Research involving and impacting Indigenous Peoples is often of little or no benefit to the communities involved and, in many cases, causes harm. Ensuring that Indigenous research is not only ethical but also of benefit to the communities involved is a long-standing problem that requires fundamental changes in higher education. To address this necessity for change, the authors of this paper, with the help of graduate and Indigenous community research assistants, undertook community consultation across their university to identify the local (...) and national ethical needs of Indigenous researchers, communities, and Elders. This paper provides an overview of the consultation process, the themes that emerged from the consultations, and a model of the Wholistic Indigenous Research Framework that emerged. (shrink)

Pediatric palliative care is specialized medical care for children who live with serious and life-limiting illnesses, with the central goal to improve quality of life for both children and their families. Presently, a majority of pediatric palliative care referrals are based on the traditional consultative model, in which primary providers serve as the gatekeepers to palliative care access. It is well-known that racial and ethnic healthcare disparities exist across the continuum of care, fraught with healthcare providers’ biases that impact the (...) care delivered. This includes the referral practices, allocation and utilization of palliative care services, and leaving vulnerable children and families with potentially unmet palliative care needs. We make the moral argument that the establishment of standard referral criteria for pediatric palliative care services is one simple step that must be taken to begin to address and hopefully ameliorate the impact of providers’ biases and disparities that exist within pediatric palliative care. (shrink)

Jean-Paul Grandjean – devenu de Fouchy en 1743, lorsqu’il est nommé secrétaire perpétuel de l’Académie des sciences – s’est formé à l’astronomie auprès de J.-N. Delisle, avant le départ de ce dernier pour la Russie. Fouchy installe bientôt chez lui un observatoire qu’il équipe d’instruments du constructeur Claude Langlois, et où il mène différentes observations. Le domaine d’intérêt principal de Fouchy concerne les «machines»; il s’agit entre autres d’appareils venant équiper les quarts-de-cercle pour en faciliter l’emploi. Comme secrétaire perpétuel, il (...) demeure en fonction jusqu’en 1776 et, à ce titre, il prononce de nombreux éloges dont une dizaine sont relatifs à des astronomes. (shrink)

The interpretation given by Craik and Lockhart of the findings by Hyde and Jenkins involving supposed depth of incidental-task processing on subsequent word recall is brought into question by the tenets of logical learning theory. It is shown that Craik and Lockhart overlooked the possible role of oppositionality in this research. An alternative explanation relying on an oppositional context and predication is offered. Two experiments present evidence supporting the hypothesis that oppositionality in an incidental task facilitates subsequent word recall . (...) In both experiments, the importance of taking a subject's meaningful understanding of the task instruction into consideration is highlighted. The discussion contrasts Boolean "binary" disjunction with the logic of oppositionality. It is shown how oppositionality allows us to conceptualize a testable theory of human agency. (shrink)

The insights described by Nevin & Grace may be summarized without reference to the Newtonian concepts they suggest. The metaphor to Newtonian mechanics seems dubious in three ways: (1) extensions seem to lead to paradoxes; (2) many well-known phenomena are ignored; (3) the Newtonian concepts seem difficult to reconcile with the larger framework of evolutionary theory.

The least infringement principle has been widely endorsed by public health scholars. According to this principle, public health policies may infringe upon “general moral considerations” in order to achieve a public health goal, but if two policies provide the same public health benefit, then policymakers should choose the one that infringes least upon “general moral considerations.” General moral considerations can encompass a wide variety of goals, including fair distribution of burdens and benefits, protection of privacy and confidentiality, and respect for (...) autonomy.In this article, we argue that the Center for Disease Control and Prevention's 2006 HIV screening recommendations may violate the least infringement principle. This is a concern because, although not legally binding, the Recommendations appear to have already influenced state laws and will likely continue to do so as legislative proposals continue to be passed. At a minimum, therefore, the Recommendations have important implications for HIV screening within the United States. (shrink)

Aristotle bequeathed to us a powerful metaphysical picture, of substances in which properties inhere. The picture has turned out to be highly problematic in many ways; but it is nevertheless a picture not easy to dislodge. Less obvious are the normative tones implicit in the picture and the way these permeate our system of values, especially when thinking of ourselves and our ambitions, hopes and fears. These have proved, if anything, even harder to dislodge than the metaphysical picture which supports (...) them. This paper first draws out the ethics suggested by a conception of being as individual substances, and finds both inner tensions among these values—expressed in divergent characteristics in the history of philosophy—and a neglect of a significant set of values. Substance metaphysics prefers freedom, independence and autonomy over relational and reciprocal values, which can even be regarded as existentially threatening. A prominent attempt to accommodate both sorts of values without eschewing substantialist metaphysics is briefly considered, before turning to examine an alternative metaphysics and the values it implies. A metaphysics which takes being as becoming, it is argued, supports an ethics centred on relational values, and their associated virtues of care. (shrink)

The book, which stepwise develops successively more powerful logical and grammatical systems, covers an unusually broad range of material.

In their article, Romanis and Adkins delineate pregnancy loss and procreative loss to show that the former is possible without the latter, as in the case of artificial amnion and placenta technology.1 Here, we are interested in examining the reverse—procreative loss without pregnancy loss—to further tease apart these two types of loss. We discuss two cases: being forced to continue a pregnancy despite fetal demise due to abortion restrictions and choosing to selectively reduce a multifetal pregnancy. Our analysis buttresses the (...) authors’ conclusion: due to our fetal-centric conception of pregnancy, we are only able to value pregnancy instrumentally (ie, for the fetus), not intrinsically. Understanding pregnancy as an embodied state rather than a process that not only acknowledges the intrinsic value of pregnancy for pregnant people but also encourages society to intrinsically value pregnant people is important. In 2022, the Supreme Court of the United States removed the constitutional right to an abortion in Dobbs v Jackson Women’s Health Organization, shifting the responsibility of determining abortion regulations to individual US states.2 Due to the Dobbs decision, there …. (shrink)

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This article discusses an approach to translational bioethics (TB) that is concerned with the adaptation—or ‘translation’—of concepts, theories and methods from bioethics to practical contexts, in order to support ‘non-bioethicists’, such as researchers and healthcare practitioners, in dealing with their ethical issues themselves. Specifically, it goes into the participatory development of clinical ethics support (CES) instruments that respond to the needs and wishes of healthcare practitioners and that are tailored to the specific care contexts in which they are to be (...) used. The theoretical underpinnings of this participatory approach to TB are found in hermeneutic ethics and pragmatism. As an example, the development of CURA, a low-threshold CES instrument for healthcare professionals in palliative care, is discussed. From this example, it becomes clear that TB is a two-way street. Practice may be improved by means of CES that is effectively tailored to specific end users and care contexts. The other way around, ethical theory may be enriched by means of the insights gained from engaging with practice in developing CES in a process of co-creation. TB is also a two-way street in the sense that it requires collaboration and commitment of both bioethicists and practitioners, who engage in a process of mutual learning. However, substantial challenges remain. For instance, is there a limit to the extent to which a method of moral reasoning can be adapted in order to meet the constraints of a given healthcare setting? Who is to decide, the bioethicist or the practitioners? (shrink)

Moral distress forms a major threat to the well-being of healthcare professionals, and is argued to negatively impact patient care. It is associated with emotions such as anger, frustration, guilt, and anxiety. In order to effectively deal with moral distress, the concept of moral resilience is introduced as the positive capacity of an individual to sustain or restore their integrity in response to moral adversity. Interventions are needed that foster moral resilience among healthcare professionals. Ethics consultation has been proposed as (...) such an intervention. In this paper, we add to this proposition by discussing Moral Case Deliberation (MCD) as a specific form of clinical ethics support that promotes moral resilience. We argue that MCD in general may contribute to the moral resilience of healthcare professionals as it promotes moral agency. In addition, we focus on three specific MCD reflection methods: the Dilemma Method, the Aristotelian moral inquiry into emotions, and CURA, a method consisting of four main steps: Concentrate, Unrush, Reflect, and Act. In practice, all three methods are used by nurse ethicists or by nurses who received training to facilitate reflection sessions with these methods. We maintain that these methods also have specific elements that promote moral resilience. However, the Dilemma Method fosters dealing well with tragedy, the latter two promote moral resilience by including attention to emotions as part of the reflection process. We will end with discussing the importance of future empirical research on the impact of MCD on moral resilience, and of comparing MCD with other interventions that seek to mitigate moral distress and promote moral resilience. (shrink)

In this book, Suzanne Kirschner traces the origins of contemporary psychoanalysis back to the foundations of Judaeo-Christian culture, and challenges the prevailing view that modern theories of the self mark a radical break with religious and cultural tradition. Instead, she argues, they offer an account of human development which has its beginnings in biblical theology and neoplatonic mysticism. Drawing on a wide range of religious, literary, philosophical and anthropological sources, Dr Kirschner demonstrates that current Anglo-American psychoanalytic theories are but (...) the latest version of a narrative that has been progressively secularized over the course of nearly two millennia. She displays a deep understanding of psychoanalytic theories, while at the same time raising provocative questions about their status as knowledge and as science. (shrink)

The twin Theses of Eliminative and Multiplicative Materialism will be analyzed and then subsumed by Occam's sword.

Once described as hermaphrodites and later as intersex people, individuals born with intersex variations are routinely subject to so-called “normalizing” medical interventions, often in childhood. Opposition to such practices has been met by attempts to discredit critics and reasserted clinical authority over the bodies of women and men with “disorders of sex development.” However, claims of clinical consensus have been selectively constructed and applied and lack evidence. Limited transparency and lack of access to justice have helped to perpetuate forced interventions. (...) At the same time, associated with the diffusion of distinct concepts of sex and gender, intersex has been constructed as a third legal sex classification, accompanied by pious hopes and unwarranted expectations of consequences. The existence of intersex has also been instrumentalized for the benefit of other, intersecting, populations. The creation of gender categories associated with intersex bodies has created profound risks: a paradoxically narrowed and normative gender binary, maintenance of medical authority over the bodies of “disordered” females and males, and claims that transgressions of social roles ascribed to a third gender are deceptive. Claims that medicalization saves intersex people from “othering,” or that legal othering saves intersex people from medicalization, are contradictory and empty rhetoric. In practice, intersex bodies remain “normalized” or eliminated by medicine, while society and the law “others” intersex identities. That is, medicine constructs intersex bodies as either female or male, while law and society construct intersex identities as neither female nor male. Australian attempts at reforms to recognize the rights of intersex people have either failed to adequately comprehend the population affected or lacked implementation. An emerging human rights consensus demands an end to social prejudice, stigma, and forced medical interventions, focusing on the right to bodily integrity and principles of self-determination. (shrink)

Children with innate variations of sex characteristics (also termed differences of sex development or intersex traits) are routinely subjected to medical interventions that aim to make their bodies appear or function more typically female or male. Many such interventions lack clear evidence of benefit, they have been challenged for thirty years, and they are now understood to violate children’s rights to bodily autonomy and bodily integrity. In this paper I argue that these persist in part due to epistemic injustices and (...) biomedical authority. Epistemic injustices include limited disclosure of current practices, the systemic marginalisation of community voices and psychosocial professionals, and attempts to discredit or misrepresent testimony. Bioethics has largely failed to change medical practice, and sometimes plays a role in perpetuating epistemic injustices. I find that the development of an intersex movement provides opportunities for epistemic justice and liberation by engaging with other disciplines and promoting oversight of medical decision-making. The paper draws particularly on Australian sources, including internationally influential ethical principles. (shrink)

Taking account of local culture: limits to the development of a professional ethos The need to extend the discussion of culture in the study of nursing, combined with an enthusiasm for the possibility of viewing nursing from a new perspective, provides the impetus for this study. Based on fieldwork undertaken in the intensive care unit (RICU) of a major public hospital in Rome (Italy), this paper explores some of the key aspects of the social relations and local staff culture of (...) one particular group of Italian nurses. In a climate of globalization, where the deployment of dominant Anglo‐American ideas is difficult to counter, the RICU presents as a setting which challenges the widespread assumptions of universal standards of nursing practice. By building a picture of the working world of these particular nurses, we are assisted in our understanding of nursing practice as a local cultural activity. In exploring the significance of local culture this paper brings into question the universality of the current paradigm of professionalism and professional identity, and emphasizes the value of acknowledging local culture. (shrink)

This research applies the theory of planned behavior to corporate managers’ decision making as it relates to fraudulent financial reporting. Specifically, we conducted two studies to examine the effects of attitude, subjective norm and perceived control on managers’ decisions to violate generally accepted accounting principles (GAAP) in order to meet an earnings target and receive an annual bonus. The results suggest that the theory of planned behavior predicts whether managers’ decisions are ethical or unethical. These findings are relevant to corporate (...) leaders who seek to improve ethical work climates of organizations and to many regulators, accountants, corporate governance officials and investors. (shrink)

Endosex, in contrast to intersex, refers to innate physical sex characteristics judged to fall within the broad range of what is considered normative or typical for ‘binary’ female or male bodies by the medical field, or to persons with such characteristics1 (p. 437). In this short contribution, we explain the origins and increasing use of this little-known term and discuss its practical and ethical relevance to medicine as well as to scholarship from a range of disciplines concerned with individuals’ sexed (...) embodiment. There is growing awareness in many quarters of the term intersex— used within some discourses to refer to clusters of bodily attributes (as in ‘intersex traits’, also termed differences of sex development or variations of sex characteristics)1 or more broadly to persons (as in ‘intersex persons’) whose bodily attributes differ from the dominant clinical, biological, or legal paradigms that categorise and differentiate female and male bodies. Intersex traits have historically been stigmatised as monstrous, morbid or tragic, justifying surgical and hormonal ‘fixing’.2 Persons born with the attributes named with these terms, even if physically healthy, therefore risk unnecessary pathologisation and medicalisation, prompting interventions, often non-voluntary, into their bodies to make them appear or function in ways that are deemed more typically female or male. In addition, some legal and social systems automatically associate persons with these traits with third categories of sex—neither female nor male—which may or may not align with their sex designation at birth, sex of rearing, personal experience or self-conception (see Coda). Being seen as intersex or being judged to have …. (shrink)

Translator's Preface LA LOGIQUE DE HUSSERL, etude sur "Logique for- melle et logique transcendentale" the original of the present translation, was published ...

Although the most common understanding of suicide is intentional self-killing, this conception either rules out someone who lacks mental capacity being classed as a suicide or, if acting intentionally is meant to include this sort of case, then what it means to act intentionally is so weak that intention is not a necessary condition of suicide. This has implications in health care, and has a further bearing on issues such as assisted suicide and health insurance. In this paper, I argue (...) that intention is not a necessary condition of suicide at all. Rather, I develop a novel approach that deploys the structure of a homicide taxonomy to classify and characterise suicides to arrive at a conceptually robust understanding of suicide. According to my analysis of suicide, an agent is the proximate cause of his death. Suicide is ‘self-killing,’ rather than ‘intentional self-killing.’ Adopting this understanding of suicide performs several functions: We acquire an external standard to assess diverging analyses on specific cases by appealing to homologous homicides. Following such a taxonomy differentiates types of suicides. This approach has application in addressing negative connotations about suicide. As a robust view, adding intention is an unnecessary complication. It is more consistent with psychological and sociological assessments of suicide than ‘intentional self-killing.’ It has useful applications in informing public policy. This paper’s focus is on classifying types of suicides, rather than on the moral permissibility or on underlying causes of suicidal ideation and behaviour. (shrink)

The current process towards formalization within evaluation research, in particular the use of pre-set standards and the focus on predefined outcomes, implies a shift of ownership from the people who are actually involved in real clinical ethics support services in a specific context to external stakeholders who increasingly gain a say in what ‘good CESS’ should look like. The question is whether this does justice to the insights and needs of those who are directly involved in actual CESS practices, be (...) it as receivers or providers. We maintain that those actually involved in concrete CESS practices should also be involved in its evaluation, not only as respondents, but also in setting the agenda of the evaluation process and in articulating the criteria by which CESS is evaluated. Therefore, we propose a participatory approach to CESS evaluation. It focuses on the concrete contexts in which CESS takes place, reflective and dialogical learning processes, and how to be democratic and inclusive. In particular, this approach to CESS evaluation is akin to realist evaluation, dialogical evaluation, and responsive evaluation. An example of a participatory approach to evaluating CESS is presented and some critical issues concerning this approach are discussed. (shrink)

In _Death in Documentaries: The Memento Mori Experience_, Benjamin Bennett-Carpenter suggests that documentaries are an especially apt form of contemporary _memento mori_; that is, documentaries offer transformative experiences for a viewer to renew one’s consciousness of mortality.

In this essay Suzanne Rice examines Aristotle's ideas about virtue, character, and education as elements in an Aristotelian conception of good listening. Rice begins by surveying of several different contexts in which listening typically occurs, using this information to introduce the argument that what should count as “good listening” must be determined in relation to the situation in which listening actually occurs. On this view, Rice concludes, there are no “essential” listening virtues, but rather ways of listening that may (...) be regarded as virtuous in the context of particular concrete circumstances. (shrink)

Development of Buddhist thought in India; 1. The Buddha’s suffering; 2. Practice and theory of no-self; 3. Kleśas and compassion; 4. The second Buddha’s greater vehicle; 5. Karmic questions; 6. Irresponsible selves, responsible non-selves; 7. The third turning: Yogācāra; 8. The long sixth to seventh century: epistemology as ethics; I. Perception and conception: the changing face ofultimate reality; II. Evaluating reasons: Naiyāyikas and Diṅnāga. III. Madhyamaka response to Yogācāra IV. Percepts and concepts: Apoha 1 ; V. Efficacy: Apoha 2 ; (...) VI. The path of the Bodhisattva; Epilogue; Background information; Appendix 1: The languages of Buddhism; Appendix 2: Intellectual context; Appendix 3: The Abhidharma. (shrink)