Ethics for Health Care, 2E takes a novel approach to learning about and understanding ethics. It draws on practical experiences and contemporary issues in its exploration of the ethical choices made in health care. The common theme followed in the book is that health care ethics are not only about setting acceptable standards, they are also about reflecting on what health care professionals should aim towards. It is about reflecting on optimal standards, and pursuing those standards. In focusing on the (...) interaction between the health provider and his or her client, the book skillfully incorporates individual and group exercises to help the reader think about particular issues or standards, or particular styles of ethical reflection. Tutorial-type triggers and case studies are also included. Over fifty of these exercises, twenty-four of them new to this edition, assist in developing familiarity with the key ways of identifying, and working to resolve, ethical issues in health care. In this framework, the philosophical aspect of ethics become a tool that every potential and current health care worker can use to reflect on ethics as it applies to their profession. (shrink)

ILaw, Regulation and Ethics introduces students to the responsibilities and standards in health care derived from legal, ethical and regulatory frameworks. The text approaches ethics and law for health care in an integrated and accessible way, covering governance, professional identity, and professional responsibility whereby accountability plays an important role. The text combines examples of legal and administrative decisions with the reasoning behind decisions, to introduce students to societal expectations of institutions and persons engaged in health care. Sourced from a variety (...) of regulatory, ethics, and policy arenas, the examples equip students with the ability to identify and understand appropriate standards in order to practice safely and competently, and to recognize when a situation is problematic and deserving of greater reflection or expert advice. Practice-oriented case examples and critical-reflection questions enhance the text and encourage students to develop effective practice habits, whereby active reflection, reasoning, problem solving and mindfulness become essential components of working in the health care sector. (shrink)

This thematic issue addresses questions of constraints on the evolution of form—physical, biological, and technical. Here, form is defined as an embodiment of a specific structure, which can be hierarchically different yet emerge from the same processes. The focus of this contribution is about how developmental biology and paleontology can be better integrated and compared in order to produce hypotheses about the evolution of form. The constraints on current EvoDevo research stem from the disconnect in the focus of study for (...) developmental geneticists and evolutionary morphologists; the former being interested in early developmental events at a molecular level in a model animal, the latter in late developmental events or comparison between adult forms, at a structural level in non-model animals. In order to truly integrate information from both fields in our understanding of evolutionary processes, morphology needs to be reintegrated in the study of gene expression, and its time frame needs to be extended beyond early developmental stages. Gene expression in non-model organisms also needs to be studied in order to gain perspective into primitive patterning at evolutionary nodes. Hypotheses formed by the comparison of expression patterns and morphologies seen in extant species can then be tested against forms found in the fossil record, coming closer to understanding the mechanisms underlying evolution. (shrink)

Although pragmatism and phenomenology have both contributed significantly to the genealogy of so-called “4E” – embodied, embedded, enactive and extended – cognition, there is benefit to be had from a systematic comparative study of these roots. As existing 4E cognition literature has tended to emphasise one or the other tradition, issues remain to be addressed concerning their commonalities – and possible incompatibilities. We begin by exploring pragmatism and phenomenology’s shared focus on contesting intellectualism, and its key assumption of mindedness as (...) representation. We then outline distinctive insights from both traditions regarding the nature and role of habits, in order to put forward a habit-based epistemology as an alternative to the Cartesian idea-based epistemology that has dominated modern philosophy. We pay particular attention to the work of classical pragmatist C.S. Peirce, arguing that his semiotics, which analyses sign-use as habit, shows how theorists of embodied cognition can break a certain false dichotomy between embodiment and logical or intellectual structure which has prevented them from fully theorising propositional knowledge. In this way, our work both augments and challenges the Dewey/Merleau-Ponty connection that has been much more extensively explored by the field. (shrink)

Mark Eli Kalderon's book boldly positions itself as a work in speculative metaphysics. Its point of departure is the familiar distinction between presentational and representational philosophies of perception. Kalderon notes that the latter has been more popular of late, as it is more amenable to "an account" explicating causal or counterfactual conditions on perception; but he wishes to rehabilitate the former, at least in part. One widely perceived disadvantage of presentationalism has been the way that understanding perception merely as registering (...) the presence of things might seem to leave us vulnerable to error about the nature of what is presented. Kalderon seeks to remedy this not by dealing at length with various disjunctivist positions concerning perception which may be friendly to his position, nor by spending much time criticising opposing views, but by explicating presentationalist perception through a series of tactile metaphors, thereby providing a radically new philosophical view. He claims that we do not just 'stand before' reality, we grasp it-the metaphor survives tellingly in ordinary language-and he thereby seeks to defend a form of realism which is robust, though he admits, "pre-modern". He draws on a remarkably rich variety of thinkers to defend this position, including pre-modern, modern, and various figures from both analytic and continental philosophy-however, although there is plenty of solid scholarship here, the book is aimed at metaphysics more than the history of ideas. (shrink)

I will defend a principle at work in Thomas Aquinas’s argument that the human intellect must be immaterial in order to know material things in SummaTheologica, Ia, q.75, a.2. Thomas relies on the position that whatever knows certain things would be impeded in this knowledge if it contained in itself thesesame things. Thus, if humans can, in principle, know all material things, then the intellect cannot be material. The position that a material intellect would be limited in knowledge of material (...) things is perhaps the most controversial part of the argument. I will articulate a version of this argument and argue that two objections to Thomas’s argument, offered by Norman Kretzmann and Robert Pasnau, fail, due in large part to a misunderstanding of proper objects of cognition. (shrink)

I first demonstrate that certain process philosophers and Aquinas hold extremely similar notions of evil. Whitehead and Hartshorne parallel Aquinas in understanding evil as relational, as a conflict of goods, and as a necessary element in a larger good. On this last point, process philosophers contend that traditional theists must either reject the claim of God’s omnipotence or admit that an omnipotent God would be responsible for evil, including moral evil. I respond that Aquinas’s distinction between physical and moral evil (...) moves beyond the process position and avoids the conclusion that God’s omnipotence must be abandoned. I argue that the process position does not take proper account of Aquinas’s claim that the cause of evil is a negation and the initial criticism relies on a distinction between moral and physical evil that process philosophy cannot make. (shrink)

I will defend a principle at work in Thomas Aquinas’s argument that the human intellect must be immaterial in order to know material things in SummaTheologica, Ia, q.75, a.2. Thomas relies on the position that whatever knows certain things would be impeded in this knowledge if it contained in itself thesesame things. Thus, if humans can, in principle, know all material things, then the intellect cannot be material. The position that a material intellect would be limited in knowledge of material (...) things is perhaps the most controversial part of the argument. I will articulate a version of this argument and argue that two objections to Thomas’s argument, offered by Norman Kretzmann and Robert Pasnau, fail, due in large part to a misunderstanding of proper objects of cognition. (shrink)

Primary substance for Aristotle is either the individual or form. These same two possibilities are the leading candidates for the source of unity in a substance.Thus, if we could determine what is responsible for the unity of a substance, we may well have located primary substance also. I consider the following possiblesources of the unity of form and matter in a substance:1) The unifier is a connector external to form and matter. (This connector may be itself a form, matter, or (...) a relation that is neither formal nor material.)2) There is no need for a unifier because form and matter are simply conceptual ways of understanding a single, already-unified, concrete being.3) The unifier is an inherent aspect of form or matter.I proceed by a process of elimination and conclude that substantial form is both what unifies a substance and the better candidate for primary substance. (shrink)

Background South Africa is likely to be the first country in the world to host an adolescent HIV vaccine trial. Adolescents may be enrolled in late 2007. In the development and review of adolescent HIV vaccine trial protocols there are many complexities to consider, and much work to be done if these important trials are to become a reality. Discussion This article sets out essential requirements for the lawful conduct of adolescent research in South Africa including compliance with consent requirements, (...) child protection laws, and processes for the ethical and regulatory approval of research. Summary This article outlines likely complexities for researchers and research ethics committees, including determining that trial interventions meet current risk standards for child research. Explicit recommendations are made for role-players in other jurisdictions who may also be planning such trials. This article concludes with concrete steps for implementing these important trials in South Africa and other jurisdictions, including planning for consent processes; delineating privacy rights; compiling information necessary for ethics committees to assess risks to child participants; training trial site staff to recognize when disclosures trig mandatory reporting response; networking among relevant ethics commitees; and lobbying the National Regulatory Authority for guidance. (shrink)

Primary substance for Aristotle is either the individual or form. These same two possibilities are the leading candidates for the source of unity in a substance.Thus, if we could determine what is responsible for the unity of a substance, we may well have located primary substance also. I consider the following possiblesources of the unity of form and matter in a substance:1) The unifier is a connector external to form and matter. (This connector may be itself a form, matter, or (...) a relation that is neither formal nor material.)2) There is no need for a unifier because form and matter are simply conceptual ways of understanding a single, already-unified, concrete being.3) The unifier is an inherent aspect of form or matter.I proceed by a process of elimination and conclude that substantial form is both what unifies a substance and the better candidate for primary substance. (shrink)

This paper reports on a survey of auditors in New Zealand which investigates the nature of the moral judgements they make on a series of problems with ethical dimensions. The framework adopted for this purpose is developed from earlier work which identifies a range of ethical principles which may be involved in business ethical decision‐making. Auditors responded to a questionnaire which posed, firstly, several questions about the context of their ethical decision‐making, and secondly, a series of vignettes elaborating problematical dilemmas (...) which required the selection of one of four possible responses. Data was analysed to determine whether or not it confirmed previous findings in suggesting a predominant ethical orientation for auditors. The results were correlated with demographic variables in order to determine whether or not age, gender, position in firm and size of employee firm were significantly correlated to ethical response. The survey results, on the whole, confirmed the ethical orientation suggested by previous findings, but there were some unexpected results in three out of the ten vignettes examined. Although some correlations were found between the demographic variables and subject responses, the evidence of this survey does not strongly suggest a consistent significant correlation. (shrink)

This paper reports on a survey of auditors in New Zealand which investigates the nature of the moral judgements they make on a series of problems with ethical dimensions. The framework adopted for this purpose is developed from earlier work which identifies a range of ethical principles which may be involved in business ethical decision‐making. Auditors responded to a questionnaire which posed, firstly, several questions about the context of their ethical decision‐making, and secondly, a series of vignettes elaborating problematical dilemmas (...) which required the selection of one of four possible responses. Data was analysed to determine whether or not it confirmed previous findings in suggesting a predominant ethical orientation for auditors. The results were correlated with demographic variables in order to determine whether or not age, gender, position in firm and size of employee firm were significantly correlated to ethical response. The survey results, on the whole, confirmed the ethical orientation suggested by previous findings, but there were some unexpected results in three out of the ten vignettes examined. Although some correlations were found between the demographic variables and subject responses, the evidence of this survey does not strongly suggest a consistent significant correlation. (shrink)

Activists’ investigations of animal cruelty expose the public to suffering that they may otherwise be unaware of, via an increasingly broad-ranging media. This may result in ethical dilemmas and a wide range of emotions and reactions. Our hypothesis was that media broadcasts of cruelty to cattle in Indonesian abattoirs would result in an emotional response by the public that would drive their actions towards live animal export. A survey of the public in Australia was undertaken to investigate their reactions and (...) responses to. The most common immediate reaction was feeling pity for the cattle. Women were more likely than men to feel sad or angry. Most people discussed the media coverage with others afterwards but fewer than 10 % contacted politicians or wrote to newspapers. We conclude that the public were emotionally affected by the media coverage of cruelty to cattle but that this did not translate into significant behavioral change. We recommend that future broadcasts of animal cruelty should advise the public of contact details for counseling and that mental health support contacts, and information should be included on the websites of animal advocacy groups to acknowledge the disturbing effect animal cruelty exposes can have on the public. (shrink)

Le geste semble procéder de lui-même, ne provenir de rien, clans une sorte de miracle qu'il faut interroger. Le présent livre questionne la danse, sous sa forme contemporaine, dans une perspective non dogmatique.

Recent work in positive psychology demonstrates the importance of self-transcendence: understanding oneself to be part of something greater than the self, such as a family, community, or tradition of sacred practice. Self-transcendence is positively associated with wellbeing and a sense of meaning and purpose. Philosophers have argued that self-transcendent motivation has a central role in good character, or virtue. Positive psychologists are just now beginning to integrate the aim of developing such motivation in character interventions. In this paper we draw (...) attention to an important but overlooked condition on effectively developing self-transcendent motivation constitutive of virtue: such a process must engage the subject’s will in the right way. If a process does not meet this condition it will fail to produce motivation constitutive of virtue according to leading philosophical accounts of virtue. We identify a suite of strategies for cultivating motivations that do meet this condition but have not been explored in relation to character interventions, namely, reappraisal strategies from the extended process model of emotion regulation (EPM-ER). (shrink)

Robert Coles' sentiment characterizes well the moral tenor of medical education today. Indeed, medical educators are frequently “seized by spasms of genuine moral awareness,” as they try to cope with the massive social and economic problems that face medical schools and teaching hospitals. The perception among educators that we currently fail to adequately teach several core aspects of doctoring, including professional values and behavior, constitutes one such spasm. In this case, the proposed remedy has generated considerable enthusiasm, but whether the (...) “core competencies” curriculum will make a difference, or simply “accommodate to the prevailing rhythms of the world we inhabit,” remains to be seen. (shrink)

Après avoir fait l’état des lieux de la base de données VALIBEL en la situant dans son contexte institutionnel, nous mettons en exergue dans cet article quelques possibilités d’investigation qu’offre la base en regard de ses évolutions récentes. Une attention particulière est portée à l’outillage des corpus en termes de disfluences (avec le programme DisMo) et à l’étude du vieillissement langagier (liée au corpus Corpage). Nous concluons en montrant en quoi l’enrichissement constant de la base (en outillage et en corpus) (...) permet d’ouvrir de nouvelles pistes de recherches dans des domaines encore peu explorés en linguistique, eu égard à des problématiques sociétales majeures. (shrink)

The multiplicity of definitions and conceptions of self-regulation that typifies contemporary research on self-regulation in psychology and educational psychology is examined. This examination is followed by critical analyses of theory and research in educational psychology that reveal not only conceptual confusions, but misunderstandings of conceptual versus empirical issues, individualistic biases to the detriment of an adequate consideration of social and cultural contexts, and a tendency to reify psychological states and processes as ontologically foundational to self-regulation. The essay concludes with a (...) consideration of educational research and intervention in the area of students’ self-regulated learning in terms of the scientific and professional interests of psychologists and educators, and the disguised manipulation of student self-surveillance in the service of the institutional mandates of schools. (shrink)

Clarembald of Arras is recognized primarily as a capable but uncreative alumnus of the school of Chartres, and not without some reason, as George and Fortin note in the opening of their introduction. Clarembald was a student of Thierry of Chartres and Hugh of St. Victor in a rather thoroughgoing sense—his written work often relies heavily on his teachers and focuses exclusively on topics on which Thierry had already written. Nonetheless, George and Fortin suggest that a closer reading of Clarembald’s (...) texts will reveal him to be a more careful and important thinker than is presently appreciated. (shrink)

This book celebrates Professor Margaret Brazier's outstanding contribution to the field of healthcare law and bioethics. It examines key aspects developed in Professor Brazier's agenda-setting body of work, with contributions being provided by leading experts in the field from the UK, Australia, the US and continental Europe. They examine a range of current and future challenges for healthcare law and bioethics, representing state-of-the-art scholarship in the field. The book is organised into five parts. Part I discusses key principles and themes (...) in healthcare law and bioethics. Part II examines the dynamics of the patient-doctor relationship, in particular the role of patients. Part III explores legal and ethical issues relating to the human body. Part IV discusses the regulation of reproduction, and Part V examines the relationship between the criminal law and the healthcare process. Offering a collaborative review of key and innovative themes in the field, the book will be of great interest and use to academics and students working in healthcare law and bioethics, and those working in health policy, law and regulation at both national and international levels. (shrink)

We examined maternal competition, an unexplored form of competition between women. Given women’s high investment in offspring and mothers’ key role in shaping their reproductive, social, and cultural success as adults, we might expect to see maternal competition between women as well as mate competition. Predictions about the effect of maternal characteristics (age, relationship status, educational background, number of children, investment in the mothering role) and child variables (age, sex) were drawn from evolutionary theory and sociological research. Mothers of primary (...) school children (in two samples: N = 210 and 169) completed a series of questionnaires. A novel nine-item measure of maternal competitive behavior (MCQ) and two subscales assessing Covert (MCQ-C) and Face-to-Face (MCQ-FF) forms of competition were developed using confirmatory factor analysis. Competitiveness (MCQ score) was predicted by maternal investment, single motherhood, fewer children, and (marginally) child’s older age. The effect of single motherhood (but not other predictors) was partially mediated by greater maternal investment. In response to a scenario of their child underperforming relative to their peers, a mother’s competitive distress was a positive function of the importance she ascribed to their success and her estimation of her child’s ability. Her competitive distress was highly correlated with the distress she attributed to a female friend, hinting at bidirectional dyadic effects. Qualitative responses indicated that nonspecific bragging and boasting about academic achievements were the most common irritants. Although 40% of women were angered or annoyed by such comments, less than 5% endorsed a direct hostile response. Instead, competitive mothers were conversationally shunned and rejected as friends. We suggest that the interdependence of mothers based on reciprocal childcare has supported a culture of egalitarianism that is violated by explicit competitiveness. (shrink)

Leading scholars explore the relationship between deconstructive theory and process thought.

An investigation of public support for coastal adaptation options and public finance options in Florida evaluated stakeholder judgments and how they changed through a participatory engagement process. The study found that public finance mechanisms that imposed fiscal burdens on those who directly benefit from hazard reduction were rated as more acceptable than others. Significantly, visualisations and data on local economic damage and return on investment of potential adaptation options further increased acceptability ratings. The question of whether a development fee for (...) adaptation or any other public purpose supported by private funds is a legal issue that depends on a test called the rational nexus. One concern of this article is to explore options for such fees to cover adaptation to climate change. This raises issues about the potential conflict with the community-wide and intergenerational nature of long-term adaptation. We also explore the relevance of environmental attitudes using the 'new environmental paradigm' (NEP) scale and political party affiliation. Results have implications for infrastructure improvements that require public approval for financing. (shrink)

Rare Disease research has seen tremendous advancements over the last decades, with the development of new technologies, various global collaborative efforts and improved data sharing. To maximize the impact of and to further build on these developments, there is a need for model consent clauses for rare diseases research, in order to improve data interoperability, to meet the informational needs of participants, and to ensure proper ethical and legal use of data sources and participants’ overall protection. A global Task Force (...) was set up to develop model consent clauses specific to rare diseases research, that are comprehensive, harmonized, readily accessible, and internationally applicable, facilitating the recruitment and consent of rare disease research participants around the world. Existing consent forms and notices of consent were analyzed and classified under different consent themes, which were used as background to develop the model consent clauses. The IRDiRC-GA4GH MCC Task Force met in September 2018, to discuss and design model consent clauses. Based on analyzed consent forms, they listed generic core elements and designed the following rare disease research specific core elements; Rare Disease Research Introductory Clause, Familial Participation, Audio/Visual Imaging, Collecting, storing, sharing of rare disease data, Recontact for matching, Data Linkage, Return of Results to Family Members, Incapacity/Death, and Benefits. The model consent clauses presented in this article have been drafted to highlight consent elements that bear in mind the trends in rare disease research, while providing a tool to help foster harmonization and collaborative efforts. (shrink)

Few figures of the Middle Ages command the attention of so many modern disciplines as Robert Grosseteste (c. 1170-1253). Theology, Philosophy, History, and Science are all areas which his life and thought continue to have significance and to inspire re-interpretation. Accompanied by a series of original commentaries, this new edition of Grosseteste's work, with English translation, draws together the perspectives of modern scientists and medieval specialists. Volume I of a six volume series, Knowing and Speaking presents two of the earliest (...) of Grosseteste's works, the treatises On the Liberal Arts and On the Generation of Sounds. These are accompanied by a significant Middle English treatise on the Seven Liberal Arts whose anonymous fifteenth-century author translated and excerpted passages from Grosseteste's treatises in a re-imagining of their structure and function.0Each work is treated separately within the volume, which is constructed in three parts. On the Liberal Arts sets Grosseteste's thoughts on the arts subjects and emphasises moral concerns about the purpose of learning. On the Generation of Sounds builds on the theories and statements of On the Liberal Arts in connection to the production of sound, elaborating the earlier position, relating the generation of sounds to human vocal and speech production. (shrink)

The current study examines patterns of attachment/self-protective strategies and rates of unresolved loss/trauma in children and adolescents presenting to a multidisciplinary gender service. Fifty-seven children and adolescents (8.42–15.92 years; 24 birth-assigned males and 33 birth-assigned females) presenting with gender dysphoria participated in structured attachment interviews coded using dynamic-maturational model (DMM) discourse analysis. The children with gender dysphoria were compared to age- and sex-matched children from the community (non-clinical group) and a group of school-age children with mixed psychiatric disorders (mixed psychiatric (...) group). Information about adverse childhood experiences (ACEs), mental health diagnoses, and global level of functioning was also collected. In contrast to children in the non-clinical group, who were classified primarily into the normative attachment patterns (A1-2, B1-5, and C1-2) and who had low rates of unresolved loss/trauma, children with gender dysphoria were mostly classified into the high-risk attachment patterns (A3-4, A5-6, C3-4, C5-6, and A/C) (χ2= 52.66;p< 0.001) and had a high rate of unresolved loss/trauma (χ2= 18.64;p< 0.001). Comorbid psychiatric diagnoses (n= 50; 87.7%) and a history of self-harm, suicidal ideation, or symptoms of distress were also common. Global level of functioning was impaired (range 25–95/100; mean = 54.88;SD= 15.40; median = 55.00). There were no differences between children with gender dysphoria and children with mixed psychiatric disorders on attachment patterns (χ2= 2.43;p= 0.30) and rates of unresolved loss and trauma (χ2= 0.70;p= 0.40).Post hocanalyses showed that lower SES, family constellation (a non-traditional family unit), ACEs—including maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence)—increased the likelihood of the child being classified into a high risk attachment pattern. Akin to children with other forms of psychological distress, children with gender dysphoria present in the context of multiple interacting risk factors that include at-risk attachment, unresolved loss/trauma, family conflict and loss of family cohesion, and exposure to multiple ACEs. (shrink)

Providers and patients bring different understandings of health and disease to their encounters in the hospital setting. The literature to date only infrequently addresses patient and provider concordance on the reported reason for hospitalization, that is, whether they express this reason in similar ways. An agreement or common ground between such understandings can serve as a basis for future communication regarding an illness and its treatment. We interviewed a convenience sample of patients on the medical wards of an urban academic (...) medical center. We asked subjects to state the reason why their doctors admitted them to the hospital, and then compared their statement with the reason in the medical record. We defined concordance on reported reason for hospitalization as agreement between the patient’s report and the reason abstracted from the chart. We interviewed and abstracted chart data from a total of 46 subjects. Concordance on reported reason for hospitalization was present in 24 (52%) and discordance in 17 (37%); 5 patients (11%) could not give any reason for their hospitalization. Among the 17 patients whose report was discordant with their chart, 12 (71%) reported a different organ system than was recorded in the chart. A significant proportion of medical inpatients could not state their physicians’ reason for admission. In addition, patients who identify a different reason for hospitalization than the chart often give a different organ system altogether. Providers should explore patient understanding of the reason for their hospitalization to facilitate communication and shared decision making. (shrink)

À travers l’étude de quatre exemples cliniques d’adolescents en souffrance, cet article propose d’illustrer diverses formes de demandes éducatives dans le travail thérapeutique. Faisant le lien avec l’approche lacanienne concernant le déclin de l’autorité paternelle, c’est alors une réflexion sur « la névrose contemporaine » qui est abordée comme base de données pour l’approche du bouleversement des structures de la famille moderne.