Background:Nursing practice is complex, as nurses are challenged by increasingly intricate moral and ethical judgments. Inadequately studied in underrepresented groups in nursing, moral distress is a serious problem internationally for healthcare professionals with deleterious effects to patients, nurses, and organizations. Moral distress among nurses has been shown to contribute to decreased job satisfaction and increased turnover, withdrawal from patients, physical and psychological symptoms, and intent to leave current position or to leave the profession altogether.Research question:Do significant gender differences exist in (...) the moral distress scores of critical care nurses?Research design:This study utilized a quantitative, descriptive methodology to explore moral distress levels in a sample of critical care nurses to determine whether gender differences exist in their mean moral distress scores.Participants and research context:Participants ( n = 31) were critical care nurses from an American Internet nursing community who completed the Moral Distress Scale–Revised online over a 5-day period in July 2013.Ethical considerations:Institutional review board review approved the study, and accessing and completing the survey implied informed consent.Findings:The results revealed a statistically significant gender difference in the mean moral distress scores of participants. Females reported statistically significantly higher moral distress scores than did males. Overall, the moral distress scores for both groups were relatively low.Discussion:The findings of a gender difference have not previously been reported in the literature. However, other findings are consistent with previous studies on moral distress.Conclusion:Although the results of this study are not generalizable, they do suggest the need for continuing research on moral distress in underrepresented groups in nursing, including cultural and ethnic groups. (shrink)

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

Johnson and Stricker published an opinion piece in the Journal of Medical Ethics presenting their perspective on the 2008 agreement between the Infectious Diseases Society of America (IDSA) and the Connecticut Attorney General with regard to the 2006 IDSA treatment guideline for Lyme disease. Their writings indicate that these authors hold unconventional views of a relatively common tick-transmitted bacterial infection caused by the spirochete Borrelia burgdorferi. Therefore, it should come as no surprise that their opinions would clash with the IDSA's (...) evidence-based guidelines for the diagnosis and treatment of Lyme disease. Their allegations of conflict of interest against the IDSA resemble those made against the National Institutes of Health, the Food and Drug Administration and the Centers for Disease Control and Prevention in 2000, which were found to be baseless. It is the responsibility of all physicians and medical scientists to stand up to antiscientific, baseless and unethical attacks on those who support an evidence-based approach to caring for patients. (shrink)

PURPOSE:To report the localization of a gene causing drusen and macular degeneration in a previously undescribed North American family. METHODS:Genetic mapping studies were performed using linkage analysis in a single family with drusen and atrophic macular degeneration. RESULTS:The clinical manifestations in this family ranged from fine macular drusen in asymptomatic middle-aged individuals to atrophic macular lesions in two children and two elderly patients. We mapped the gene to chromosome 6q14 between markers D6S2258 and D6S1644. CONCLUSIONS:In a family with autosomal dominant (...) drusen and atrophic macular degeneration, the gene maps to a 3.2-cM region on chromosome 6q14. This locus appears to be distinct from, but adjacent to, the loci for cone-rod dystrophy 7 (CORD7) and North Carolina macular dystrophy (MCDR1). Future identification of the gene responsible for the disease in this family will provide a better understanding of macular degeneration. (shrink)

Quo usque tandem abutere, Catilina, patientia nostra?. The famous incipit—‘And what are you reading, Master Buddenbrook? Ah, Cicero! A difficult text, the work of a great Roman orator. Quousque tandem, Catilina. Huh-uh-hmm, yes, I've not entirely forgotten my Latin, either’— already impressed contemporaries, including some ordinarily not so readily impressed. It rings through Sallust's version of Catiline's shadowy address to his followers, when he asks regarding the injustices they suffer : quae quousque tandem patiemini, o fortissumi uiri?. More playfully, and (...) less well-known, Sallust employed the expression again in a speech by Philippus : uos autem, patres conscripti, quo usque cunctando rem publicam intutam patiemini et uerbis arma temptabitis?. Soon afterwards it served Cicero's son, who, as governor of Asia, put down Hybreas fils for having dared to quote from his father's work in his presence : ‘age’, inquit [sc. Marcus Tullius], ‘non putas me didicisse patris mei: “quousque tandem abutere, Catilina, patientia nostra”?’. Just about the same time, Livy recalled it in order to colour Manlius’ exhortation of his followers : quousque tandem ignorabitis uires uestras, quas natura ne beluas quidem ignorare uoluit? … audendum est aliquid uniuersis aut omnia singulis patienda. quousque me circumspectabitis?. Thereafter Quintilian would refer to it twice, when discussing apostrophe and rhetorical questions, just a couple of years before Tacitus has the maladroit Q. Haterius encourage Tiberius to seize the reins—quo usque patieris, Caesar, non adesse caput rei publicae? ; a few decades later still, Apuleius puts it into the mouth of the slave who chastises his master, now in asinine form : ‘quo usque tandem’, inquit, ‘cantherium patiemur istum paulo ante cibariis iumentorum, nunc etiam simulacris deorum infestum?’. He trusted, no doubt, that the famous question would alert his readers more than anything to the many ‘similarities between Catiline and Lucius’, in order to have them appreciate this ‘ludicrous copy of Cicero's arch-enemy’. Some time after, and in a different corner of the Empire altogether, a teacher's bronze statue would carry the inscription:VERBACICRO | NISQVOVSQ | TANDEMABVTE | RECATELINAPA | TIENTIANOS | TRA. (shrink)

A person points to a situation, A, and says that A is morally repugnant; A ought to be condemned; we should do something about A. In response, another person says, “Well, what about B? B is analogous to A in that it is equally morally repugnant. If we ought to condemn and do something about A then we should also condemn and do something about B.” This “what about” response is an argumentative strategy, sometimes called “whataboutery” or “whataboutism.” In popular (...) discussion, whataboutery is condemned as a fallacy, in particular an instance of the tu quoque fallacy. I will present an analysis of whataboutery showing that, to the degree that this is a fallacy, it is a red herring. But this argumentative move cannot always be dismissed as fallacious. Sometimes the imputation of fallacious reasoning attempts to cover over political commitments. (shrink)

La investigación ecológica a largo plazo (Long Term Ecological Research, LTER) maneja problemas que abarcan décadas o plazos más largos. El programa y su nombre formal comenzaron en Estados Unidos en 1980. Si bien los estudios y observaciones a largo plazo comenzaron tempranamente en 1400 y 1800 en Asia y Europa, respectivamente, el enfoque a largo plazo no se formalizó sino hasta el establecimiento de los programas de investigación ecológica de largo plazo en Estados Unidos. Estos programas han permitido experimentos (...) a nivel de ecosistemas y comparaciones entre sitios que condujeron a una mejor comprensión de la estructura y funcionamiento de la biosfera. El enfoque ecosistémico holístico de esta iniciativa permite también la incorporación de la dimensión humana en la ecología, y recientemente ha dado lugar al nuevo concepto de investigación socio-ecológica de largo plazo (LTSER). Hoy los programas de investigación socio-ecológica a largo plazo existen en por lo menos 32 países (esto es, los miembros de la Red Internacional de Investigación Ecológica a Largo Plazo o ILTER (International Long Term Ecological Research). Sin embargo, la consolidación de la red internacional dentro del paradigma de investigación socio-ecológica a largo plazo todavía requiere: (1) inclusión de algunas regiones remotas del mundo que aún están poco representadas, como el suroeste de América del Sur; (2) modificaciones en el tipo de investigación realizado, tales como la integración de las ciencias sociales y naturales con las humanidades y la ética, y (3) la incorporación de las conclusiones y resultados dentro de los procesos sociales y políticos. En este contexto, la naciente red de investigación socio-ecológica a largo plazo en Chile, que se extiende en el rango latitudinal más largo de bosque templado en el Hemisferio Sur, agrega una nueva región remota a las investigaciones ecológicas de largo plazo que había sido pasada por alto anteriormente. Además, la colaboración con la Universidad de North Texas y otros asociados internacionales ayuda a desarrollar un enfoque interdisciplinario para integrar las ciencias ecológicas y la filosofía ambiental, junto con los conocimientos ecológicos tradicionales, la educación informal y formal, la política, las humanidades, los procesos socio-políticos y la conservación biocultural. (shrink)

La investigación ecológica a largo plazo (Long Term Ecological Research, LTER) maneja problemas que abarcan décadas o plazos más largos. El programa y su nombre formal comenzaron en Estados Unidos en 1980. Si bien los estudios y observaciones a largo plazo comenzaron tempranamente en 1400 y 1800 en Asia y Europa, respectivamente, el enfoque a largo plazo no se formalizó sino hasta el establecimiento de los programas de investigación ecológica de largo plazo en Estados Unidos. Estos programas han permitido experimentos (...) a nivel de ecosistemas y comparaciones entre sitios que condujeron a una mejor comprensión de la estructura y funcionamiento de la biosfera. El enfoque ecosistémico holístico de esta iniciativa permite también la incorporación de la dimensión humana en la ecología, y recientemente ha dado lugar al nuevo concepto de investigación socio-ecológica de largo plazo (LTSER). Hoy los programas de investigación socio-ecológica a largo plazo existen en por lo menos 32 países (esto es, los miembros de la Red Internacional de Investigación Ecológica a Largo Plazo o ILTER (International Long Term Ecological Research). Sin embargo, la consolidación de la red internacional dentro del paradigma de investigación socio-ecológica a largo plazo todavía requiere: (1) inclusión de algunas regiones remotas del mundo que aún están poco representadas, como el suroeste de América del Sur; (2) modificaciones en el tipo de investigación realizado, tales como la integración de las ciencias sociales y naturales con las humanidades y la ética, y (3) la incorporación de las conclusiones y resultados dentro de los procesos sociales y políticos. En este contexto, la naciente red de investigación socio-ecológica a largo plazo en Chile, que se extiende en el rango latitudinal más largo de bosque templado en el Hemisferio Sur, agrega una nueva región remota a las investigaciones ecológicas de largo plazo que había sido pasada por alto anteriormente. Además, la colaboración con la Universidad de North Texas y otros asociados internacionales ayuda a desarrollar un enfoque interdisciplinario para integrar las ciencias ecológicas y la filosofía ambiental, junto con los conocimientos ecológicos tradicionales, la educación informal y formal, la política, las humanidades, los procesos socio-políticos y la conservación biocultural. (shrink)

La investigación ecológica a largo plazo (Long Term Ecological Research, LTER) maneja problemas que abarcan décadas o plazos más largos. El programa y su nombre formal comenzaron en Estados Unidos en 1980. Si bien los estudios y observaciones a largo plazo comenzaron tempranamente en 1400 y 1800 en Asia y Europa, respectivamente, el enfoque a largo plazo no se formalizó sino hasta el establecimiento de los programas de investigación ecológica de largo plazo en Estados Unidos. Estos programas han permitido experimentos (...) a nivel de ecosistemas y comparaciones entre sitios que condujeron a una mejor comprensión de la estructura y funcionamiento de la biosfera. El enfoque ecosistémico holístico de esta iniciativa permite también la incorporación de la dimensión humana en la ecología, y recientemente ha dado lugar al nuevo concepto de investigación socio-ecológica de largo plazo (LTSER). Hoy los programas de investigación socio-ecológica a largo plazo existen en por lo menos 32 países (esto es, los miembros de la Red Internacional de Investigación Ecológica a Largo Plazo o ILTER (International Long Term Ecological Research). Sin embargo, la consolidación de la red internacional dentro del paradigma de investigación socio-ecológica a largo plazo todavía requiere: (1) inclusión de algunas regiones remotas del mundo que aún están poco representadas, como el suroeste de América del Sur; (2) modificaciones en el tipo de investigación realizado, tales como la integración de las ciencias sociales y naturales con las humanidades y la ética, y (3) la incorporación de las conclusiones y resultados dentro de los procesos sociales y políticos. En este contexto, la naciente red de investigación socio-ecológica a largo plazo en Chile, que se extiende en el rango latitudinal más largo de bosque templado en el Hemisferio Sur, agrega una nueva región remota a las investigaciones ecológicas de largo plazo que había sido pasada por alto anteriormente. Además, la colaboración con la Universidad de North Texas y otros asociados internacionales ayuda a desarrollar un enfoque interdisciplinario para integrar las ciencias ecológicas y la filosofía ambiental, junto con los conocimientos ecológicos tradicionales, la educación informal y formal, la política, las humanidades, los procesos socio-políticos y la conservación biocultural. (shrink)

This book is a collection of secondary essays on America's most important philosophic thinkers—statesmen, judges, writers, educators, and activists—from the colonial period to the present. Each essay is a comprehensive introduction to the thought of a noted American on the fundamental meaning of the American regime.

This book shows that Hauriou's positivist and pragmatic jurisprudence and social theory, as well as their application to the study of institutions, is satisfactorily supported by his idealistic philosophy. The nine chapters first locate Hauriou's influences, then situate his disciplinary methodologies within methodology in general. The central chapters concern each of the three methodologies in turn.

This paper explores possible connections between gender and the willingness to engage in unethical business behavior. Two approaches to gender and ethics are presented: the structural approach and the socialization approach. Data from a sample of 213 business school students reveal that men are more than two times as likely as women to engage in actions regarded as unethical but it is also important to note that relatively few would engage in any of these actions with the exception of buying (...) stock with inside information. Fifty percent of the males were willing to buy stock with insider information. Overall, the results support the gender socialization approach. (shrink)

When Dr. van Fleteren writes of the articles I criticized as dating from some twenty years ago, the unwary reader might infer that my criticism of those articles was, for its part, relatively recent. The fact is, however, that when the two connected articles I eventually criticized appeared in the volumes of Augustinian Studies, I wrote this reply while Fr. Robert Russell, of happy memory, was still at the helm, and was promised publication in the near future. Meanwhile, however, Fr. (...) Russell had the discourtesy to move on to a more intimate acquaintance with Augustine than any of us on this confused planet can boast of, and someone sowed cockle into field he had tended: in unaccountable fashion my article seems to have disappeared. Only a recent letter of inquiry on my part, and Fr. Allan Fitzgerald’s understanding reply, resulted in this renewal of dialogue between Dr. van Fleteren and me. Let me assure both Dr. van Fleteren and Fr. Fitzgerald that I am grateful for giving it exactly that form, a courteous dialogue. (shrink)

Peirce’s doctrine of God has scarcely been studied at all. This is surprising because his own naturally religious temperament, his desire for philosophical completeness and the influence of Kant, all led him to give an important place to theistic speculation in his philosophy. It is true that few parts of his philosophy reveal more than the fragmentary and unfinished nature of his thinking. This however does not take away from its importance both for the interpretation of his philosophy and for (...) the evaluation of its contribution. In this paper I want to examine his doctrine of God mainly in order to discover and outline what views he held in the matter. Such examination is an essential preliminary to any consideration of the value of his theistic thinking. Moreover, an objective exposition is already the best beginning of evaluation. However it is impossible to undertake this kind of examination without a careful search into various corners of his writings and a meticulous and slightly laboured presentation of one’s findings. But I think that the patience involved in such research has a rich reward. (shrink)

John Paul II’s encyclical Veritatis Splendor lists several objections to the theological concept of fundamental option. This article summarizes that concept, primarily as presented by Josef Fuchs. It then locates the concept, as Fuchs did, in the overarching theological anthropology of Karl Rahner, which is discussed at length. The objections of the encyclical are then engaged. In some cases, it is shown, the encyclical misunderstands fundamental option. In other cases, its rejection of the idea seems to entail rejection also of (...) traditional Catholic doctrines. All this leads to concluding reflections in which fundamental option is evaluated in terms of its cogency, adequacy, usefulness, and necessity for a contemporary Christian anthropology. (shrink)

The phase space formulation of quantum mechanics is based on the use of quasidistribution functions. This technique was pioneered by Wigner, whose distribution function is perhaps the most commonly used of the large variety that we find discussed in the literature. Here we address the question of how one can obtain distribution functions and hence do quantum mechanics without the use of wave functions.

Christopher Hookway has been influential in promoting engagement with pragmatist and naturalist perspectives from classical and contemporary American philosophy. This book reflects on Hookway’s work on the American philosophical tradition and its significance for contemporary discussions of the understanding of mind, meaning, knowledge, and value. -/- Hookway’s original and extensive studies of Charles S. Peirce have made him among the most admired and frequently referenced of Peirce’s interpreters. His work on classical American pragmatism has explored the philosophies of William (...) James, John Dewey, and Josiah Royce, and examined the influence of pragmatist ideas outside of the United States. Additionally, Hookway has participated in a number of celebrated exchanges with some of the most high-profile figures of twentieth- and twenty-first-century philosophy, including Karl-Otto Apel, Philip Pettit, Hilary Putnam, and W.V.O. Quine, through which his treatments of a large range of topics in epistemology and the philosophies of mind and language have been developed and promoted. The chapters in this book—which include contributions from several of Hookway’s former students and colleagues—include studies of Hookway’s engagement with the works of Peirce, James, and Dewey, his contributions to virtue epistemology, and his discussions of hope and pragmatist metaphysics. -/- Pragmatic Reason will be of interest to researchers and advanced students working on American philosophy, the history of analytic philosophy, and epistemology. (shrink)

Recent developments of three-dimensional printing of biomaterials in medicine have been portrayed as demonstrating the potential to transform some medical treatments, including providing new responses to organ damage or organ failure. However, beyond the hype and before 3D bioprinted organs are ready to be transplanted into humans, several important ethical concerns and regulatory questions need to be addressed. This article starts by raising general ethical concerns associated with the use of bioprinting in medicine, then it focuses on more particular ethical (...) issues related to experimental testing on humans, and the lack of current international regulatory directives to guide these experiments. Accordingly, this article considers whether there is a limit as to what should be bioprinted in medicine; examines key risks of significant harm associated with testing 3D bioprinting for humans; investigates the clinical trial paradigm used to test 3D bioprinting; analyses ethical questions of irreversibility, loss of treatment opportunity and replicability; explores the current lack of a specific framework for the regulation and testing of 3D bioprinting treatments. (shrink)

This paper considers two contenders for the title of highest good in Kant's theory of practical reason: happiness proportioned to virtue and the maximization of happiness and virtue. I defend the against criticisms made by Andrews Reath and others, and show how it resolves a dualism between prudential and moral practical reasoning. By distinguishing between the highest good as a principle of evaluation and an object of agency, I conclude that the maximization of happiness and virtue is a corollary of (...) the instantiation of the proportionality thesis. (shrink)

Elizabeth Anscombe introduced the notion of “practical knowledge” into contemporary philosophy. Philosophers of action have criticized Anscombe’s negative characterization of such knowledge as “non-observational,” but have recently come to pay more attention to her positive characterization of practical knowledge as “the cause of what it understands.” I argue that two recent Anscombean accounts of practical knowledge, “Formalism” and “Normativism,” each fail to explain the productive character of practical knowledge in a way that secures its status as non-observational. I argue that (...) to do this, we must appreciate the role of know-how or skill in practical knowledge. (shrink)

This study investigates the impact of Securities and Exchange Commission enforcement actions on individuals holding Certified Public Accountant accreditation. While prior research has investigated both the characteristics of companies that have been investigated by the SEC and litigation against audit firms, it has not addressed the ways in which SEC investigations impact CPAs. Using a sample of 262 CPAs, we find that the most common CPA breach was associated with overstating revenues/income or earnings. The study finds serious consequences for CPAs (...) in terms of employment restrictions and SEC actions, incorporating suspension, which is often permanent. We find that the primary factors relating to the severity of actions by the SEC is whether the CPA intentionally breached the professional code of conduct, the age of the CPA, whether the CPA is still a member of the AICPA with CPA status and whether the CPA was operating as an external auditor or in a corporate accounting role. Our findings have implications for accounting practitioners, the AICPA and boards of directors. (shrink)

This landmark collection of essays by six renowned philosophers explores the implications of the contentious realism/antirealism debate for epistemology. The essays examine issues such as whether epistemology needs to be realist, the bearing of a realist conception of truth on epistemology, and realism and antirealism in terms of a pragmatist conception of epistemic justification. Richard Rorty's essay provides a critical commentary on the other five.

In February 54b.c. Cicero concludes a missive to his brother with a passing and – for us – tantalizing remark:Lucreti poemata ut scribis ita sunt, multis luminibus ingeni, multae tamen artis. sed cum veneris. virum te putabo si Sallusti Empedoclea legeris; hominem non putabo. Quintus had, it seems, readDe rerum natura, or at least parts thereof, just before he left Rome for an undisclosed location nearby, and he shared his enthusiasm with his brotherper codicillos. Meanwhile, he was corresponding with Julius (...) Caesar, whose staff in Gaul he was about to join. When, a few months later, he was stationed with Caesar, he was involved in another literary affair, this time concerning his brother who wrote to him, inquiring about his autobiographicalDe temporibus suis:quo modo nam, mi frater, de nostris versibus Caesar? nam primum librum se legisse scripsit ad me ante, et prima sic ut neget se ne Graeca quidem meliora legisse; reliqua ad quendam locum ῥᾳθυμότερα (hoc enim utitur verbo). dic mihi verum: num aut res eum aut χαρακτὴρ non delectat?(Q.fr.2.15.5). (shrink)

Abstract:This paper contends that rationality is more properly evaluated as a property of an organization’s relationships with its stakeholders than of the organization itself. We predicate our approach on the observation that stakeholders can hold goals quite distinct from those of owners and top managers, and these too can be rationally pursued. We build upon stakeholder theory and Weber’s classic distinction betweenwertrationalitatandzweckrationalitat, adding to them the “new institutionalist” concept of the organization field (1983, 1991). Stakeholders employ a variety of direct (...) and indirect mechanisms to rationalize relations with the firm. We discuss four: internal subunits, legislated stakeholder participation, legislated access to information, and direct stakeholder activism. These developments are blurring the distinction between the environment and the organization by importing the values and goals of external stakeholders into the internal organization. They are also precipitating a more structured set of relationships among the actors who comprise the field. To the extent that thezweckrationalitatvalues of managers and owners as well as thewertrationalitatconcerns of stakeholders are met, the firm is more rational. (shrink)