Excerpt from Higher Psychical Development (Yoga Philosophy): An Outline of the Secret Hindu Teachings I wish to acknowledge, here, my very great indebted ness to Mr. Frederick T. Harris, for his invaluable as sistence in the preparation of this work. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original (...) format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

Despite their ethical intentions, ethically minded consumers rarely purchase ethical products (Auger and Devinney: 2007, Journal of Business Ethics76, 361–383). This intentions–behaviour gap is important to researchers and industry, yet poorly understood (Belk et al.: 2005, Consumption, Markets and Culture8(3), 275–289). In order to push the understanding of ethical consumption forward, we draw on what is known about the intention–behaviour gap from the social psychology and consumer behaviour literatures and apply these insights to ethical consumerism. We bring together three separate (...) insights – implementation intentions (Gollwitzer: 1999, American Psychologist54(7), 493–503), actual behavioural control (ABC) (Ajzen and Madden: 1986, Journal of Experimental Social Psychology22, 453–474; Sheeran et al.: 2003, Journal of Social Psychology, 42, 393–410) and situational context (SC) (Belk: 1975, Journal of Consumer Research2, 157–164) – to construct an integrated, holistic conceptual model of the intention–behaviour gap of ethically minded consumers. This holistic conceptual model addresses significant limitations within the ethical consumerism literature, and moves the understanding of ethical consumer behaviour forward. Further, the operationalisation of this model offers insight and strategic direction for marketing managers attempting to bridge the intention–behaviour gap of the ethically minded consumer. (shrink)

Summary During the past decade, the cultural restorationist wing of the New Right has sought to impose its own anachronistic and sentimental conception of ?British culture? on schools and colleges. This conception, which is little more than a glib celebration of quintessential ?Englishness?, characterises the national culture in largely monolithic and ethnically undifferen?tiated terms. Concerned about the possible pernicious effects of educational policies inspired by such thinking, we present the findings of a recently completed ethnographic study of 8?11 year?olds? conceptions (...) of British national culture. Our paper considers the extent to which children's understanding of this complex form of collective identity may vary with age, and ethnicity. We conclude by exploring the implications of the findings for anti?racist and multicultural education. (shrink)

To commemorate 40 years since the founding of the Journal of Business Ethics, the editors in chief of the journal have invited the editors to provide commentaries on the future of business ethics. This essay comprises a selection of commentaries aimed at creating dialogue around the theme Ethics at the centre of global and local challenges. For much of the history of the Journal of Business Ethics, ethics was seen within the academy as a peripheral aspect of business. However, in (...) recent years, the stakes have risen dramatically, with global and local worlds destabilized by financial crisis, climate change, internet technologies and artificial intelligence, and global health crises. The authors of these commentaries address these grand challenges by placing business ethics at their centre. What if all grand challenges were framed as grand ethical challenges? Tanusree Jain, Arno Kourula and Suhaib Riaz posit that an ethical lens allows for a humble response, in which those with greater capacity take greater responsibility but remain inclusive and cognizant of different voices and experiences. Focussing on business ethics in connection to the grand challenge of environmental emergencies, Steffen Böhm introduces the deceptively simple yet radical position that business is nature, and nature is business. His quick but profound side-step from arguments against human–nature dualism to an ontological undoing of the business–nature dichotomy should have all business ethics scholars rethinking their “business and society” assumptions. Also, singularly concerned with the climate emergency, Boudewijn de Bruin posits a scenario where, 40 years from now, our field will be evaluated by its ability to have helped humanity emerge from this emergency. He contends that Milieudefensie v. Royal Dutch Shell illustrates how human rights take centre stage in climate change litigation, and how business ethics enters the courtroom. From a consumer ethics perspective, Deirdre Shaw, Michal Carrington and Louise Hassan argue that ecologically sustainable and socially just marketplace systems demand cultural change, a reconsideration of future interpretations of “consumer society”, a challenge to the dominant “growth logic” and stimulation of alternative ways to address our consumption needs. Still concerned with global issues, but turning attention to social inequalities, Nelarine Cornelius links the capability approach to global and corporate governance, arguing that CA will continue to lie at the foundation of human development policy, and, increasingly, CSR and corporate governance. Continuing debate on the grand challenges associated with justice and equality, Laurence Romani identifies a significant shift in the centrality of business ethics in debates on managing differences, positing that dialogue between diversity management and international management can ground future debate in business ethics. Finally, the essay concludes with a commentary by Charlotte Karam and Michelle Greenwood on the possibilities of feminist-inspired theories, methods, and positionality for many spheres of business ethics, not least stakeholder theory, to broaden and deepen its capacity for nuance, responsiveness, and transformation. In the words of our commentators, grand challenges must be addressed urgently, and the Journal of Business Ethics should be at the forefront of tackling them. (shrink)

In his paper on transcendental intersubjectivity in Husserl, which refers mainly to the Fifth Cartesian Meditation, Schutz (1966a) marks out four stages in Husserl's argument and finds what are for him insurmountable problems in each stage. These stages are: (1) isolation of the primordial world of one's peculiar ownness by means of a further epoche; (2) apperception of the other via pairing; (3) constitution of objective, intersubjective Nature; (4) constitution of higher forms of community. Because of the problems Schutz encounters (...) in each of these stages, he concludes that Husserl's theory is unacceptable (Schutz, 1966a, p.82). Having already proved that it is unacceptable, he now explains why these problems arise in Husserl's theory. Intersubjectivity, says Schutz, is "a datum of the life-world," (1966a, p.82) not a transcendental problem. In other words, intersubjectivity must be dealt with as a problem of the life-world of the natural attitude, not a "problem of constitution which can be solved within the transcendental sphere." (Schutz, 1966a, p.82). There is no such thing as transcendental intersubjectivity, if by that is meant intersubjectivity of a plurality of transcendental egos. The role of transcendental phenomenology in the problem of intersubjectivity is to explicate within the transcendental reduction the sense: "intersubjectivity in the life-world." Husserl was diverted from this proper role of phenomenology--in his words, to "explicate the sense which this world has for us prior to all philosophy" (trans. and quoted by Schutz from "Cartesianische Meditationen, para. 62, in fine," in Schutz, 1966a, p.82)--because of the unobtrusive transformation of sense of his concept of constitution from that of explication and clarification to "creation," in the sense of providing an ontology of the lifeworld. The fact that phenomenology is in principle incapable of doing this lies behind the failure of Husserl's theory of intersubjectivity (Schutz, 1966a, pp.83-84). Unlike Schutz, I will deal with this general issue explicitly in the context of the stages in Husserl's argument and Schutz's objections. It seems to me that Husserl does remain within the sphere of clarification of sense, but to do explication and clarification of certain "senses" results inevitably in doing a kind of ontology. (shrink)

The nursing metaparadigm, as described by Fawcett in 1984, includes human, health, nursing, and the environment, all of which support theory development by giving direction to our focus as a scientific body. Nursing scientists make their mark in biotechnological applications, mobile health, informatics, and human factors research. We give voice to the patient through design feedback and incorporating technological advancements in our evolving nursing knowledge; however, we have not formally acknowledged technology in our metaparadigm. To continue patient‐centered care in this (...) age where machines are enmeshed in daily human life, we propose technology must be a domain of the metaparadigm to continue advancing nursing science and knowledge. In this paper, we propose a separate domain of technology within the metaparadigm to challenge nurses to consider approaches within their research and practice of how technology will impact patient care and their personal development within the profession. A technology‐specific domain within the metaparadigm also is a signal to other bodies of science of our willingness and ability to run at pace with novel, exciting new discoveries while adding our perspective. Nurses may become active agents in novel developments rather than passive adopters, continuing our legacy of patient advocacy through new knowledge generation. Emerging and continuing nurse leadership has set the stage for the next era of nurse‐led innovation and technology development, which provides an opportunity to embed technology as a core aspect of the nursing metaparadigm. (shrink)

While mainstream CSR research has generally explored and argued for positive ethical, social and environmental performance, critical CSR scholars argue that change has been superficial—at best, and not possible in any substantial way within the current capitalist system. Both views, however, only address the role of business within larger systems. Little attention has been paid to the everyday material CSR practice of individual managers. We go inside the firm to investigate how the micro-level acts of individual managers can aggregate to (...) drive transformation of the macro-level business logic. We draw on the strategy-as-practice approach to organize our research. The study reveals two orientations towards the integration of personal ethics into the workplace: abdication and activism. These orientations are supported by managerial practice such as reproductive and coping tactics and covert and overt tactics ; and, three enabling conditions of activist practice: empowerment and psychological safety, moral shock, and morality praxis. While our findings illustrate the tremendous challenges managers face when attempting to influence organizational practices towards their ethical and environmental aspirations, we also show that under specific conditions, individual managers can become fully engaged advocates and drivers of positive change from the inside. In so doing, our individual-level analysis of intrapreneurship provides a more complex picture of the possibilities for positive change than have been previously put forth by mainstream and critical CSR research. (shrink)

Summary In her highly publicised polemic, All Must Have Prizes (1996), Melanie Phillips launches a scathing attack upon the British educational establishment and various facets of policy and practice during the past three decades. She is especially critical of progressivism and approaches to teaching and learning supposedly predicated upon relativist principles (e.g. multicultural education). Our own research on primary?school children's constructions of British identity (Carrington, B. & Short, G. (1995): What makes a person British? Children's conceptions of their national (...) culture and identity, Educational Studies, 21, pp. 217?238) is singled?out for criticism. We begin this paper with a rejoinder to Phillips. Among other things, we take issue with her defence of an assimilationist approach to the curriculum. In the second part of the paper, we present the findings of a recently completed case?study of 12? and 13?year?olds? constructions of their national identity, which replicates the earlier work (criticised by Phillips) with 8? to 11?year?olds. We show that the young adolescents, in common with their counterparts in primary schools, tended to adopt a pluralist viewpoint. Once again, there was an almost complete dearth of comments that were racist or nationalistic. We conclude by briefly exploring the policy implications of the findings. [1] Paper presented to the 1997 Conference of the Association for Moral Education: The Voices of Care and Justice?enhancing dialogue among theorists, researchers and practitioners, Emory University, Atlanta, GA, USA. (shrink)

Summary Compared to the literature on children's racial and ethnic identities, relatively little is known about their understanding of national identity. Such knowledge is necessary if schools are to challenge racism, xenophobia and ethnocentrism effectively. In this paper, we present the findings of a case?study (undertaken in a mainly?white Edinburgh primary school) of 9?11 year?olds? understanding of this complex form of collective identity. Particular attention is given to age?related differences in response. Comparisons are drawn between the Scottish children's conceptions of (...) their national identity and those of a multiethnic cohort drawn from three English primary schools (in a recently?completed, parallel investigation by the same authors). We conclude by exploring the policy implications of our data. (shrink)

In recent years, policy?makers in England, Australia and other countries have called for measures to increase male recruitment to the teaching profession, particularly to the primary sector. This policy of targeted recruitment is predicated upon a number of unexamined assumptions about the benefits of matching teachers and pupils by gender. For example, it is held that the dearth of male ?role models? in schools continues to have an adverse effect on boys? academic motivation and engagement. Utilizing data from interviews with (...) more than 300 7? to 8?year?olds attending primary schools in the north?east and south?east of England, the paper sets out to scrutinize these claims. The findings revealed that the gender of teachers had little apparent effect on the academic motivation and engagement of either boys or girls. For the majority of the children, the gender of the teacher was largely immaterial. They valued teachers, whether men or women, who were consistent and even?handed and supportive of them as learners. (shrink)

In the published article the Acknowledgment section is missing. The following text should have been included.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Anchors of Democracy: A New Division of Powers, Representation, Sense of Limits by Rocco PezzimentiAdam CarringtonPEZZIMENTI, Rocco. The Anchors of Democracy: A New Division of Powers, Representation, Sense of Limits. Herefordshire, U.K.: Gracewing, 2021. 207 pp. Paper, $22.00Rocco Pezzimenti's The Anchors of Democracy: A New Division of Powers, Representation, Sense of Limits is an ambitious book. A professor at LUMSA, Rome, he seeks to consider anew the (...) nature, structure, and purposes of democracy as well as the society in which this form of government best operates. He sees this task as needed because, he argues, contemporary democracies face new challenges that threaten their legitimacy and their capacity to fulfill their just and needed purposes. He notes that democracies are not "infallible," either morally or in their ability to maintain themselves, and thus need conscious understanding and prudent maintenance.The subtitle establishes the three main themes by which he diagnoses and addresses democracy's trials. Pezzimenti orders his argument most through the lens of limits. While present in all spheres and regimes, popular government in particular partakes of limitation, since "mutual limitation... is the basis of our democracies." Limits for Pezzimenti stem from distinct elements of a society competing for finite power ordered toward action. Many of our political and social problems, both past and present, stem from denying limitations or misordering their interactions. The presentism that tempts democracy must be tempered by the limits the past places on it. Institutions are one helpful means for this interaction, which helps guard against a "utopianism which wants to solve everything immediately, deceiving itself that it can perform miracles." Law itself involves limits, placing boundaries on the action of private persons and public entities. So does pluralism and "polyarchy," whereby we recognize the limits particular persons and communities place on politics' universalism as well as how politics restrains these other elements from descending into intolerant, selfish particularity. Important to this point is Pezzimenti's discussion of sovereignty, which must not be reduced to a mere question of who rules and where but to the question of rightly pursuing a common good respectful of individual rights. True freedom inheres in the proper cohering of these elements.Pezzimenti turns to the distribution of powers within a community as part of the discussion of limits. He argues that "the traditional tripartition, theorized by Polybius and on to Montesquieu, today appears certainly insufficient." To define all political power as legislative, executive, and judicial, then to distribute them among competing institutions, does not fully account for the contemporary political landscape. Moreover, those [End Page 361] "classic" powers themselves need to be rethought to meet today's concerns. Legislative power must account for claims that its representative systems either are oligarchic in practice or lead to crass populism, and that they fail to account for group identities as opposed to class ones. The executive must evolve in pursuit of a better "efficiency and efficacy"—including speed of response to problems—that requires a better relationship with the modern bureaucracy, which he describes as "the other face of the executive." The judicial power must focus on a renewed impartiality, especially in relation to the additional powers Pezzimenti thinks need to be named and then tamed. The new powers that he says we must recognize include the press, mass media, technology, and more. Here, Pezzimenti categorizes as powers the functions of government (making, enforcing, and adjudication of the law) alongside avenues or means for exercising political influence, if not outright control. These other forces have distorted democracy's needed limits partly because law and custom have not adequately accounted for their evolving role in power.These issues lead to the last challenge, that of representation. The problem of representation threatens democracy's legitimacy, since this form of government is grounded more than any other in the idea that "power must be the expression of the community." Yet even here the issue of limits orders the discussion. The unaccounted-for new powers described above remove too many limitations either on crass populism or encroaching rule of elites. The former can abuse individual rights, which he says "are not negotiable," based on oppressive whims... (shrink)

Since the mid-1980s many schools in predominantly white areas have taken active steps to counter racism and ethnocentrism and raise awareness of Britain's ethnic diversity through curriculum development. This paper is primarily concerned with the ethical issues raised by research into such initiatives at primary school level. We begin by alluding very briefly to the shortcomings of extant research into children's prejudice, noting that some studies can be criticised for the unwitting reinforcement of stereotypes. We move on to examine the (...) ethical and methodological considerations which have underpinned our own work in this area, focusing on a recent investigation into children's understanding of Jewish culture and identity. The techniques employed to probe the children's beliefs and attitudes and challenge their taken-for-granted assumptions are described at length, together with the ethical dilemmas addressed during the course of the research. In the second part of the paper, we focus on issues raised by our own curriculum development work in anti-racist and multicultural education in 'all white' schools. We draw extensively on a recent case-study of 10 and 11 year-olds' responses to a teaching programme which aimed to counter stereotypical images both of developing countries and Islam. (shrink)

The terminology employed to explore consumption ethics, the counterpart to business ethics, is increasingly varied not least because consumption has become a central discourse and area of investigation across disciplines. Rather than assuming interchangeability, we argue that these differences signify divergent understandings and contextual nuances and should, therefore, inform future writing and understanding in this area. Accordingly, this article advances consumer ethics scholarship through a systematic review of the current literature that identifies key areas of convergence and contradiction. We then (...) present the articles in this Journal of Business Ethics Symposium and analyse how these articles fit within the interdisciplinary themes. Subsequently, we develop a transdisciplinary theoretical framework that encapsulates the complexity and contextual nature of consumption ethics. We conclude by outlining how genuinely transdisciplinary research into the intersection of ethics with consumption may develop. (shrink)

The Unconscious as Space explores the experience of being and the practice of psychoanalysis by thinking of the unconscious in mathematical terms. Anca Carrington introduces mathematical models of space, from dimension theory to algebraic topology and knot theory, and considers their immediate psychoanalytic relevance. The hypothesis that the unconscious is structured like a space marked by impossibility is then examined. Carrington considers the clinical implications, with particular focus on the interplay between language and the unconscious as related topological (...) spaces in which movement takes place along knot-like pathways. The Unconscious as Space will be of appeal to psychotherapists, psychoanalysts, and mental health professionals in practice and in training. (shrink)

Marxism, Cultural Studies and Sport assesses the contemporary relevance of Marxist approaches and offers a unique and diverse examination of modern sports ...

Endochondral bone formation can take place in the embryo, during fracture healing, or in postnatal animals after induction by implanted demineralized bone matrix. This matrix‐induced bone formation recapitulates the embryonic sequence of bone formation morphologically and biochemically. The steps in bone formation in both systems include differentiation of cartilage from mesenchyme, cartilage maturation, invasion of the cartilage by blood vessels and marrow precursors, and formation of bone and bone marrow. Recently, bone inductive molecules from demineralized bone matrix have been purified, (...) sequenced and produced as recombinant proteins. While there are similarities between bone development in the embryo and that after induction by these purified molecules, the molecules responsible for bone induction in the embryo have not yet been defined. Because of similarities between the two methods of bone formation, studies of Bone induction by demineralized bone matrix may help to elucidate mechanisms of embryonic bone induction. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Human Gene TherapyMary Carrington Coutts (bio)On September 14, 1990, researchers at the U.S. National Institutes of Health (NIH) performed the first approved gene therapy procedure on a four-year-old girl named Ashanti DeSilva. Born with a rare genetic disease, severe combined immune deficiency (SCID), Ashanti lacked a healthy immune system and was extremely vulnerable to infection. Children with SCID usually develop overwhelming infections and rarely survive to adulthood; even (...) a common childhood illness like chicken pox is life-threatening. Ashanti led a cloistered existence, avoiding contact with people outside her family, remaining in the sterile environment of her home, and battling frequent illnesses with massive amounts of antibiotics.In Ashanti's gene therapy procedure, her own white blood cells were genetically modified and then infused back into her bloodstream. Laboratory tests show that the therapy has strengthened Ashanti's immune system. She no longer has recurrent colds, has been allowed to attend school, and has been immunized against whooping cough. This gene therapy procedure is not a cure, however. The genetically-treated white blood cells only survive for a few months and must then be replaced, but Ashanti's future is much brighter because of the new therapy (VI, Thompson [The First] 1993).Although this simplified description of Ashanti's gene therapy procedure sounds like a happy ending, it is little more than an optimistic chapter in a long story. The road to the first approved gene therapy procedure was rocky and fraught with controversy. The biology of human gene therapy is very complex, and there are still many techniques that need to be developed and diseases that need to be understood more fully before gene therapy is well established. The public policy debate surrounding the possible use of genetically engineered material in human subjects is equally complex. Major participants in the debate come from the fields of biology, government, law, medicine, philosophy, politics, and religion, each bringing different views to the discussion.In studying the ethics of gene therapy, one should draw a distinction between [End Page 63] therapy on somatic (non-reproductive) cells and germ (reproductive) cells. Only the germ cells carry the genes that will be passed on to the next generation. Reactions to gene therapy have varied widely. Some commentators on gene therapy object to any form of genetic manipulation, no matter how well-intentioned (VI, Rifkin 1983). Another reaction is to allow the use of somatic-cell therapy, but not to approve the use of germ-line therapy, which could have unforeseeable effects on future generations. A different stance is that, with proper regulation and safeguards, germ-line gene therapy is a logical extension of the progress made to date and that it is an ethically acceptable procedure.TechniquesTo date, 43 research protocols have been approved for somatic-cell gene therapy in the United States. The techniques employed in each protocol vary, but in general a virus is used as a "vector" to insert the desired gene into the DNA of the patient's cells, in order to compensate for a defective gene. For Ashanti's gene therapy, this technique involved obtaining white blood cells and introducing properly functioning genes into as many of the cells as possible. The normal genes were delivered through the use of a specially-engineered virus.Although similar techniques are used in germ-line gene therapy, the procedure is more difficult. There are two basic ways to perform germ-line gene therapy: (1) to treat a preimplantation embryo that carries a serious genetic defect before its implantation in the mother, which necessitates the use of in vitro fertilization techniques; or (2) to treat the germ cells (sperm or egg cells) of afflicted adults so that the genetic defects would not be passed on to their offspring, which requires the technical expertise to delete the defective gene and insert a properly functioning replacement. Because of the complexity of the procedures involved and the attendant ethical controversy, germ-line therapy is not currently performed.Candidate Diseases for Gene TherapyAt present, gene therapy is likely to be most successful in treating diseases that are caused by single-gene defects and has been approved for treating diseases such... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Teaching Ethics in the Health Care Setting Part I:Survey of the LiteratureMary Carrington Coutts (bio)The last twenty years have brought important changes to health care and health care education. Educators and students alike face an enormous number of new fields of study and new medical technologies. Health care professionals and institutions are also facing new challenges in the form of shrinking economic resources, and the AIDS epidemic. They (...) must also respond to increased patient participation in health care decisions, and public concern about abortion and euthanasia. These challenges to the health care professional have compelled educators to accommodate ethics within their already overcrowded curriculum. Those same dilemmas have influenced health care institutions to become active in health care ethics education.Medical ethics education gained a foothold in the United States during the late 1960s, when the medical schools of Pennsylvania State University, the University of Florida, and the State University of New York at Stonybrook established programs in the humanities (Pellegrino 1982). In 1978 Robert Veatch noted that formal teaching in medical ethics was rare; most institutions that taught medical ethics used "informal instruction in the apprenticeship mode" (Veatch 1978). However, by 1982 a survey by the American Medical Association (AMA) revealed that all but one of the 127 medical schools had courses that included medical ethics. Thirty eight of these had medical ethics as a required course (Pellegrino 1985). And by 1989, 43 of the 127 medical schools had separate courses in medical ethics, while 100 covered medical ethics within required courses. Medical ethics is now an accepted part of medical curriculum, though it is not fully mature, and its future remains somewhat unclear (Miles 1989).The evolution of ethics in the nursing curriculum has essentially mirrored that of the medical curriculum. A 1977 survey of baccalaureate nursing programs revealed that only 7 percent of nursing programs required courses in ethics [End Page 171] (Aroskar 1977). A decade later a second survey of undergraduate programs identified 85 percent of responding nursing schools as teaching nursing ethics either in separate ethics courses or within other required courses (Cassells and Redman 1989).Though the precise future of health care ethics may be unpredictable, there is little thought that the role of ethics will diminish in importance as the 21st century approaches. Ethics is seen as part of a larger plan to develop and enhance the health professional's human values, social conscience, and interpersonal skills. "This broader effort derives from concerns about the personal attributes and humanistic sensitivity of physicians, the recent overly 'scientized' trend in premedical education, the selection of medical students, and the socialization and cynicism engendered by medical education" (Miles 1989, p. 705).While nearly every medical and nursing school in the United States now teaches ethics in one form or another, the degree to which ethics is integrated into the curriculum varies from school to school. Some ethics courses are required elements of the students' education; some institutions require attendance at seminars and ethics grand rounds. Other schools offer an array of elective courses in topics that relate to ethics in medicine and nursing (including medical humanities, medicine and the law, literature and medicine, history of medicine, patient advocacy, and human values in nursing.) "Brown bag" seminars and journal clubs are also common.There is much debate over how health care ethics should be taught. Some argue that medical professionals should be conversant with theories of ethics and principles of biomedical ethics. Others think that a theoretical approach will alienate already over-worked medical or nursing students, and that instruction in ethical theory should be kept to a minimum. Case studies are frequently cited as a way to involve students in medical decision making, forcing them to analyze problems that they can relate to their own experiences.Additional concerns center around who should teach health care ethics. Frequently, physicians and nurses interested in ethics teach courses. Some commentators see this as the most desirable arrangement, asserting that practicing health care professionals best understand the conflicts faced by physicians and nurses-in-training. However, there is a growing pool of professionals who are undergoing training as medical ethicists. These individuals study ethical theory and bioethical... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Fetal Tissue ResearchMary Carrington Coutts (bio)I. IntroductionThe use of tissue from fetal remains for transplantation and biomedical research has become a controversial issue in recent years, involving scientists, doctors, patients, and the federal government. Fetal tissue is potentially useful in a wide range of treatments for a number of serious diseases, some of them affecting millions of people. Despite the promise, transplantation research using fetal tissue from induced (...) abortion slowed dramatically in the U.S. in 1988, when a moratorium was declared on federal funding for such research involving humans. That moratorium was lifted by President Clinton on January 21, 1993. Though the future of fetal tissue transplantation research is brighter, public debate on the issue is likely to continue, exacerbated by the "acrimonious abortion debate" (VI, Post 1991, p. 14).Using fetal tissue in biomedical research and in transplantation is not a new practice. As early as 1928 unsuccessful attempts were made to transplant fetal pancreas cells into diabetics (VII, Fichera 1928). Fetal tissue was used effectively in biomedical research during the 1950s, and was instrumental in the culture of the polio virus, which led to the development of the polio vaccine. Fetal tissue cultures were also essential in the development of the rubella vaccine, and continue to be used in virology research. Transplantation of fetal thymus cells into patients with DiGeorge Syndrome has been recognized as effective therapy since the late 1960s.Many of the therapeutic applications involving fetal tissue are still experimental, so it is difficult to pinpoint fetal tissue transplantation's therapeutic potential. One promising application is the transplantation of human fetal brain cells into the substantia nigra of patients with Parkinson's disease to restore motor function. Fetal neural transplants have also shown promise for patients suffering from Alzheimer's disease, spinal cord and other neural tissue injuries, and possibly some forms of cortical blindness. Fetal liver cells may be useful for treatment of some kinds of bone marrow disease seen in leukemia and aplastic anemia patients. [End Page 81] Fetal tissue transplantation may also help those suffering from blood clotting disorders, such as sickle cell anemia, thalassemia, and hemophilia. Fetal pancreatic tissue has potential applications in the treatment of diabetes, especially juvenile onset diabetes. Human gene therapy may also employ embryonic and early fetal cells.The Center for Biomedical Ethics at the University of Minnesota reports that more than 1,000 patients have received transplanted fetal tissue worldwide. Countries where fetal tissue transplantation has occurred include: Australia, Canada, China, the Commonwealth of Independent States (formerly the U.S.S.R.), Cuba, Czechoslovakia, Finland, France, Germany, Great Britain, Hungary, India, Italy, Mexico, Norway, Spain, Sweden, and Yugoslavia (IV, Vawter 1992, p. 2; I, Spain 1988; VII, Reinikainen 1989).Fetal tissue has unique characteristics that make it especially valuable in some treatments. Fetal cells develop much faster than adult cells, hastening the therapeutic effect—a potentially significant benefit for gravely ill patients. They are also less likely to be rejected by transplant recipients because they are less antigenic than adult cells. This reduces the need for the exact tissue matches that can be so difficult to obtain. Fetal tissue is also easier to culture and proliferates more readily than comparable adult tissue. Furthermore, fetal tissue is in greater supply, due to the number of elective abortions.Questions about the use of fetuses and fetal tissue in biomedical research were raised in the United States in the early 1970s. Between 1969 and 1973, all 50 states enacted the Uniform Anatomical Gift Act, allowing for the donation of all or part of the body of a dead fetus for research or therapeutic research. Prospects for the use of fetal tissue increased after the Supreme Court decision in Roe v. Wade legalized abortion. As the availability of fetal tissue increased so did the concern over the potential for controversial research on living, soon-to-be-aborted fetuses, and anxiety over maltreatment of dead abortuses. Vivid examples include Geoffrey Chamberlain's 1968 report of an experiment on a fetus of 26 weeks gestational age. Delivered by hysterotomy from a 14-year-old patient, the fetus was attached to an "artificial placenta" and kept alive for more than... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Basic Resources in Bioethics*Mary Carrington Coutts (bio)OrganizationsKennedy Institute of Ethics Georgetown University Washington, DC 20057 National Reference Center for Bioethics Literature 800-MED-ETHX or 202-687-3885The Hastings Center 255 Elm Road Briarcliff Manor, NY 10510 914-762-8500Society for Health and Human Values 6728 Old McLean Village Drive McLean, VA 22101 703-556-9222NOTE: There are numerous organizations in the United States and abroad that deal with bioethical issues. For a more comprehensive listing (...) of those organizations, see:American Hospital Association. Directory of Biomedical Ethics Organizations. Chicago: American Hospital Association, 1989.National Reference Center for Bioethics Literature. International Directory of Bioethics Organizations edited by Robert Iosco. Washington, DC: Georgetown University, 1986.Encyclopedia and DictionaryDictionary of Medical Ethics. Edited by A.S. Duncan, G.R. Dunstan, and R.B. Welborn. New rev. ed. New York: Crossroad, 1981. [End Page 75]Encyclopedia of Bioethics. Edited by Warren T. Reich. 4 vols. New York: Macmillan-Free Press, 1978; or 1982 reprint in 2 volumes available to members of the Kennedy Institute of Ethics through the membership office, 202-687-8099.Online DatabaseBioethicsline. Produced by the Kennedy Institute of Ethics for the National Library of Medicine. Searchable through the MEDLARS system. Focuses on questions of ethics and public policy in the fields of health care and biomedical research. Searches available upon request to the National Reference Center for Bioethics Literature. For information on securing a personal access code from the National Library of Medicine, call 800-638-8480.BibliographiesBibliography of Bioethics. Edited by LeRoy Walters and Tamar Joy Kahn. Washington, DC: Kennedy Institute of Ethics, Georgetown University. Issued annually since 1975. Corresponds to the BIOETHICSLINE database. Provides references to resources on ethical and public policy issues in medicine and biomedical research. Includes abstracts; arranged by broad subject categories.Ethics in Nursing. Edited by Terry Pence. 2nd ed. New York: National League for Nursing, 1986. An annotated bibliography of nursing ethics. Includes author and subject indexes.Goldstein, Doris M. Bioethics: A Guide to Information Sources. Detroit: Gale Research, 1982. A selected, annotated bibliography to the literature of bioethics.The Hastings Center's Bibliography of Ethics, Biomedicine and Professional Responsibility. Compiled by the staff of the Hastings Center. Frederick, MD: University Publications of America, 1984.Medical Ethics: An Annotated Bibliography. Edited by Mark Siegler, Peter A. Singer and David L. Schiedermayer. Philadelphia: American College of Physicians, 1988.Current Awareness ServicesNOTE: Several journals have sections where they highlight new publications. See, for example, the "In The Literature" section of the Hastings Center Report, or the "Medicolegal Reference Shelf" section of Law, Medicine and Health Care. Other services include:BioLaw. Edited by James F. Childress and Ruth D. Gaare. Frederick, MD: [End Page 76] University Publications of America, 1983 to present. Annual with bimonthly updates. (Previous title: Bioethics Reporter.) A compendium of articles and legal documents on ethical and legal issues in medicine, health care administration and human experimentation. Includes the text of important legal decisions in the Resources section.New Titles in Bioethics. Edited by Luanda Fitch Huttlinger. Washington, DC: National Reference Center for Bioethics Literature, Kennedy Institute of Ethics, Georgetown University. Published monthly 1975-1989; quarterly 1990—present. List of acquisitions by the National Reference Center for Bioethics Literature. Organized by subject categories. Includes ordering information for difficult-to-find items. Annual cumulation available.Scope Notes Series. Washington, DC: National Reference Center for Bioethics Literature, Kennedy Institute of Ethics, Georgetown University. A series of issue briefs including annotated bibliographies on the following popular bioethical topics:No 1. Dangerousness, September 1982, 5 p.No 2. Living Wills and Durable Powers of Attorney: Advance Directive Legislation and Issues, Revised February 1990, 15 p.No 3. Ethics Committees in Hospitals, Revised June 1989, 12 p.No 4. Diagnosis Related Groups and the Prospective Payment System, June 1984, 11 p.No 5. Baby Fae, January 1985, 19 p.No 6. Surrogate Mothers, Revised January 1988, 12 p.No 7. Withholding or Withdrawing Nutrition or Hydration, Revised September 1988, 12 p.No 8. AIDS: Law, Ethics and Public Policy, April 1988, 12 p.No 9. Bioethics Audiovisuals 1982 to Present, September 1988, 12 p.No 10. Ethical Issues in... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:EugenicsMary Carrington Coutts (bio) and Pat Milmoe McCarrick (bio)The word eugenics (from the Greek eugenes or well-born) was coined in 1883 by Francis Galton, an Englishman and cousin of Charles Darwin, who applied Darwinian science to develop theories about heredity and good or noble birth (I, Kevles 1985, p. x).The entry under "eugenics" in the Encyclopedia of Bioethics notes that the term has had different meanings in different (...) eras: "a science that investigates methods to ameliorate the genetic composition of the human race; a program to foster such betterment; a social movement; and in its perverted form, a pseudo-scientific retreat for bigots and racists" (V, Ludmerer 1978, p. 457). Kevles, who places a stronger emphasis than Ludmerer on the degeneration of eugenics, says that by 1935 it "had become 'hopelessly perverted' into a pseudoscientific facade for 'advocates of race and class prejudice, defenders of vested interests of church and state, Fascists, Hitlerites, and reactionaries generally'" (I, Kevles 1985, p. 164).Phrases such as "survival of the fittest" and "struggle for existence" came into use at the end of the nineteenth century when eugenics societies were created throughout the world to popularize genetic science. "Negative eugenics" utilized marriage restriction, sterilization, or custodial commitment of those thought to have unwanted characteristics. "Positive eugenics" tried to encourage the population perceived as "superior" to have more offspring (V, Ludmerer 1978, p. 459).In the United States, after World War I, new information, such as the importance of environmental influences and the more complex concept of multi-gene effects in inheritance, diminished the scientific justification for eugenics, but this knowledge did not decrease the pressure for legislation, judicial action, or immigration controls. The U.S. Immigration Restriction Act of 1924 favored immigration from northern Europe and greatly restricted the entry of persons from other areas referred to as "biologically inferior." Between 1907 and 1937, 32 [End Page 163] states required sterilization of various citizens viewed as undesirable: the mentally ill or handicapped; those convicted of sexual, drug, or alcohol crimes; and others viewed as "degenerate" (V, Larson 1991).In Germany, interest in eugenics flourished after the turn of the century when Dr. Alfred Ploetz founded the Archives of Race-Theory and Social Biology in 1904 and the German Society of Racial Hygiene in 1905. The German term Rassenhygiene or race hygiene encompassed more than the word "eugenics;" it included all attempts to improve hereditary qualities as well as measures directed at population increase (III, Weiss 1987). By the 1920s, various German textbooks incorporated ideas of heredity and racial hygiene, and German professors were participating in the international eugenics movement. The Kaiser Wilhelm Institute of Anthropology, Human Heredity, and Eugenics was founded in 1927; by 1933 a sterilization law, the Law for the Prevention of Congenitally Ill Progeny, which originally was entitled "Eugenics in the Service of Public Welfare," indicated compulsory sterilization "for the prevention of progeny with hereditary defects" in cases of "congenital mental defects, schizophrenia, manic-depressive psychosis, hereditary epilepsy... and severe alcoholism." (III, Müller-Hill 1988, p. 10).The co-mingling of science, politics, and Weltanschauung (ideological or religious world view) caused the darkest period for eugenics when Nazi Germans embarked on their "final solution" to the Jewish "problem", or the Holocaust. The Nazi racial-hygiene program began with involuntary sterilizations and ended with genocide. Beginning with the 1933 Law for the Prevention of Congenitally Ill Progeny, 350,000 schizophrenic and other mentally ill persons were involuntarily sterilized, and marriage or sexual contact between Jews and other Germans was banned. Several hundred black children and 30,000 German Gypsies were sterilized. By 1945, when the allies liberated those remaining in Nazi concentration camps, six million Jews, 750,000 Gypsies, and 70,000 German psychiatric patients had been killed by the Nazis (III, Müller-Hill 1992, p. 47). As a result of the German experience, eugenic thought dropped to its nadir, and to the present day, the term "eugenics" invokes a sense of horror in some people.Great Britain, the United States, and Germany were the countries most involved with eugenic science in the first half of this century, but interest was present in Europe and other... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Teaching Ethics in the Health Care SettingPart II: Sample SyllabusMary Carrington Coutts (bio)The National Reference Center for Bioethics Literature at the Kennedy Institute of Ethics receives many inquiries from instructors at institutions that are just beginning to teach medical ethics. In an effort to assist those individuals, we have devised a syllabus that could be adapted for many uses. This is intended to be an introductory level syllabus, (...) perhaps one that would be appropriate for continuing staff education in a hospital or for an undergraduate college course. Of course, every instructor has his or her own style and preference for course content. This is offered merely as a place to start.Recognizing that participants bring a variety of backgrounds to a course, four possible text books and two casebooks have been selected as texts for a course in health care ethics. There are a number of other books that also could have been chosen. Some of these are listed in Scope Note 15: Basic Resources in Bioethics (published in the Kennedy Institute of Ethics Journal 1 (1): 75-90, March 1991). Other video selections are listed in Scope Note 9: Bioethics Audiovisuals: 1982-Present (1988); (available directly from the National Reference Center for Bioethics Literature). Additional recommendations for works that provide cross-cultural or international views of medical ethics appear in the supplemental readings list at the end of this syllabus.TextbooksBiomedical Ethics. Edited by Thomas A. Mappes and Jane S. Zembaty. 3rd ed. New York: McGraw-Hill, 1990, 641 pp. Cited: (M&Z). This text is well-suited for undergraduate education, with selected readings by philosophers, lawyers, and physicians. Includes 45 brief case studies to [End Page 263] illustrate various units of readings.Contemporary Issues in Bioethics. Edited by Tom L. Beauchamp and LeRoy Walters. 3rd ed. Belmont, CA: Wadsworth Pub. Co., 1989, 655 pp. Cited: (B&W). Appropriate for upper-level undergraduate or graduate education, this text includes selected readings by important philosophers, lawyers, physicians, and organizations. Includes the abridged texts of many significant court cases and government or organizational documents. Does not include case studies.Ethical Issues in Modern Medicine. Compiled by John Arras and Nancy K. Rhoden. 3rd ed. Mountain View, CA: Mayfield, 1989, 585 pp. Cited: (A&R). This text is suitable for upper-level undergraduate or graduate studies. It includes selections from well-respected lawyers, philosophers, and a few physicians. Includes excerpts from important court cases and policy documents. Provides only a few hypothetical case studies but does relate some authentic cases that are relevant to the various sections.Taking Sides: Clashing Views on Controversial Bioethical Issues. Edited by Carol Levine. 3rd ed. Guilford, CT: Dushkin Pub. Group, 1989, 370 pp. Cited: (L). A compilation of contrasting readings from the popular Hastings Center Report, this book is appropriate for undergraduate or continuing health care education. It does not include an introduction to basic biomedical ethical theory. Perhaps less systematic in its approach to bioethics than the previous textbooks, this book covers twenty topics relating to reproduction, death and dying, human and animal experimentation, and selected public policy issues. Provides pro and con arguments for each issue.CasebooksCases in Bioethics: Selections from the Hastings Center Report. Edited by Carol Levine. Rev. and updated ed. New York: St. Martin's Press, 1989, 291 pp. Cited: (HCR). This text includes cases studies taken from the well-known Hastings Center Report. Two or three commentaries usually accompany each case.Pence, Gregory E. Classic Cases in Medical Ethics: Accounts of the Cases That Have Shaped Medical Ethics, With Philosophical, Legal, and Historical Backgrounds. New York: Mc-Graw-Hill, 1990, 398 pp. Cited: (CC). This book describes a collection of famous (and infamous) cases from the history of biomedical ethics. The accounts of the cases here are more detailed than in other texts, and the style is more casual. [End Page 264]Course OutlineBelow are possible topics for discussion, listed with the relevant portions for each book. It is anticipated that only one textbook and one casebook would be chosen for a course. Whenever possible, price information for video purchase or rentals has been included, however this information is subject to change.Session 1... (shrink)