RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)

From a traditional moral point of view, business practitioners often seem overly concerned about the behavior of their peers in deciding how they ought to act. We propose to account for this concern by introducing a mutual trust perspective, where moral obligations are grounded in a sense of trust that others will abide by the same rules. when grounds for trust are absent, the obligation is weakened. We illustrate this perspective by examining the widespread ambivalence with regard to deception about (...) one's settlement preferences in negotiation. On an abstract level, such deception generally seems undesirable, though in many individual cases it is condoned, even admired as shrewd bargaining. Because of the difficulty in verifying someone's settlement preferences, it is hard to establish a basis for trusting the revelations of the other party, especially in competitive negotiations with relative strangers. (shrink)

The central question for this book is whether schools should attempt to cultivate patriotism, and if so why, how, and with what conception of patriotism in mind. The promotion of patriotism has figured prominently in the history of public schooling in the United States, always with the idea that patriotism is both an inherently admirable attribute and an essential motivational basis for good citizenship. It has been assumed, in short, that patriotism is a virtue in its own right and that (...) it is a foundational aspect of civic virtue more generally. Through an integrated historical and philosophical approach, this book demonstrates that there have been many and diverse attempts to cultivate patriotism in public schools in the United States and that they have been predicated on different conceptions of patriotism, citizenship, and learning. In order to assess these assumptions and evaluate the various practices of patriotic education, we address the nature of virtue and the motivational foundations of civic responsibility, and we frame a general approach to the ethics of education. We find that the history of attempts to cultivate patriotism in schools offers both cautionary and positive lessons. We argue that there is a virtuous form of patriotism and that an inclusive and enabling just school community may contribute to its development. Yet, we conclude that patriotism is not a virtue as such. We argue that civic virtue is what schools should aim to cultivate, and that civic education should be organized around three components of civic virtue, namely civic intelligence, civic friendship, and civic competence. We hold that virtuous patriotism is an appropriate responsiveness to a country’s value, and that such responsiveness is part and parcel of civic virtue that is also responsive to what has value beyond one’s own country. The book concludes with a defense of global civic education, arguing that it should promote global civic friendship and cooperation. The book situates its understanding of patriotism in the context of nationalist, populist, and authoritarian movements in the United States and Europe, and it mounts a spirited defense of democratic institutions that should be of interest to anyone concerned about the polarization of public life and future of democracy. (shrink)

Social poetics as research and practice: living in and learning from the process of research This paper is both a report of research work carried out by one author of the paper with the other involved in a supervisory role, and a reflection on methodology that was an emergent property of the research process. The research question arose when professional preunderstandings about schizophrenia as a biological disturbance were bracketed as a Husserlian form of phenomenology was adopted. The initial study focused (...) on the meanings three individuals attached to being diagnosed with a mental illness and being involved in psychiatric treatment systems. The exploration of meanings led to the researcher being guided by one study participant in relation to a suitable framework for making sense of her lived experience of being entangled in psychiatric systems. This involved an appreciation of the poetics of interpersonal interaction that was simultaneously fuelled by the researcher’s reading of social poetics in psychology. Thus, the research became a hermeneutic inquiry, focused upon the text of one participant (Beth)1 and the psychiatric system that she and colleagues encountered. Beth’s psychiatric predicament was described by a loss of ‘self’, psychiatric interrogation, and positive and negative features of immersion in the system. A byproduct of taking a poetic approach was that the participant found the research process therapeutic. Thus, social poetics encouraged a beneficial blurring of the boundaries between research and practice. In both arenas, social poetics can lead to a different level of understanding. This is contradictory to mainstream approaches to research that value objectivity with a strict division between the researcher and the subjects, with the aim of producing scientific knowledge. (shrink)

Taking the possibility of visual argumentation seriously, this essay explores how refutation might proceed. We posit three ways in which images can refute and be refuted in a mixed-media environment: (1) dissection, in which an image is broken down discursively; (2) substitution, in which one image is replaced within a larger visual frame by a different image; and (3) transformation, in which an image is recontextualized in a new visual frame. These strategies are illustrated in an analysis of three American (...) documentary films on abortion. (shrink)

Through network diagrams and sustained narrative, sociologist Randall Collins traces the development of philosophical thought from ancient Greece to modern ...

Attitudinal- and stress theory are used to investigate the effect of ethical climate on job outcomes. Responses from 208 service employees who work for a country health department were used to test a structural model that examines the process through which ethical climate (EC) affects turnover intention (TI). This study shows that the EC–TI relationship is fully mediated by role stress (RC), interpersonal conflict (IC), emotional exhaustion (EE), trust in supervisor (TS), and job satisfaction (JS). Results show that EC reduces (...) (RS) and increases TS. Lower stress levels result in lower EE, higher JS, and lower TI. Also, supervisor trust (TS) reduces IC and EE. The structural model predicts 53.9% of the variance of TI. (shrink)

In the popular misconception fostered by blockbuster action movies and best-selling thrillers--not to mention conventional explanations by social scientists--violence is easy under certain conditions, like poverty, racial or ideological hatreds, or family pathologies. Randall Collins challenges this view in Violence, arguing that violent confrontation goes against human physiological hardwiring. It is the exception, not the rule--regardless of the underlying conditions or motivations. -/- Collins gives a comprehensive explanation of violence and its dynamics, drawing upon video footage, cutting-edge forensics, and (...) ethnography to examine violent situations up close as they actually happen--and his conclusions will surprise you. Violence comes neither easily nor automatically. Antagonists are by nature tense and fearful, and their confrontational anxieties put up a powerful emotional barrier against violence. Collins guides readers into the very real and disturbing worlds of human discord--from domestic abuse and schoolyard bullying to muggings, violent sports, and armed conflicts. He reveals how the fog of war pervades all violent encounters, limiting people mostly to bluster and bluff, and making violence, when it does occur, largely incompetent, often injuring someone other than its intended target. Collins shows how violence can be triggered only when pathways around this emotional barrier are presented. He explains why violence typically comes in the form of atrocities against the weak, ritualized exhibitions before audiences, or clandestine acts of terrorism and murder--and why a small number of individuals are competent at violence. (shrink)

What does it take for a property to be a social property? This question is different from questions about what it takes for a property to be socially constructed. That is: it is one thing to be social, it is another to be socially constructed. Compared to questions about social construction, this question about sociality has received relatively little attention in social metaphysics. Here, I work from a very specific set of observations which arise from the social metaphysics literature to (...) uncover a sufficient condition on sociality for properties, a condition which I argue all non-social properties fail to satisfy. (shrink)

Leaders play a critical role in setting the tone for ethical climate in organizations. In recent years, there has been an increased skepticism about the role played by corporate executives in developing and implementing ethics in business practices. Sales and marketing practices of businesses, particularly in the pharmaceutical industry, have come under increased scrutiny. This study identifies a type of leadership style that can help firms develop an ethical climate. Responses from 333 salespeople working for a North American subsidiary of (...) an international pharmaceutical company were used to analyze the impact of instrumental leadership on ethical climate. We also examined the effect of ethical climate on effort, satisfaction with the supervisor, and job satisfaction. Managerial implications are provided. (shrink)

In this eye-opening look at the doctor-patient decision-making process, physician and law professor Jay Katz examines the time-honored belief in the virtue of silent care and patient compliance. Historically, the doctor-patient relationship has been based on a one-way trust -- despite recent judicial attempts to give patients a greater voice through the doctrine of informed consent. Katz criticizes doctors for encouraging patients to relinquish their autonomy, and demonstrates the detrimental effect their silence has on good patient care. Seeing a growing (...) need in this age of medical science and sophisticated technology for more honest and complete communication between physician and patients, he advocates a new, informed dialogue that respects the rights and needs of both sides. In a new foreword to this edition of The Silent World of Doctor and Patient , Alexander Morgan Capron outlines the changes in medical ethics practice that have occurred since the book was first published in 1984, paying particular attention to the hotly debated issues of physician-assisted suicide and informed consent in managed care. (shrink)

There has been considerable debate in the literature about the relative merits of information processing versus dynamical approaches to understanding cognitive processes. In this article, we explore the relationship between these two styles of explanation using a model agent evolved to solve a relational categorization task. Specifically, we separately analyze the operation of this agent using the mathematical tools of information theory and dynamical systems theory. Information-theoretic analysis reveals how task-relevant information flows through the system to be combined into a (...) categorization decision. Dynamical analysis reveals the key geometrical and temporal interrelationships underlying the categorization decision. Finally, we propose a framework for directly relating these two different styles of explanation and discuss the possible implications of our analysis for some of the ongoing debates in cognitive science. (shrink)

This book presents an innovative analysis of the role of imagination as a central concept in both literary and art criticism. Dee Reynolds brings this approach to bear on works by Rimbaud, Mallarme;, Kandinsky, and Mondrian. It allows her to redefine the relationship between Symbolism and abstract art, and to contribute new methodological perspectives to comparative studies of poetry and painting. The late nineteenth and early twentieth century was a crucial period in the emergence of new modes of representation, and (...) is currently at the forefront of critical enquiry. This is the first book to examine Symbolism and abstraction in this way, and the first to treat these poets and painters together. It is an original contribution to interdisciplinary scholarship in art history, literary history, and comparative aesthetics. (shrink)

An evaluation of a health condition-specific hope scale adapted from the more general dispositional Hope Scale (Snyder et al., 1991) is provided. Participants (N = 202) with a rare, debilitating, and potentially stigmatising health condition were recruited from readers of the Anal Fissure Self Help Page. Data were gathered anonymously using an online survey linked to the website. Consistent with hope theory, this new measure yielded a pathways factor (perceived capacity to find ways to achieve desired goals) and an agency (...) factor (perceived motivation to pursue goals energetically). Respondents with stronger pathways thoughts reported greater benefits from website information for understanding and generating strategies for managing anal fissures. Stronger agency beliefs were related to more frequent website visits, more rereading of first-hand patient accounts, and shorter duration of fissure symptoms. Results offer preliminary support for validity of this scale and for using web-based methodologies to study conditions, such as anal fissure. (shrink)

An evaluation of a health condition-specific hope scale adapted from the more general dispositional Hope Scale (Snyder et al., 1991) is provided. Participants (N = 202) with a rare, debilitating, and potentially stigmatising health condition were recruited from readers of the Anal Fissure Self Help Page. Data were gathered anonymously using an online survey linked to the website. Consistent with hope theory, this new measure yielded a pathways factor (perceived capacity to find ways to achieve desired goals) and an agency (...) factor (perceived motivation to pursue goals energetically). Respondents with stronger pathways thoughts reported greater benefits from website information for understanding and generating strategies for managing anal fissures. Stronger agency beliefs were related to more frequent website visits, more rereading of first-hand patient accounts, and shorter duration of fissure symptoms. Results offer preliminary support for validity of this scale and for using web-based methodologies to study conditions, such as anal fissure. (shrink)

Reason and Value collects 15 new papers by leading contemporary philosophers on themes from the work of Joseph Raz. Raz has made major contributions in a wide range of areas, including jurisprudence, political philosophy, and the theory of practical reason; but all of his work displays a deep engagement with central themes in moral philosophy. The subtlety and power of Raz's reflections on ethical topics make his writings a fertile source for anyone working in this area. Especially significant are his (...) explorations of the connections between practical reason and the theory of value, which constitute a sustained and penetrating treatment of a set of issues at the very center of moral philosophy as it is practiced today. The contributors to the volume acknowledge the importance of Raz's contributions by engaging critically with his positions and offering independent perspectives on the topics that he has addressed. The volume aims both to honour Raz's accomplishments in the area of ethical theorizing, and to contribute to an enhanced appreciation of the significance of his work for the subject. (shrink)

"Children live in a realm of direct experience, engaged with their senses and absorbed in events as they occur. But as adults, we've come to depend on our acquired skills of language, logic, and familiar thinking strategies to get things done and get through our days. For decades, innovative neuroscience educator Dee Joy Coulter has been treasure-hunting for fresh insights into learning that we can actually use-to transform the way we perceive, think, feel, and learn. Original Mind guides us into (...) her expansive vision for unfolding our natural brilliance. Applying the findings of scientists, artists, and cultures across the globe-and illuminated with stories and hands-on practices from her own work-readers will explore:. How to see, listen, feel, and taste again with childlike wonder. The oral tradition-reclaiming the cognitive power of storytelling and metaphor. Problem-solving and learning at the deepest levels. Empty mind -the art of rejuvenation as taught by the Buddha, composers and artists, and children across the globe. Boredom, Complexity, Ambiguity, Permeability, and Novelty-five tolerances essential to fulfillment. Surfing the edges of inner chaos-the theta-gamma states of inspired genius, and many other topics Readers both new and well-versed in brain training, meditation, and stress reduction will find here a wealth of inspiration to amplify the richness of their perceptions, intuition, creativity, emotional balance-and the untapped wonder hidden within each moment of our lives."--Publisher's description. (shrink)

This book expounds and defends a new conception of the relation between truth and meaning. Atlas argues that the sense of a sense-general sentence radically underdetermines its truth-conditional content. He applies this linguistic analysis to illuminate old and new philosophical problems of meaning, truth, falsity, negation, existence, presupposition, and implicature. In particular, he demonstrates how the concept of ambiguity has been misused and confused with other concepts of meaning, and how the interface between semantics and pragmatics has been misunderstood. The (...) problems he tackles are common to philosophy, linguistics, cognitive psychology, and artificial intelligence, and his conclusions will be of interest to all those working in these fields. (shrink)

Achieving genuine engagement and understanding between communities with radically divergent worldviews is challenging. If there is no common ground on which to stand and have a discussion, the likely outcomes of an apparent intercultural disagreement are a stalemate, or the (sometimes colonialist) imposition of a single worldview, or a kind of relativistic tolerance that falls short of genuine engagement. In this paper, we suggest a way forward that takes as its starting point the philosophical discussion of deep disagreement, using the (...) example of taniwha (powerful water beings that must be treated with respect) to outline a strategy for building intercultural understanding and enabling constructive intercultural dialogue. (shrink)

Force Fields collects the recent essays of Martin Jay, an intellectual historian and cultural critic internationally known for his extensive work on the history of Western Marxism and the intellectual migration from Germany to America.

The researcher : researching and developing ourselves -- The participant : responsibility, care and consideration -- Relational ethics : the relationship between the researcher and the participant -- Establishing trust : the fundamental ingredients -- Research dilemmas, decisions and details -- Research ethics committees : structures and procedures -- The social and political contexts of research and the ethics of dissemination.

This fresh look at the philosophy of language focuses on the interface between a theory of literal meaning and pragmatics--a philosophical examination of the relationship between meaning and language use and its contexts. Here, Atlas develops the contrast between verbal ambiguity and verbal generality, works out a detailed theory of conversational inference using the work of Paul Grice on Implicature as a starting point, and gives an account of their interface as an example of the relationship between Chomsky's Internalist Semantics (...) and Language Performance. Atlas then discusses consequences of his theory of the Interface for the distinction between metaphorical and literal language, for Grice's account of meaning, for the Analytic/Synthetic distinction, for Meaning Holism, and for Formal Semantics of Natural Language. This book makes an important contribution to the philosophy of language and will appeal to philosophers, linguists, and cognitive scientists. (shrink)

Ethical dimensions of friendship have rarely been explicitly addressed as aspects of friendship quality in studies of children's peer relationships. This study identifies aspects of moral virtue significant for friendship, as a basis for empirically investigating the role of ethical qualities in children's friendship assessments and aspirations. We introduce a eudaimonic conception of friendship quality, identify aspects of moral virtue foundational to such quality, review and contest some grounds on which children have been regarded as not mature enough to have (...) friendships that require virtue, and report a qualitative study of the friendship assessments and aspirations of children aged nine and ten. In focus group sessions conducted in ten schools across Great Britain, moral qualities figured prominently in children's assessments of friendship quality. The findings provide evidence of children having friendships exhibiting mutual respect, support, and valuing of each other's good character. (shrink)

This is the first philosophical study of artifacts that is book length. In it Randall Dipert develops a theory of what artifacts are and applies it extensively to one of the most complex and intriguing kind of artifacts, art works. He presents his own account of what agents, intentions, and actions are, then uses these notions to clarify what it is for an agent to "make" something. From this starting point, he develops a full theory of artifacts and other (...) artificial things - and, especially, a theory of art works and performances of art works as artifacts. He proposes a theory of nature and of the value of nature as what is essentially nonartificial. Two chapters are devoted to value considerations: merit in artifacts generally, and the evaluation of art works and performance art as artifacts or intentional gestures. Believing that a developed theory of action and philosophy of mind is necessary for a developed aesthetics and philosophy of art, Dipert relies on classical and contemporary research on agency, actions, and intentions, and on the intentionalist theory of mental objects of Brentano and Meinong. Dipert considers artifacts to be physical entities, but he also includes in the definition thoughts, utterances, and performances. This vast category encompasses everyday household objects and tools, streets and edifices, as well as communicative and artistic artifacts. Especially with regard to artistic artifacts, Dipert proposes a theory of expression and communication as actions and extensively discusses the problems of interpreting and recognizing actions, artifacts, and art works. (shrink)

The current study uses a sensemaking model and thinking strategies identified in earlier research to examine ethical decision making. Using a sample of 163 undergraduates, a low-fidelity simulation approach is used to study the effects personal involvement (in causing the problem and personal involvement in experiencing the outcomes of the problem) could have on the use of cognitive reasoning strategies that have been shown to promote ethical decision making. A mediated model is presented which suggests that environmental factors influence reasoning (...) strategies, reasoning strategies influence sensemaking, and sensemaking in turn influences ethical decision making. Findings were mixed but generally supported the hypothesized model. It is interesting to note that framing the outcomes of ethically charged situations in terms of more global organizational outcomes rather than personal outcomes was found to promote the use of pro-ethical cognitive reasoning strategies. (shrink)

In this essay we will use mind as the term to designate the totality and manner in which our thoughts take place. We use the term brain to refer to the underlying mechanics, the substrate and the manner in which it supports the operations needed to carry out thoughts.

John Calvin claims that the foundation of Scripture is the oracles and visions revealed to the patriarchs, transmitted through countless generations by an oral tradition that faithfully preserved these oracles. The oral tradition of the patriarchs also contains practices not found in written Scripture that are applicable to the church of Calvin day.