Despite the fact that ethics consultations are an accepted practice in most healthcare organizations, many clinical ethicists continue to feel marginalized by their institutions. They are often not paid for their time, their programs often have no budget, and institutional leaders are frequently unaware of their activities. One consequence has been their search for concrete ways to evaluate their work in order to prove the importance of their activities to their institutions through demonstrating their efficiency and effectiveness.

Most organizations and/or their sub-units like ethics programs want to acquire the knowledge, skills and other resources needed to achieve their goals efficiently and effectively. Thus, they want to acquire or develop needed capacity. But there are pre-conditions to building capacity that are often overlooked or forgotten, but which nevertheless, must be in place before capacity can be developed. This essay identifies these pre-conditions and discusses why they are necessary before attempts are made to enhance the capacity of any ethics (...) program. The essay closes by offering a series of questions that ethics program leaders/and or members can asked themselves to assess whether or not these pre-conditions exist. (shrink)

The prelims comprise: Introduction The Physician and the Provider Organization The Physician and the Payer Organization Dealing with Systems Conclusion Notes References.

These CQ Sources were compiled by Bette Anton, Edward M. Spencer, Ann E. Mills, and Carlton Hegwood Jr.

Increased international migration of health professionals is weakening healthcare systems in low‐income countries, particularly those in sub‐Saharan Africa. The migration of nurses, physicians and other health professionals from countries in sub‐Saharan Africa poses a major threat to the achievement of health equity in this region. As nurses form the backbone of healthcare systems in many of the affected countries, it is the accelerating migration of nurses that will be most critical over the next few years. In this paper we present (...) a comprehensive analysis of the literature and argue that, from a human rights perspective, there are competing rights in the international migration of health professionals: the right to leave one's country to seek a better life; the right to health of populations in the source and destination countries; labour rights; the right to education; and the right to nondiscrimination and equality. Creative policy approaches are required to balance these rights and to ensure that the individual rights of health professionals do not compromise the societal right to health. (shrink)

Feminist Theory: A Philosophical Anthology addresses seven philosophically significant questions regarding feminism, its central concepts of sex and gender, and the project of centering women’s experience. Topics include the nature of sexist oppression, the sex/gender distinction, how gender-based norms influence conceptions of rationality, knowledge, and scientific objectivity, feminist ethics, feminst perspectives on self and autonomy, whether there exist distinct feminine moral perspectives, and what would comprise true liberation. Features an introductory overview illustrating the development of feminism as a philosophical movement (...) Contains both classic and contemporary sources of feminist thought, including selections by Mary Wollstonecraft, John Stuart Mill, Simone de Beauvior, Kate Millett, bell hooks, Marilyn Frye, Martha Nussbaum, Louise Antony, Sally Haslanger, Helen Longino, Marilyn Friedman, Catharine MacKinnon, and Drucilla Cornell. (shrink)

I argue that science will be better, by its own criteria, if it pursues multiculturalism, by which I mean an ethnic- and gender-diverse set of scientists. I argue that minority and women scientists will be more likely to recognize false, prejudiced assumptions about race and gender that infect theories. And the kinds of changes that society will undergo in pursuing multiculturalism will help reveal these faulty assumptions to scientists of all races and genders.

Although it may seem from its formalism that game theory must have sprung from the mind of John von Neumann as a corollary of his work on computers or theoretical physics, it should come as no real surprise to philosophers that game theory is the articulation of a historically developing philosophical conception of rationality in thought and action. The history of ideas about rationality is deeply contradictory at many turns. While there are theories of rationality that claim it is fundamentally (...) social and aims at understanding and molding all facets of human psychological life, game theory takes rationality to be essentially located in individuals and to concern only the means to achieve predetermined ends. Thus, there are some thinkers who have made important contributions to this history who do not appear in the story of game theory at all, among them, Plato, Kant, and Hegel. There is, however, a clear trail to follow linking theories of instrumental rationality from Aristotle to the nineteenth-century marginalist economists and ultimately to von Neumann and Morgenstern and contemporary game theorists, that historically grounds game theory as a model of rational interaction. (shrink)

Journal of Social Philosophy, EarlyView.

In “Prozac or Prosaic Diaries?”, Ginger Hoffman and Jennifer Hansen examine gendered messages in popular depression memoirs, using narrative self-constitution theory to emphasize the damaging effects such messages can have on women readers. In doing so, they bring a welcome feminist perspective to matters of mental health, as well as raising thought-provoking questions about depression memoirs, a genre that can have a far-reaching impact on public opinions about mental illness. Overall, Hoffman and Hansen do an excellent job of explaining the (...) philosophical concepts that form a basis for their arguments. This work allows even relative newcomers to philosophy to follow along, co-inspecting the... (shrink)

Additional support is presented for the necessity of awareness of the CS-US relation in human autonomic conditioning. However, possible limitations and exceptions regarding this general rule are discussed. Limitations include the lack of relationship between conditioned response (CR) strength and degree of awareness, and an important exception may be the finding of conditioning with backwardly masked CSs of a biologically prepared nature.

Human decision making shows systematic simplifications and deviations from the tenets of rationality (‘heuristics’) that may lead to suboptimal decisional outcomes (‘cognitive biases’). There are currently three prevailing theoretical perspectives on the origin of heuristics and cognitive biases: a cognitive-psychological, an ecological and an evolutionary perspective. However, these perspectives are mainly descriptive and none of them provides an overall explanatory framework for the underlying mechanisms of cognitive biases. To enhance our understanding of cognitive heuristics and biases we propose a neural (...) network framework for cognitive biases, which explains why our brain systematically tends to default to heuristic (‘Type 1’) decision making. We argue that many cognitive biases arise from intrinsic brain mechanisms that are fundamental for the working of biological neural networks. In order to substantiate our viewpoint, we discern and explain four basic neural network principles: (1) Association, (2) Compatibility (3) Retainment, and (4) Focus. These principles are inherent to (all) neural networks which were originally optimized to perform concrete biological, perceptual, and motor functions. They form the basis for our inclinations to associate and combine (unrelated) information, to prioritize information that is compatible with our present state (such as knowledge, opinions and expectations), to retain given information that sometimes could better be ignored, and to focus on dominant information while ignoring relevant information that is not directly activated. The supposed mechanisms are complementary and not mutually exclusive. For different cognitive biases they may all contribute in varying degrees to distortion of information. The present viewpoint not only complements the earlier three viewpoints, but also provides a unifying and binding framework for many cognitive bias phenomena. (shrink)

The last decade has seen a slow but steady increase in the number of postdoctoral scholars employed in faculties of education. In this article, seven postdoctoral scholars who worked in the same Ca...

Faculty in a large, urban school of engineering designed a longitudinal study to assess the critical thinking skills of undergraduate students as they progressed through the engineering program. The Paul-Elder critical thinking framework was used to design course assignments and develop a holistic assessment rubric. This paper presents the analysis of the freshman course artifacts (baseline and course critical thinking assignments) and associated faculty scoring sessions for all three cohorts. A total of 649 first semester freshman students at least 18 (...) years old agreed to participate in the study. The majority were white males with a mean high school grade point average of 3.73, ACT composite score of 28.33, and final freshman engineering course grade of 3.57. There was a statistically significant positive relationship between the freshman course artifacts and the faculty scores. Data from the study are being used to enhance the critical thinking experiences for undergraduate engineering students. (shrink)

Despite the growing debate about scholarly impact, an analysis of the onto-epistemic grammar underlying impact has remained absent. By taking a different analytical approach to examining impact, we interrogate the concept through the lens of decolonial thought. We offer an empathetic review of the impact scholarship and illuminate the limits of the modern imaginary that circumscribe critiques of impact in the literature, making visible the Eurocentric and provincial horizons of modern reason underlying these critiques and impact in general. Drawing on (...) Śūnyatā ontological perspective, we seek to articulate from modernity imaginary’s edges and suggest imagining and being otherwise. We argue that the question of scholarly impact is intimately structured by and connected to the modern subject’s desire for ontological security. (shrink)

In the influential 1995 article “Social Conditions as Fundamental Causes of Disease,” Bruce Link and Jo Phelan described social and political factors as “fundamental causes” of death and disease. Whitney Pirtle has recently declared racial capitalism another such fundamental cause. Using the case of the water crisis in Flint, Michigan, she has argued that racial capitalism's role in that situation meets each of the criteria Link and Phelan's article outlines: racial capitalism influenced multiple disease outcomes, affected disease outcomes through multiple (...) risk factors, involved access to flexible resources that can be used to minimize both risks and the consequences of disease, and was reproduced over time through the continual replacement of intervening mechanisms. We argue for Pirtle's conclusion using the extensive literature on racial capitalism and case studies concerning housing in the United States and Brazil and what Naomi Klein has termed “corona capitalism” in India. If races correspond to hierarchies of material security, as suggested by Ruth Wilson Gilmore, then these hierarchies and their causal effects are fundamental determinants of public health. (shrink)

A central feature of our waking mental experience is that our attention naturally toggles back and forth between “external” and “internal” stimuli. In the midst of an externally demanding task, attention can involuntarily shift internally with no clear reason how or why thoughts momentarily shifted inward. In the case of external attention, we are typically exploring and encoding aspects of our external world, whereas internal attention often involves searching for and retrieving potentially relevant information from our memory networks. Cognitive science (...) has traditionally focused on understanding forms of internal and external attention separately, leaving a mystery about what sparks the seemingly automatic shifts between the two. Specifically, what shifts attentional focus from being outward‐directed to being inward‐directed? We present a candidate mechanism: Familiarity‐detection. (shrink)

An investigation of the nature of truth, ethics, and deception.