Nursing as a profession has a social mandate to contribute to the good of society through knowledge-based practice. Knowledge is built upon theories, and theories, together with their philosophical bases and disciplinary goals, are the guiding frameworks for practice. This article explores a philosophical perspective of nursing's social mandate, the disciplinary goals for the good of the individual and society, and one approach for translating knowledge into practice through the use of a middle-range theory. It is anticipated that the integration (...) of the philosophical perspective and model into nursing practice will strengthen the philosophy, disciplinary goal, theory, and practice links and expand knowledge within the discipline. With the focus on humanization, we propose that nursing knowledge for social good will embrace a synthesis of the individual and the common good. This approach converges vital and agency needs described by Hamilton and the primacy of maintaining the heritage of the good within the human species as outlined by Maritain. Further, by embedding knowledge development in a changing social and health care context, nursing focuses on the goals of clinical reasoning and action. McCubbin and Patterson's Double ABCX Model of Family Adaptation was used as an example of a theory that can guide practice at the community and global level. Using the theory-practice link as a foundation, the Double ABCX model provides practising nurses with one approach to meet the needs of individuals and society. The integration of theory into nursing practice provides a guide to achieve nursing's disciplinary goals of promoting health and preventing illness across the globe. When nursing goals are directed at the synthesis of the good of the individual and society, nursing's social and moral mandate may be achieved. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 44.3 (2006) 467-468 [Access article in PDF] Richard Hunter. Plato's "Symposium". New York: Oxford University Press, 2004. Pp. xiii + 150. Cloth, $40.00. Paper, $14.95. The editors of the series in which Plato's "Symposium" appears state that its constituent texts are to be "essays in criticism and interpretation that will do justice to the subtlety and complexity of the works under discussion" (...) (vi). In the preface, Hunter identifies as his audience "those who have already read or are in the process of reading the Symposium" (ix).Plato's "Symposium" has much to offer to classics students and to the general reader. The book provides useful literary and cultural background regarding the conduct of Greek symposia (5–15). It is filled with valuable interpretive remarks, as for example when Hunter proposes that Alcibiades' depiction of Socrates "as a carved Silenus" instantiates a "common form of sympotic verbal game, the 'likeness'—'Why is X (usually one of the symposiasts) like Y (usually something nonhuman)?'" (5–6). Hunter's rich knowledge of Greek literature pays off in a range of ways, as for instance in his remarks on literary articulations of erôs (16–18). The volume's final chapter, on the history of the dialogue's reception, offers a number of figures and contexts on which to reflect.Hunter makes helpful observations regarding the seriocomic and special features of Plato's recourse to it (9–11), noting that, "in the attack upon the spoudaiogeloion, it is the spoudaiogeloion itself which is the principal weapon" (36). Hunter's orientation in this regard yields nuanced interpretations of the logoi of Pausanias and Eryximachus. Hunter observes helpfully that Aristophanes' encomium functions as "an example of a very familiar aspect of the technique of Aristophanic comedy, namely, the literalization of metaphorical language (as, for example, when 'weighing up' poetry becomes a matter of real weighing in the Frogs)" (65). In Hunter's view, Agathon's contribution, in turn, illustrates Plato's contention in the Gorgias that tragedy is a type of flattery (kolakeia). Drawing on Aristophanes' Women at the Thesmophoria, Hunter makes the useful suggestion that the comic poet's depiction "can... help to explain the extravagance of the Platonic character's speech" (76).While Plato's "Symposium" will also provide valuable background to students of philosophy, on its own the book does not do justice to Socrates' encomium, in particular the crucial "ascent passage" (210a–12a). A key point of contention among philosophical interpreters of the Symposium is whether one is to read the ascent passage as "inclusive" or "exclusive" regarding erôs as directed toward individuals. (For the formulation of the controversy in these terms, see J. M. E. Moravcsik, "Reason and Eros in the 'Ascent'-Passage of the Symposium," in Essays in Ancient Greek Philosophy, eds. Anton and Kustas [1971], 293.) The strongly exclusivist stance has had a number of exponents and is most famously associated with Gregory Vlastos (see "The Individual as an Object of Love in Plato," in Platonic Studies, 2nd ed. [1981], 31). For a contrasting view, one may consult, for example, John Brentlinger, according to whom "it does not follow from Plato's claim that we love persons (or anything else) because we believe them to be beautiful and good, that we really love the properties of beauty and goodness per se, and do not really love persons per se" (The "Symposium" of Plato [1970], 122; see also C. J. Rowe, Plato: "Symposium" [1998], 7). Hunter states that the Symposium's "apparent rejection of the value of lasting love between individuals has often seemed to modern readers to present a harshly intellectual view of erôs which ignores basic, [End Page 467] universal facts of human experience and which offers little comfort to all but a Socrates" (98). It will not, I think, be evident to readers not already familiar with pertinent philosophical literature on the ascent to just what interpretive debate this remark is (at most) a glancing gesture.Hunter quotes Symposium 210d, where Plato says that the... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Research Ethics after World War II: The Insular Culture of BiomedicineAllan M. Brandt (bio) and Lara Freidenfelds (bio)Human subjects research in the United States has only recently emerged as an important area of historical investigation. Over the last quarter century, scholars have begun the process of grounding within an historical context both the complex relationship between researchers and subjects and the processes by which biomedical knowledge is produced. Their (...) studies examine topics ranging from the impact of the anti-vivisectionist movement on human experimentation in the early twentieth century (Lederer 1995) to the development of the discipline of bioethics in the 1960s and 1970s (Rothman 1991) and the emergence of the legal concept of informed consent for human research (Katz, Glass, and Capron 1972). Many of the discussions focus on isolated incidents of scandal, such as the Tuskegee Syphilis Study (Jones 1993; Brandt 1978) and the Willowbrook School hepatitis study (Rothman and Rothman 1984). In doing so, they attempt to explain how such clearly unethical research could have been initiated and what consequences have resulted from public knowledge of such research.Nonetheless, the broader historical contexts and implications of human subjects research have yet to be fully delineated. This project will be of crucial importance, not only for historians, but also for those concerned with research policy and medical ethics. The historical examination of human subjects research will provide further insight into the details of research methods, the construction of protocols, and the historically specific interest in certain diseases. In addition, scholars will better understand the relationships of power and authority between researcher and subject, as well as the social and scientific mechanisms for the production of new biomedical knowledge. The process of enlisting research subjects illuminates the significance of class, gender, ethnicity, and race in science, in biomedicine, and in society. The fact that, historically, much research has employed research subjects from vulnerable populations, who participated in coercive contexts, has exposed powerful social assumptions embedded in the research enterprise. [End Page 239]The revelation of new documents indicating past abuses has sparked much of the investigation into human subjects research and the recent investigation of human radiation experiments during the Cold War era. One of the most important achievements of the Advisory Committee on Human Radiation Experiments was the uncovering of thousands of documents, a remarkable mine of archival data, that had been previously inaccessible to researchers. Jonathan Moreno and Susan Lederer’s article on the history of Cold War research ethics in this issue of the Kennedy Institute ofEthics Journal represents the first attempt since the publication of the Committee’s Final Report to analyze the Committee’s findings in a serious historical context.Historical accounts of the emergence of bioethics traditionally have left a great void in their discussions of human experimentation, generally ignoring the period between the writing of the Nuremberg Code in 1947 and the publication of Henry Beecher’s 1966 New England Journal ofMedicine article condemning systematic, unethical practices in human experimentation (Rothman 1991). The period from 1946 to 1966, however, was a time of vigorous research characterized by a fragmented community of medical researchers who applied inconsistent ethical standards and employed highly variable research practices. Both military and civilian medical researchers were intensely interested in radiation and thus conducted human subjects research along those lines, including examinations of the effects of plutonium injections and of total body irradiation, the use of trace radioisotopes to study various body processes, and observations of the effects of radiation intentionally released into the environment. The U.S. Government sponsored several thousand such studies (ACHRE 1995 [GPO, pp. 227–31; Oxford, pp. 135–38]), some of which were conducted on hospital patients, institutionalized children, military personnel, and prisoners. The Cold War scientific culture that produced this research must be examined from an historical ethical perspective.A central aspect of the culture of biomedical science after World War II was its insularity. Increasingly high standards of admission and challenging training had come to ensure that only a select group of individuals was admitted to the professions of medicine and research science. In this culture of experts, trustworthiness and ethical judgment were considered to be dependent upon expertise... (shrink)

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

Developing ethical standards for clinical use of large-scale genome and exome sequencing has proven challenging, in part due to the inevitability of incidental or secondary findings. Policy of the American College of Medical Genetics and Genomics has evolved but remains problematic. In 2013, ACMG issued policy recommending mandatory analysis of 56 extra genes whenever sequencing was ordered for any indication, in order to ascertain positive findings in pathogenic and actionable genes. Widespread objection yielded a 2014 amendment allowing patients to opt-out (...) from analysis of the extra genes. In 2015, ACMG published the amended policy, providing that patients could opt out of the full set of extra genes, but not a subset. In 2016, ACMG enlarged the set and indicated planned expansion of the roster of extra genes to include pharmacogenetic findings. ACMG policy does not protect the respect for patient choice that prevails in other domains of clinical medicine, where informed consent allows patients to opt in to desired testing. By creating an expanding domain of genomic testing that will be routinely conducted unless patients reject the entire set of extra tests, ACMG creates an exceptional domain clinical practice that is not supported by ethics or science. (shrink)

Human genomics is a translational field spanning research, clinical care, public health, and direct-to-consumer testing. However, law differs across these domains on issues including liability, consent, promoting quality of analysis and interpretation, and safeguarding privacy. Genomic activities crossing domains can thus encounter confusion and conflicts among these approaches. This paper suggests how to resolve these conflicts while protecting the rights and interests of individuals sequenced. Translational genomics requires this more translational approach to law.

Participant-driven research is a burgeoning domain of research innovation, often facilitated by mobile technologies. Return of results and data are common hallmarks, grounded in transparency and data democracy. PDR has much to teach traditional research about these practices and successful engagement. Recommendations calling for new state laws governing research with mHealth modalities common in PDR and federal creation of review mechanisms, threaten to stifle valuable participant-driven innovation, including in return of results.

In 2004, the United States Sentencing Commission amended the Federal Sentencing Guidelines to allow firms that create “effective compliance and ethics programs” to receive better treatment if prosecuted for fraud. Effective compliance and ethics, however, appear to be limited to activities focused on complying with the firms’ internal legal and ethical standards. We explored a potential connection between the firms’ external corporate social responsibility (CSR) behaviors and internal compliance: Is there an organizationally valid relationship between these two firm activities? That (...) is, when organizations demonstrate CSR with behaviors external to the firm, such as employee volunteerism, are their employees more likely to demonstrate uncompromised legal and ethical compliance behavior internally? We collected data from 164 working professionals enrolled in a top-tier MBA program in the southeastern United States regarding their employer-sponsored volunteer activities and their intentions to comply in various organizational compliance vignettes. We found that employer-sponsored volunteerism is associated with uncompromised compliance choices in one of the three vignettes. This finding indicates preliminary support for further inquiry into the relationship within the firm between external CSR behaviors and policies regarding organizational compliance. Post hoc analyses suggest that employer-sponsored volunteerism is strongly associated with a positive organizational identity, but organizational identity is not associated with the significant compliance vignette. This evidence suggests that the underlying mechanism that connects external CSR behaviors and internal compliance intentions is complex and requires future study. (shrink)

In The Ethics of Ambiguity , Simone de Beauvoir makes reference to an “apprenticeship of freedom,” but she does not directly address why freedom requires an apprenticeship or what such an apprenticeship entails. Working from Beauvoir’s discussion of freedom in The Ethics of Ambiguity and her discussion of apprenticeships in The Second Sex , I explicate the idea of an apprenticeship of freedom, establishing why an apprenticeship is a necessary condition of freedom and describing how such an apprenticeship is administered. (...) In doing so, I draw together two strands of thought within recent research on Beauvoir—first, that Beauvoir conceives of freedom as embodied and, second, that she conceives of freedom as interpersonal—to consider how adults’ interactions with a child either support or impede the realization of this child’s freedom. (shrink)

Mouse models of human genetic disorders provide a valuable resource for investigating the pathogenesis of genetic disease and for testing potential therapies. The high degree of resolution of linkage mapping in the mouse allows mutant phenotypes to be mapped precisely which, combined with the accurate definition of areas of homology between the mouse and human genomes, greatly facilitates the identification of mouse models. We describe here mouse models of human single gene disorders dividing them into three categories depending on the (...) information available; phenotypic similarities, comparative mapping and identification of the underlying genetic lesion. (shrink)

Adrienne Asch pioneered a way of doing bioethics that few are brave enough to attempt. In addition to summoning logic, arguing values, and applying reasoning to cases, Adrienne lived bioethics. Without compromising the strength of her analysis, she grounded that analysis explicitly in her own lived experience of disability. Hers was the view from somewhere—a deep invitation to others to rethink everything from embryo selection to end‐of‐life decisions through the lens of lived disability.

A Skeptical View of the Liberal Peace reflects on the place of democracy in the global community. The article pays particular attention to the widespread assumption that there is an inherent relationship between democracy and peace, and that peace most assuredly is derived from democracy itself. I find these assertions to be highly questionable and overstated. Reflection on the philosophy which underpins these claims can only be helpful for international relations. In particular, given the United States’ apparent imperialistic urge to (...) force democracies on other nations as Iraq, the article seems especially timely. (shrink)

Health care reform proposals threaten to exacerbate tensions physicians already face in trying to balance traditional duties to individual patients against increasing pressure to serve broader societal and institutional goals. To cope with reform, medical ethics must clarify physicians' moral obligations, change existing ethical codes, and develop an ethics of institutions.

This article examines two questions pertaining to the extension of infertility treatment to postmenopausal women. First, what concepts and principles of infertility practice apply to assisted reproduction for the postmenopausal patient? Second, what role should these concepts play in the development of an ethical justification for extending women's reproductive lives past the menopausal boundary? The argument offered here supports their claim to infertility services on the basis of the formal principle of justice, which requires that similar cases be treated similarly. (...) The cases of many postmenopausal patients are argued to be relevantly similar to classes of patients who already receive assistance in reproduction. (shrink)

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

The current explosion of genetic knowledge and the rapid proliferation of genetic tests has rightly provoked concern that we are approaching a future in which people will be labeled and disadvantaged based on genetic information. Indeed, some have already suffered harm, including denial of health insurance. This concern has prompted an outpouring of analysis. Yet almost all of it approaches the problem of genetic disadvantage under the rubric of “genetic discrimination.”This rubric is woefully inadequate to the task at hand. It (...) ignores years of commentary on race and gender demonstrating the limits of antidiscrimination analysis as an analytic framework and corrective tool. Too much discussion of genetic disadvantage proceeds as if scholars of race and gender had not spent decades critiquing and developing antidiscrimination theory.Indeed, there are multiple links among race, gender, and genetics. Dorothy Roberts has discussed the historical links between racism and genetics, while she and others have begun to map connections between gender and genetics. (shrink)

An overview and critical discussion of Christine Overall’s Pets and People: The Ethics of Our Relationships With Companion Animals. Argues that the book contains important contributions to many of the major ethical issues associated with the keeping of “pets” but is lacking in discussion of the most fundamental issue—namely, whether it is ethical to keep “pets” at all.

Charles V was a scholarly king who commissioned French versions of ancient & medieval treatises for the express purpose of guiding his government. To translate Aristotle's "Politics" he chose Nicole Oresme, an ingenious philosopher whose aptitude & attitudes made him an effective supporter of the Valois monarchy. Oresme's task was to take his text out of the language of a small but international community of scholars & adapt it to serve the French people, making it accessible to a new & (...) broad audience. Contents: Oresme & his Version of the "Politics"; Oresme & the Commentary Tradition of the "Politics"; Nat. Sovereignty & the Hierarchy of Communities; The Public State & the Common Good; The "Politics," the "Livre de Politiques," & the Church; Aristotle, Oresme, & Gallicanism; Conclusion; & Bibliography. (shrink)

Returning genomic research results to family members raises complex questions. Genomic research on life-limiting conditions such as cancer, and research involving storage and reanalysis of data and specimens long into the future, makes these questions pressing. This author group, funded by an NIH grant, published consensus recommendations presenting a framework. This follow-up paper offers concrete guidance and tools for implementation. The group collected and analyzed relevant documents and guidance, including tools from the Clinical Sequencing Exploratory Research Consortium. The authors then (...) negotiated a consensus toolkit of processes and documents. That toolkit offers sample consent and notification documents plus decision flow-charts to address return of results to family of living and deceased participants, in adult and pediatric research. Core concerns are eliciting participant preferences on sharing results with family and on choice of a representative to make decisions about sharing after participant death. (shrink)

Kant objects on principle to any duty of moral self-perfection that would aim at the moral self-perfection of another person. Yet, despite the apparent barrier posed by the introspective technique of self-perfecting effort, I argue that such a duty is both possible and desirable as a part of moral friendship. Through mutual sincere efforts at self-disclosure, we escape the prison of mutual distrust which otherwise characterizes social life and consolidate the very sincerity necessary for moral improvement.

The everyday experience of someone, or something, getting in one’s face reveals a depth that is the difference between a world that is intrusive and a world that is respectful. This depth, I argue, should be conceived, not in feet and inches, but in terms of violation and honor. I explore three factors that contribute to this depth’s emergence. First, I examine our body’s capacity, at the level of sense experience, for giving the world a figure/ground structure; this structure insures (...) that most of the world we are in constant contact with, nonetheless, keeps its distance as background. I demonstrate the importance of this figure/ground structure to the depth of our world by considering the experience of people with autism; for those with autism, this structure seems to be, if not entirely missing, at least substantially less robust than our own. Next, I examine our body’s ability, at the level of more personal experience, to handle the world; our handling of the world, which rests on the acquisition of specific skills, transforms things that could easily assault us into the usually motionless objects we tend to take for granted. I demonstrate the importance of these skills to the depth of our world by considering the experience of Gregg Mozgalla; until recently, Mozgalla, who has cerebral palsy, could only lurch, rather than walk, through the world. Finally, I draw on the work of the artist Mierle Ukeles to examine the maintenance work that other people, at a broader social level, perform; other’s maintenance work keeps in good condition a world that, by falling into bad condition, could easily intrude on us. (shrink)

The phenotype of some spontaneous mutations in Drosophila can be modified by mutations at unlinked loci. The affected alleles are caused by the insertion of retroviral transposable elements. The idiosyncratic functional and structural properties of these elements play a key role in determining the expression characteristics of the genes into which they are inserted. These phenotypes are reversed or intensified by the allelic state of suppressor and enhancer loci through changes in the transcriptional properties of the transposable elements.

This study investigates the effectiveness of pedagogical practices used to teach business ethics. The business community has greatly increased its demands for better ethics education in business programs. Educators have generally agreed that the ethical principles of business people have declined. It is important, then, to examine how common methods of instruction used in business ethics could contribute to the development of higher levels of moral judgment competence for students. To determine the effectiveness of these methods, moral judgment competence levels (...) for undergraduate and graduate students from three institutions were measured and compared based upon the pedagogical method used in a business class. Significant differences were found for moral reasoning and moral competence scores depending on the method used for ethics instruction. Students in classes with more highly integrated ethics coverage scored higher in moral reasoning and moral competence. (shrink)

Debate over the relationship of law and bioethics is growing - what the relationship has been and what it should be in the future. While George Annas has praised law and rights-talk for creating modern bioethics, Carl Schneider has instead blamed law for hijacking bioethics and stunting moral reflection. Indeed, as modern bioethics approaches the 40-year mark, historians of bioethics are presenting divergent accounts. In one account, typified by Albert Jonsen, bioethics largely grew out of philosophy and theology, not law. (...) In another account, law has deeply shaped bioethics from the start, forging its central commitment to the rights of patients and research subjects and the fields imposition of broad fiduciary responsibilities on health care professionals and researchers.In addition to debating how to properly describe laws historical relationship to bioethics, commentators have argued over whether laws influence in bioethics is now good or bad. (shrink)

Moral debate over vegetarianism forms the backdrop to a preliminary consideration of the questions: Is it ethical to produce, sell and eat faux meat? Is it ethical to produce, sell and wear fake animal skin? Is it ethical to sell or wear secondhand or thriftshop genuine animal skin? If vegetarianism is morally required, the question of just what uses of nonhuman animals are ethical or unethical and on what grounds is always on tap. In this piece, I examine the above (...) questions in light of deontological then utilitarian reasons for vegetarianism. I conclude deontological or animal rights grounds entail the moral condemnation of faux meat and fake and secondhand animal skin. I conclude utilitarian or animal welfare grounds entail, with some qualification, the moral acceptability of faux meat and fake animal skin but the clear moral unacceptability of secondhand animal skin. (shrink)