, 95% CI [0.46–0.75]. The odds of consent for sharing for research was greater for those who think EHR will improve research quality, OR = 11.26, 95% CI [4.13, 30.73]; those who value research benefit over privacy OR = 2.72, 95% CI [1.55, 4.78]; and those who value control over research benefit OR = 0.49, 95% CI [0.26, 0.94]. Consumers’ choices about electronically sharing health information are affected by their attitudes toward EHRs as well as beliefs about research benefit and individual control. Design of person-centered interventions utilizing electronically collected health information, and policies regarding data sharing should address these values of importance to people. Understanding of these perspectives is critical for leveraging health data to support learning health care systems. (shrink)

This paper presents a summary and discussion of an assignment that asked students about the impact of Large Language Models on their college education. Our analysis summarizes students’ perception of GPT-3, categorizes their proposals for modifying college courses, and identifies their stated values about their college education. Furthermore, this analysis provides a baseline for tracking students’ attitudes toward LLMs and contributes to the conversation on student perceptions of the relationship between writing and philosophy.

Background Rapid ethical access to personal health information to support research is extremely important during pandemics, yet little is known regarding patient preferences for consent during such crises. This follow-up study sought to ascertain whether there were differences in consent preferences between pre-pandemic times compared to during Wave 1 of the COVID-19 global pandemic, and to better understand the reasons behind these preferences. Methods A total of 183 patients in the pandemic cohort completed the survey via email, and responses were (...) compared to the distinct pre-pandemic cohort ; all were patients of a large Canadian cancer center. The survey covered broad versus study-specific consent; opt-in versus opt-out contact approach; levels of comfort sharing with different recipients; perceptions of commercialization; and options to track use of information and be notified of results. Four focus groups were subsequently conducted to elucidate reasons motivating dominant preferences. Results Patients in the pandemic cohort were significantly more comfortable with sharing all information and biological samples, sharing information with the health care institution, sharing information with researchers at other hospitals, sharing PHI provincially, nationally and internationally compared to the pre-pandemic cohort. Discomfort with sharing information with commercial companies remained unchanged between the two cohorts. Significantly more pandemic cohort patients expressed a wish to track use of PHI, and to be notified of results. Thematic analysis uncovered that transparency was strongly desired on outside PHI use, particularly when commercialization was involved. Conclusions In pandemic times, patients were more comfortable sharing information with all parties, except with commercial entities, where levels of discomfort remained unchanged. Focus groups identified that the ability to track and receive results of studies using one’s PHI is an important way to reduce discomfort and increase trust. These findings meaningfully inform wider discussions on the use of personal health information for research during global crises. (shrink)

These comments, which take the form of criticism and response, were the basis of a zoom conversation at the Eastern APA, January 2021. Josh is putting them up on philpapers (with permission from all involved) in case they are helpful to people interested in the themes of this book.

Early in the COVID-19 pandemic there was widespread concern that healthcare systems would be overwhelmed, and specifically, that there would be insufficient critical care capacity in terms of beds, ventilators or staff to care for patients. In the UK, this was avoided by a threefold approach involving widespread, rapid expansion of critical care capacity, reduction of healthcare demand from non-COVID-19 sources by temporarily pausing much of normal healthcare delivery, and by governmental and societal responses that reduced demand through national lockdown. (...) Despite high-level documents designed to help manage limited critical care capacity, none provided sufficient operational direction to enable use at the bedside in situations requiring triage. We present and describe the development of a structured process for fair allocation of critical care resources in the setting of insufficient capacity. The document combines a wide variety of factors known to impact on outcome from critical illness, integrated with broad-based clinical judgement to enable structured, explicit, transparent decision-making founded on robust ethical principles. It aims to improve communication and allocate resources fairly, while avoiding triage decisions based on a single disease, comorbidity, patient age or degree of frailty. It is designed to support and document decision-making. The document has not been needed to date, nor adopted as hospital policy. However, as the pandemic evolves, the resumption of necessary non-COVID-19 healthcare and economic activity mean capacity issues and the potential need for triage may yet return. The document is presented as a starting point for stakeholder feedback and discussion. (shrink)

Since the early 1980’s, with the clinical advent of in vitro fertilization resulting in so-called “test tube babies,” a wide array of ethical considerations and concerns regarding artificial womb technology (AWT) have been described. Recent breakthroughs in the development of extracorporeal neonatal life support by means of AWT have reinitiated ethical interest about this topic with a sense of urgency. Most of the recent ethical literature on the topic, however, pertains not to the more imminent scenario of a physiologically improved (...) method of neonatal care through AWT, but instead to the remote scenario of “complete ectogenesis” that imagines human gestation occurring entirely outside of the womb. This scoping review of the ethical literature on AWT spans from more abstract concerns about complete ectogenesis to more immediate concerns about the soon-to-be-expected clinical life support of what we term the fetal neonate or fetonate. Within an organizing framework of different stages of human gestational development, from conception to the viable premature infant, we discuss both already identified and newly emerging ethical considerations and concerns regarding AWT and the care of the fetonate. (shrink)

How do actors cope when their repeated efforts to bring change seem futile? In this qualitative study, we consider sustainable development initiatives within a U.S. higher education institution where repeated efforts by actors led to nominal change. We focus on understanding how actors sought to enact sustainable development initiatives in the face of an unresponsive context, that is, in a context characterized by pressures to maintain the status quo. We show how actors’ attempts to embed sustainable development practices into the (...) university represent a dynamic process, characterized by periods of persistence and suspension. Our theorizing reveals that actors used three coping mechanisms to maintain focus on their sustainability goals: community building, resourcefulness, and vision. By emphasizing these dimensions of their initiatives, actors’ emotional response is focused on encouragement and hope to persist in a context that is largely unresponsive to sustainable development. Our study contributes to the sustainability literature by explicating how actors develop resilience in their efforts to pursue sustainable development in unresponsive contexts. (shrink)

In this co-authored article, one contributor presents a case story from an interview with a social worker in Slovenia, while five others offer commentaries on ethical aspects of the case. The story comes from a practitioner working with a pregnant young woman, arranging for adoption following birth. The social worker respected the woman’s request to keep her identity secret, hence not registering her in the institutional records. However, whilst the social worker was on holiday, the baby was born and anonymity (...) was not maintained. Commentaries 1 and 2 evaluate the story through its form: as a narrative with a tempo and plot; and as a performance that creates its narrator as an agent with an ethical identity. Commentary 3 uses a normative moral philosophical framework (virtue ethics), while the final two commentaries take a more grounded approach. Commentary 4 views the social worker as using discretion to act in a space void of rules (there is no provision for anonymous birth), whereas Commentary 5 foregrounds the Slovenian code of ethics as a source of ethical standards unremarked upon by the social worker. The article ends with reflections on the value of exploring multiple perspectives and engaging in dialogue in developing ethical understandings and actions. (shrink)

Is behavioral integration a necessary feature of belief in folk psychology? Our data from over 5,000 people across 26 samples, spanning 22 countries suggests that it is not. Given the surprising cross-cultural robustness of our findings, we argue that the types of evidence for the ascription of a belief are, at least in some circumstances, lexicographically ordered: assertions are first taken into account, and when an agent sincerely asserts that p, nonlinguistic behavioral evidence is disregarded. In light of this, we (...) take ourselves to have discovered a universal principle governing the ascription of beliefs in folk psychology. (shrink)

Cognitive flexibility, the adaptation of representations and responses to new task demands, improves dramatically in early childhood. It is unclear, however, whether flexibility is a coherent, unitary cognitive trait, or is an emergent dimension of task-specific performance that varies across populations with divergent experiences. Three-to 5-year-old English-speaking U.S. children and Tswana-speaking South African children completed two distinct language-processing cognitive flexibility tests: the FIM-Animates, a word-learning test, and the 3DCCS, a rule-switching test. U.S. and South African children did not differ in (...) word-learning flexibility but showed similar age-related increases. In contrast, U.S. preschoolers showed an age-related increase in rule-switching flexibility but South African children did not. Verbal recall explained additional variance in both tests but did not modulate the interaction between population sample (i.e., country) and task. We hypothesize that rule-switching flexibility might be more dependent upon particular kinds of cultural experiences, whereas word-learning flexibility is less cross-culturally variable. (shrink)

In the remainder of this article, we will disarm an important motivation for epistemic contextualism and interest-relative invariantism. We will accomplish this by presenting a stringent test of whether there is a stakes effect on ordinary knowledge ascription. Having shown that, even on a stringent way of testing, stakes fail to impact ordinary knowledge ascription, we will conclude that we should take another look at classical invariantism. Here is how we will proceed. Section 1 lays out some limitations of previous (...) research on stakes. Section 2 presents our study and concludes that there is little evidence for a substantial stakes effect. Section 3 responds to objections. The conclusion clears the way for classical invariantism. (shrink)

This article examines whether people share the Gettier intuition (viz. that someone who has a true justified belief that p may nonetheless fail to know that p) in 24 sites, located in 23 countries (counting Hong Kong as a distinct country) and across 17 languages. We also consider the possible influence of gender and personality on this intuition with a very large sample size. Finally, we examine whether the Gettier intuition varies across people as a function of their disposition to (...) engage in “reflective” thinking. (shrink)

Since at least Hume and Kant, philosophers working on the nature of aesthetic judgment have generally agreed that common sense does not treat aesthetic judgments in the same way as typical expressions of subjective preferences—rather, it endows them with intersubjective validity, the property of being right or wrong regardless of disagreement. Moreover, this apparent intersubjective validity has been taken to constitute one of the main explananda for philosophical accounts of aesthetic judgment. But is it really the case that most people (...) spontaneously treat aesthetic judgments as having intersubjective validity? In this paper, we report the results of a cross‐cultural study with over 2,000 respondents spanning 19 countries. Despite significant geographical variations, these results suggest that most people do not treat their own aesthetic judgments as having intersubjective validity. We conclude by discussing the implications of our findings for theories of aesthetic judgment and the purpose of aesthetics in general. (shrink)

Philosophers have long debated whether, if determinism is true, we should hold people morally responsible for their actions since in a deterministic universe, people are arguably not the ultimate source of their actions nor could they have done otherwise if initial conditions and the laws of nature are held fixed. To reveal how non-philosophers ordinarily reason about the conditions for free will, we conducted a cross-cultural and cross-linguistic survey (N = 5,268) spanning twenty countries and sixteen languages. Overall, participants tended (...) to ascribe moral responsibility whether the perpetrator lacked sourcehood or alternate possibilities. However, for American, European, and Middle Eastern participants, being the ultimate source of one’s actions promoted perceptions of free will and control as well as ascriptions of blame and punishment. By contrast, being the source of one’s actions was not particularly salient to Asian participants. Finally, across cultures, participants exhibiting greater cognitive reflection were more likely to view free will as incompatible with causal determinism. We discuss these findings in light of documented cultural differences in the tendency toward dispositional versus situational attributions. (shrink)

Does the Ship of Theseus present a genuine puzzle about persistence due to conflicting intuitions based on “continuity of form” and “continuity of matter” pulling in opposite directions? Philosophers are divided. Some claim that it presents a genuine puzzle but disagree over whether there is a solution. Others claim that there is no puzzle at all since the case has an obvious solution. To assess these proposals, we conducted a cross-cultural study involving nearly 3,000 people across twenty-two countries, speaking eighteen (...) different languages. Our results speak against the proposal that there is no puzzle at all and against the proposal that there is a puzzle but one that has no solution. Our results suggest that there are two criteria—“continuity of form” and “continuity of matter”— that constitute our concept of persistence and these two criteria receive different weightings in settling matters concerning persistence. (shrink)

Thousands of youth suffering from acquired brain injury or other early-life neurological disease live, mature, and learn with only limited communication and interaction with their world. Such cognitively capable children are ideal candidates for brain-computer interfaces. While BCI systems are rapidly evolving, a fundamental gap exists between technological innovators and the patients and families who stand to benefit. Forays into translating BCI systems to children in recent years have revealed that kids can learn to operate simple BCI with proficiency akin (...) to adults. BCI could bring significant boons to the lives of many children with severe physical impairment, supporting their complex physical and social needs. However, children have been neglected in BCI research and a collaborative BCI research community is required to unite and push pediatric BCI development forward. To this end, the pediatric BCI Canada collaborative network was formed, under a unified goal to cooperatively drive forward pediatric BCI innovation and impact. This article reflects on the topics and discussions raised in the foundational BCI-CAN meeting held in Toronto, ON, Canada in November 2019 and suggests the next steps required to see BCI impact the lives of children with severe neurological disease and their families. (shrink)

The scope of Philosophy in Multiple Voices provides the reader with eight philosophical streams of thought-African-American, Afro-Caribbean, Asian-American, Feminist, Latin-American, Lesbian, Native-American and Queer-that introduce readers to alternative, complex philosophical questions concerning gendered, sexed, racial and ethnic identities, canon formation, and meta-philosophy. The overriding theme of the text is that philosophy is pluralistic in voice, rich in diversity, and ought to valorize democratic intellectual spaces of philosophical engagement.

BackgroundThe interpretation of clinical gait data in children with cerebral palsy (CP) is time-consuming, requires extensive expertise and often lacks transparency. Here we aimed to develop a set of look-up tables to support this process, linking typical gait features as present in CP to their potential underlying impairments.MethodsWe developed an initial core set of gait features and their potential underlying impairments based on biomechanical reasoning, literature and clinical experience. This core set was further specified through a Delphi process in a (...) multidisciplinary group of experts in gait analysis of children with CP and evaluated on 20 patient cases. The likelihood of the listed gait feature–impairment relationships was scored by the expert panel on a five-point scale.ResultsThe final core set included 120 relevant gait feature–impairment relations including likelihood scores. This set was presented in the form of look-up tables in both directions, i.e., sorted by gait features with potential underlying impairment, and sorted by impairments with potential related gait features. The average likelihood score for the relations was 3.5 ± 0.6 (range 2.1–4.6).ConclusionThe developed set of look-up tables linking gait features and impairments, can assist gait analysts and clinicians in standardized biomechanical reasoning, to support treatment decision-making for gait impairments in children with CP. (shrink)

Forty years ago in this journal, Herbert Spiegelberg examined Wittgenstein's direct references to Augustine in the works that were available to the public at that time. Although there are many allusions to Augustine in the portions of the Nachlass to which Spiegelberg did not have access, Wittgenstein read only the Confessions and his interest lay in a small set of topics for which certain sentences from Augustine served him as repeated proof texts. Given these facts and given how fundamentally Wittgenstein (...) disagreed with Augustine about the nature and purpose of philosophy, it is... (shrink)

Let me begin by saying that I am extremely grateful to Sarah Mattice for organizing this symposium on my book, Taking Back Philosophy: A Multicultural Manifesto, and to the three reviewers, each of whom read my work with great care and offered feedback that is extremely generous and insightful.1After providing a clear and sympathetic summary of my book, David Kim raises two questions. First, how should the study of what I have called the Less Commonly Taught Philosophies be incorporated (...) into the curriculum of philosophy departments?2 Kim suggests five degrees of incorporation, in order of increasing rigor: 1Make electives on the LCTP available to students in philosophy departments. 2Require for the major or... (shrink)

This paper argues that just as full beliefs can constitute knowledge, so can properties of your credence distribution. The resulting notion of probabilistic knowledge helps us give a natural account of knowledge ascriptions embedding language of subjective uncertainty, and a simple diagnosis of probabilistic analogs of Gettier cases. Just like propositional knowledge, probabilistic knowledge is factive, safe, and sensitive. And it helps us build knowledge-based norms of action without accepting implausible semantic assumptions or endorsing the claim that knowledge is interest-relative.

This paper argues that several leading theories of subjunctive conditionals are incompatible with ordinary intuitions about what credences we ought to have in subjunctive conditionals. In short, our theory of subjunctives should intuitively display semantic humility, i.e. our semantic theory should deliver the truth conditions of sentences without pronouncing on whether those conditions actually obtain. In addition to describing intuitions about subjunctive conditionals, I argue that we can derive these ordinary intuitions from justified premises, and I answer a possible worry (...) for my derivation by refuting a subjunctive triviality result modeled on (Lewis 1976). I conclude that the debate over the correct theory of subjunctive conditionals requires settling meta-philosophical questions about the relative value of various virtues of first-order theories of subjunctive conditionals. (shrink)

Secession is again a hot political topic. Consider the recent events in Catalonia. In an illegal referendum in October 2017, amid large-scale demonstrations and violent interventions by the Spanish...

As the usual regulatory framework did not fit well during the last Ebola outbreak, innovative thinking still needed. In the absence of an outbreak, randomised controlled trials of clinical efficacy in humans cannot be done, while during an outbreak such trials will continue to face significant practical, philosophical, and ethical challenges. This article argues that researchers should also test the safety and effectiveness of novel vaccines in wild apes by employing a pluralistic approach to evidence. There are three reasons to (...) test vaccines in wild populations of apes: i) protect apes; ii) reduce Ebola transmission from wild animals to humans; and iii) accelerate vaccine development and licensing for humans. Data obtained from studies of vaccines among wild apes and chimpanzees may even be considered sufficient for licensing new vaccines for humans. This strategy will serve to benefit both wild apes and humans. (shrink)

line-by-line notes are invariably informative and helpful, as well thought-provoking.' John M. Cooper, Stuart Professor of Philosophy, Princeton UniversityIn a new English translation by Christopher Rowe, this great classic of moral philosophy is accompanied here by an extended introduction and detailed lin-by-line commentary by Sarah Broadie. Assuming no knowledge of Greek, her scholarly and instructive approach will prove invaluable for students reading the text for the first time. This thorough treatment of Aristotle's text will be an indispensable resource for (...) students, teachers, and scholars alike. (shrink)

Letheby’s naturalistic theory of psychedelic therapy argues that the therapeutic power of psychedelics lies in their ability to allow individuals “to discover the contingency, mutability and simulatory nature of their own sense of identity and habitual modes of attention.” The general shape of this project is persuasive; it is hard to see how the claim that successful therapy must involve changes to the self could be objected to, and Letheby sketches a consistent, if speculative, picture of psychedelic experience. But the (...) role of affect in psychedelic therapy is insufficiently explored by Letheby as a comparison to MDMA-assisted therapy indicates. This comparison further suggests that Letheby’s reliance on a particular conceptualization of ego dissolution experiences is in need of further explanation and justification. (shrink)

The Glass Bees by Ernst Jünger was first published in Germany in 1957. It is a speculative fictional work that foretells much of what today is the reality of life in a technological society. Of particular import is his portrayal of the ambiguity of human character and moral guideposts that leave only power to mediate human relationships. These psychological and cultural symptoms can be traced to a society under the unremitting spell of the extension of technique. Headlines drawn from today (...) demonstrate that the portrayal was not overstated. (shrink)

This article reports the findings of a qualitative study that explored the organizational influences on moral distress for health professionals working in pediatric intensive care units across Canada. Participants were recruited to the study from PICUs across Canada. The PICU is a high-tech, fast-paced, high-pressure environment where caregivers frequently face conflict and ethical tension in the care of critically ill children. A number of themes including relationships with management, organizational structure and processes, workload and resources, and team dynamics were identified. (...) This study provides a rare and important multi-disciplinary perspective on this topic and the findings have implications for administrators and leaders who seek to improve the moral climate of healthcare delivery. (shrink)

The aims of this book are to “explain the concept of an inalienable right,” “show why it is morally justifiable to ascribe inalienability to some legal rights,” and “examine in more detail some selected rights”. Inalienability of rights is said to be particularly pertinent in bioethics since, for example, if the right to life is inalienable, it would seem that euthanasia and assisted suicide would be impermissible. I will limit my comments to McConnell’s discussions of the first two aims and (...) his discussions on euthanasia and assisted suicide. Given the highly contentious nature of the debate over euthanasia and assisted suicide, the possibility of illuminating that debate through a study of inalienable rights is quite attractive. (shrink)

The purpose of this study was to examine how young publics in the United States and South Korea perceive the corporate social responsibility (CSR) practices of multinational corporations and evaluate the effectiveness of CSR practices in terms of organization–public relationship (OPR). Results showed that young publics in the United States and South Korea differently characterized CSR practices of multinational corporations and evaluated relationships with them. Young American participants evaluated the CSR practices of multinational corporations more favorably than did the young (...) Korean participants. In addition, four CSR practices (internal environment, moral, discretionary, and relational) were associated with OPR dimensions in the United States, while only relational CSR practices were significantly related to OPR dimensions in South Korea. Overall, the findings highlight that cultural and societal meanings were embedded in identifying CSR practices and evaluating the relationship with multinational corporations involved in CSR practices. (shrink)

One of the problems in economics that economists have devoted a considerable amount of attention in prevalent years has been to ensure consistency in the models they employ. Assuming markets to be generally in some state of equilibrium, it is asked under what circumstances such equilibrium is possible. The fundamental mathematical tools used to address this concern are fixed point theorems: the conditions under which sets of assumptions have a solution. This book gives the reader access to the mathematical techniques (...) involved and goes on to apply fixed point theorems to proving the existence of equilibria for economics and for co-operative and noncooperative games. Special emphasis is given to economics and games in cases where the preferences of agents may not be transitive. The author presents topical proofs of old results in order to further clarify the results. He also proposes fresh results, notably in the last chapter, that refer to the core of a game without transitivity. This book will be useful as a text or reference work for mathematical economists and graduate and advanced undergraduate students. (shrink)

Dix personnes, qui forment le Bureau des dépositions, créent des performances à Grenoble depuis 2018. En s’adressant les un·es aux autres et à un public, en ré-agençant les (im)-possibilités de paroles depuis la mise à découvert d’injustices légalement produites, elles, ils élaborent des conditions de trans-formations : langagières, sensibles, politiques. Dans le même temps, plusieurs performeurs sont inquiétés par le contentieux du droit des étrangers et du droit d’asile, expulsés légalement ou encore menacés d’expulsion. Des réponses se formulent auprès des (...) tribunaux : alors que les performances requièrent la co-présence physique de chacun·e, les absences forcées portent atteinte à un milieu de création. Le droit d’auteur et de la propriété intellectuelle est ici convoqué et réinterprété dans le contexte d’expulsions légales et d’ œuvres-milieux. (shrink)