Hastings Center Report, Volume 52, Issue S1, Page S72-S78, March‐April 2022.

Evidence-based medicine (EBM), by its ability to decrease irrational variations in health care, was expected to improve healthcare quality and outcomes. The utility of EBM principles evolved from individual clinical decision-making to wider foundational clinical practice guideline applications, cost containment measures, and clinical quality performance measures. At this evolutionary juncture one can ask the following questions. Given the time-limited exigencies of daily clinical practice, is it tenable for clinicians to follow guidelines? Whose or what interests are served by applying performance (...) assessments? Does such application improve medical care quality? What happens when the best interests of vested parties conflict? Mindful of the constellation of socially and clinically relevant variables influencing health outcomes, is it fair to apply evidence-based performance assessment tools to judge the merits of clinical decision-making? Finally, is it fair and just to incentivize clinicians in ways that might sway clinical judgment? To address these questions, we consider various clinical applications of performance assessment strategies, examining what performance measures purport to measure, how they are measured and whether such applications demonstrably improve quality. With attention to the merits and frailties associated with such applications, we devise and defend criteria that distinguish between justice-sustaining and justice-threatening performance-based clinical protocols. (shrink)

In this issue of The Journal of Clinical Ethics, we offer a variety of perspectives on the moral and medical responsibilities of professionals with regard to a woman’s choice of where she will birth her baby. The articles in this special issue focus on place of birth, but they have larger resonance for clinicians whose decisions about providing the best possible care require them to sort through evidence, consider their own possible biases and the limitations of their training, and balance (...) the wishes of their patients with the demands of colleagues, hospitals, and insurers. The articles published in this special issue of The Journal of Clinical Ethics will help those who wrestle with such dilemmas in everyday clinical decision making. (shrink)

If the world itself is metaphysically indeterminate in a specified respect, what follows? In this paper, we develop a theory of metaphysical indeterminacy answering this question.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Common Good and the Global Emergency: God and the Built Environment by T. J. GorringeLibby GibsonThe Common Good and the Global Emergency: God and the Built Environment T. J. Gorringe New York: Cambridge University Press, 2011. 309 pp. $90.00Building on arguments set forth in A Theology of the Built Environment: Justice, Empowerment, and Redemption (2002), theologian Timothy Gorringe begins The Common Good and the Global Emergency by (...) exploring whether an idea of the common good is relevant in a multicultural society and, if so, how an account of the common good can give rise to an alternative economic paradigm grounded in grace. While respect for cultural differences and the rise of individualism may argue against a robust understanding of the common good, Gorringe looks to the concept of oikonomia, or household management, to express the concept of managing “our affairs in such a way as to further what we perceive to be good ends” (35). Since our understanding of the economy shapes every aspect of the built environment, Gorringe traces local, regional, and national economies to what Wendell Berry calls “the great economy” or God’s creation, redemption, and sustenance of all things.Gorringe grounds his arguments about the common good in his Trinitarian theology of the built environment, expressed as God the Creator, God the Reconciler, and God the Redeemer. The triune perichoretic nature of God is inherently relational; therefore, as humans made in God’s image, we cannot ignore our interdependence. While God the Creator offers a sense of the common good springs from creation, God the Reconciler gives Gorringe traction to discuss the many barriers—race, gender, class, and space—that divide human beings and how our built environments structure these separations. God the Redeemer is concerned with empowering human beings to challenge all things that destroy life; thus Gorringe sees his project as contributing a theology of liberation committed to justice and fullness of life for all humans.Gorringe argues that our best chance to identify a common good rests on constructively addressing the common bad that he calls the global emergency. This emergency can be seen in the doubling of the world’s population in the past forty years, the problem of climate change, and global resource depletion. Seeing climate change and food, water, and energy issues as among the most pressing ethical issues of the coming decades, Gorringe challenges the reader to examine how our current common values have degraded the environment [End Page 202] and the lives of people worldwide. Since he specifically addresses the built environment, Gorringe’s purview is necessarily anthropocentric and justified by the doctrine of incarnation. Yet the Creator God expresses great wisdom in the laws of nature, and much could be learned from the “built” environments in the animal kingdom. While this line of thought would clearly depart from the rigorous academic method of Gorringe’s analysis, the book arose from a feeling that the Lord instructed him to continue working in this area, and attending to other nonrational sources of wisdom could greatly enhance our understanding of God’s grace in all the world.Gorringe acknowledges that the chapters do not unfold linearly, and that he seeks to point out points of confluence. The fluidity with which he addresses theological, political, economic, architectural, sociological, and ethical issues leads the reader to an overall picture of the common good and its powers to liberate us from injustice while an exact map of this process may be difficult to draw. Gorringe clearly and directly addresses both critics and supporters of his previous work on the built environment and solidifies his case for attending to the ways that our built environments could express a common good, grounded in grace, that allows for the fullness of life for all beings.Libby GibsonVirginia Theological SeminaryCopyright © 2013 Society of Christian Ethics... (shrink)

It has become increasingly common to endorse and implement anonymous grading as a way of promoting fairness or equality of opportunity in the classroom. The American Philosophical Association currently recommends anonymous grading, as do the Canadian Philosophical Association, the British Philosophical Association, the Society for Women in Philosophy, and Minorities and Philosophy. Despite its increasing prevalence, the practice has received surprisingly little attention in applied ethics. This paper begins filling this gap. I start by clarifying the ‘Standard Argument’ from fairness (...) or equality of opportunity for anonymous grading. I then argue that the Standard Argument fails to support current models for anonymous grading. The issue: current models for anonymous grading are practically self-undermining if the aim is to reduce violations of equality of opportunity or fairness. So, if we want to address bias in grading because we care about equality of opportunity or fairness, we need to change how we do it. (shrink)

Introduction: human rights in healthcare -- A right to treatment? the allocation of resouces in the National Health Service -- Ensuring quality healthcare: an issue of rights or duties? -- Autonomy and consent in medical treatment -- Treating incompetent patients: beneficence, welfare and rights -- Medical confidentiality and the right to privacy -- Property right in the body -- Medically assisted conception and a right to reproduce? -- Termination of pregnancy: a conflict of rights -- Pregnancy and freedom of choice (...) -- The right to life at the end of life -- The law and ethics of assisted dying: is there a right to die? (shrink)

Focuses on the encounters of feminist and queer theories, on the ways in which basic terms such as - sex, gender, and sexuality change meaning as they move from one body of theory to another. This book includes essays by Judith Butler, Evelynn Hammonds, Biddy Martin, Kim Michasiw, Carole-Anne Tyler, and Elizabeth Weed.

During this time of ecological crisis, spiritual guides are needed to provide inspiration and impel action. In the Roman Catholic tradition, saints act as role models and are associated with particular causes, locations, or professions. Who, then, are the ecological saints, whose witness can inspire hope and action in support of the environment? This article explores that question in two ways. First the writings and accounts of saints who are traditionally connected to the environment are examined to produce six indicators (...) of the beliefs, characteristics, and actions of ecological saints. Second, a green gaze is applied to Saint Marguerite Bourgeoys, a seventeenth‐century educator who lived in what would become Montreal, Canada, by comparing her writings and accounts of her life to the six indicators of an ecological saint. Identifying more ecological saints can promote environmental responsibility, and the six indicators of an ecological saint can be the lens through which beloved saints are re‐examined. (shrink)

In the writings of Pierre Teilhard de Chardin, the word “nature” occurs more than a thousand times, though this term is not listed in the Teilhard Lexicon by Siôn Cowell. A qualitative analysis of nature throughout Teilhard's writings produced 13 distinct definitions that can be summarized into five categories; nature can be an inherent way of being, sacred, an object, or that which is not artificial. The multivalent term has produced different interpretations of Teilhard's work, specifically in the ecological eschatological (...) question of whether living organisms will be included in the final transformation. Theologians’ responses to this question range from affirmation to dissension, with varying levels of certainty, demonstrating the variability that can be caused by ambiguous language. (shrink)

This article represents conversations with the American composer Libby Larsen in which she described her beliefs about music, music education, and the dilemmas that our current system faces as we seek to provide relevant and meaningful music education to our students. Our conversation explores such topics as cognitive psychology, music theory, cultural practices and developments in American culture, and current music education practices. Larsen brought up many questions about music education in America, providing some suggestions for the future and (...) posing problems for which the solution may require a great deal of imagination by music education teachers. The article is structured as a Socratic dialogue, in which Larsen constructs an inductively strong argu- ment for making radical changes to current music education practice. (shrink)

A prominent hypothesis holds that by speaking to infants in infant‐directed speech (IDS) as opposed to adult‐directed speech (ADS), parents help them learn phonetic categories. Specifically, two characteristics of IDS have been claimed to facilitate learning: hyperarticulation, which makes the categories more separable, and variability, which makes the generalization more robust. Here, we test the separability and robustness of vowel category learning on acoustic representations of speech uttered by Japanese adults in ADS, IDS (addressed to 18‐ to 24‐month olds), or (...) read speech (RS). Separability is determined by means of a distance measure computed between the five short vowel categories of Japanese, while robustness is assessed by testing the ability of six different machine learning algorithms trained to classify vowels to generalize on stimuli spoken by a novel speaker in ADS. Using two different speech representations, we find that hyperarticulated speech, in the case of RS, can yield better separability, and that increased between‐speaker variability in ADS can yield, for some algorithms, more robust categories. However, these conclusions do not apply to IDS, which turned out to yield neither more separable nor more robust categories compared to ADS inputs. We discuss the usefulness of machine learning algorithms run on real data to test hypotheses about the functional role of IDS. (shrink)

The existence of the obligation to follow rules in sport is widely accepted, but there are only a few studies that provide accounts that justify it. Building upon Wolff's challenge to traditional political theories, this study proposes a theory that limits the level of normativity to which participants in sport contests are bound in an effort to maximize their autonomy. Instead of constructing a unitary theory of obligations to follow sport rules, a pluralistic account is offered, one that allows for (...) multiple sources of normativity, thus augmenting the freedom of communities to play games according to their values. (shrink)

As children gradually master grammatical rules, they often go through a period of producing form‐meaning associations that were not observed in the input. For example, 2‐ to 3‐year‐old English‐learning children use the bare form of verbs in settings that require obligatory past tense meaning while already starting to produce the grammatical –ed inflection. While many studies have focused on overgeneralization errors, fewer studies have attempted to explain the root of this earlier stage of rule acquisition. In this work, we use (...) computational modeling to replicate children's production behavior prior to the generalization of past tense production in English. We illustrate how seemingly erroneous productions emerge in a model, without being licensed in the grammar and despite the model aiming at conforming to grammatical forms. Our results show that bare form productions stem from a tension between two factors: (1) trying to produce a less frequent meaning (the past tense) and (2) being unable to restrict the production of frequent forms (the bare form) as learning progresses. Like children, our model goes through a stage of bare form production and then converges on adult‐like production of the regular past tense, showing that these different stages can be accounted for through a single learning mechanism. (shrink)

Attention has become increasingly focused in recent years on the role agri-food system transformations have played in driving the global diet-related chronic disease burden. Identifying the role played by the food-consuming industries (predominantly large manufacturers, processors, distributors, and retailers) in particular, and identifying possibilities to facilitate healthier diets through intervening in these industries, have been identified as a research priority. This paper explores the potential for one promising analytic framework—the nutrition-oriented value chain approach—to contribute to this area, drawing on recent (...) insights from the global value chain (GVC) literature to develop an institutionally-enriched approach. The research focused on a canned deciduous fruit value chain linking growers, processors, and retailers in South Africa and Australia. Findings reveal the multiple drivers which have converged to shape this value chain over time, and the key actors which are influencing product availability, composition, price, and promotion within this sector. With its emphasis on identifying implications for end-consumption, rather than economic outcomes within the chain, nutrition-oriented value chain research represents a significant shift in focus for the GVC framework. Therefore, an immediate opportunity for further research is to extend the analytic framework to primary research on end-consumption behaviours. (shrink)

Demonstrating the connections between contemporary psychoanalysis, Jewish thought and Jewish history, this volume is a significant contribution to the traditions of dialogue, debate and change-within-continuity that epitomize these disciplines. The authors of this volume explore the cross-disciplinary connections between psychoanalysis and Jewish thought, while seeking out the resonance of new meanings, to exemplify the uncanny similarities that exist between ancient Rabbinic methods of interpretation and contemporary psychoanalytic theory and methodology, particularly the centrality of the question and the deconstruction of narrative. (...) In doing so, this collaboration addresses the bi-directional influence between, and the relevance of, the Jewish interpretive tradition and psychoanalysis to provide readers with renewed insight into key topics such as Biblical text and midrash, religious traditions, trauma, gender, history, clinical work and the legacies of the Holocaust on psychoanalytic theory. Creating an intimate environment for interdisciplinary dialogue, this is an essential book for students, scholars and clinicians alike, who seek to understand the continued significance of the multiple connections between psychoanalysis and Jewish thought. (shrink)

This article closely reads “Chelsea Girls,” an autobiographical short story by Eileen Myles that depicts her experience caring for the diabetic, bipolar poet James Schuyler when she was a young writer getting started in East Village in the late 1970s. Their dependency relationship is a form of queer kinship, an early version of the caring relations between lesbians and gay men that HIV/aids would demand over the next two decades as chosen families emerged to nurture gay men and lesbians rejected (...) by their families of origin. The representation of queer kinship offers an alternative to more traditional portrayals of care in literature that focus on the heteronormative family, a site of care that feminist dependency theory also paradoxically privileges. This article synthesizes insights from queer theory and critical disability studies in order to expand our understanding of the roles participants in care can play, the ways they can feel, and the outcomes they can achieve. Myles and Schuyler’s dependency relationship was sustaining for both of them and also critical for her development as a pioneering lesbian poet in an art world still dominated by men. (shrink)

History in times of crisis is practical: future action depends on historical framing. Moving beyond “human scales” to include the evolutionary and the geological, and beyond humans to include other species, demands different approaches and new “archives” like ice-cores. This paper considers history in the Long Now, and particularly how museums and big public arts institutions develop new sorts of history through practical story-telling, taking seriously the notion that “the central role of museums [is] both an expression of cultural identity (...) and … a powerful force for human development and education.” The museum has a particular value as “slow media”, deepening news stories in times of rapid change. The new epoch of Earth, the Anthropocene, where humans have become a geological force, poses challenges for exhibitions, but also reshapes museums themselves. Crucial to managing stories, collections and objects in Anthropocene times is the capacity to change course, to remain open to new developments, using performances, events and “pop-up” exhibitions alongside traditional museum offerings. New Museology regards stories as the fundamental unit of museums. Thus, the curation of stories is central work. No longer are museums defined solely by objects: the artistic and the ephemeral are all part of story-telling. (shrink)

Este artículo analiza la poesía de Leonel Lienlaf, poeta mapuche, desde una óptica ecocrítica. Para ello, se toman varias poesías del poemario Se ha despertado el ave de mi corazón (autotraducidas al español por el autor) con el fin de subrayar la importancia de la relación hombre-naturaleza. La dimensión simbólica utilizada por el autor se conecta directamente con la dimensión etnocultural del pueblo mapuche que, si bien no es el objeto principal del análisis, será igualmente importante considerarla. El artículo quiere (...) destacar el diálogo con la naturaleza queLienlaf pone de manifiesto en sus poesías y que se convierte, en última instancia, en una coexistencia con el medio ambiente. (shrink)

Contends that psychologists can contribute to the debate on the nature of science. The author suggests that the work of individual scientists can best be understood as a joint product of intellectual background and willingness to adopt a position with respect to important elements of that context.

This article examines Erich Przywara‘s conceptual understanding of the proofs for the existence of God. It also interprets the proofs of God’s existence. Тhe concept of God in the philosophy of Przywara is considered by exploring the nature of the relations between the transcendent sphere of God and the spiritual world of the human person. From the point of view of historiography, the role of the book “The Analogia entis” by Przywara is highlighted.

Modal constitution theory is one of the most influential solutions to the paradoxes of coincidence, and the problem of personal identity. It rests on three fundamental premises: common-sense objects exist; sometimes objects coincide in space; the coincidence of objects in space requires explanation. In this article, the author offers a critique of the modal theory of constitution. First, the definition of the constitution is examined and a new argument is offered that modal theory either does not provide asymmetry of the (...) constitution or leads to an infinite series of constitutive objects, unsatisfactorily extending ontology. Also, the author demonstrates that possible additions to the constitutive definition, which can make the definition sufficient for asymmetric relation, lead to additional theoretical difficulties, leading to the logical impossibility of constitution relation. Second, the author demonstrates that the theory of constitution offers an unsatisfactory theory of identity because it faces three problems: the overpopulation problem, the epistemic problem, and the personal problem. All of these considerations lead the author to conclude that modal constitution theory is not metaphysically satisfactory. (shrink)

Conventionalism in sport philosophy has been rejected as unable to provide a theory of normativity and as collapsing in ethical relativism, but this criticism is rather imprecise about its target, which invites doubt about the legitimacy of the concept of conventionalism described by its critics. Instead, a more charitable and legitimate account of conventionalism is proposed, one that draws inspiration from conventionalism in axiomatic geometry and is able to avoid the counterarguments directed against conventionalism. This new model allows for a (...) number of non-conventional elements of sport, namely the definition of sport and certain central moral norms, while at the same time arguing that normativity in sport is not exhausted by them, which leaves athletic communities with authority over a broad range of norms. (shrink)

By mid-2019 there were more than 80 AI ethics guides available in the public domain. Despite this, 2020 saw numerous news stories break related to ethically questionable uses of AI. In part, this is because AI ethics theory remains highly abstract, and of limited practical applicability to those actually responsible for designing algorithms and AI systems. Our previous research sought to start closing this gap between the ‘what’ and the ‘how’ of AI ethics through the creation of a searchable typology (...) of tools and methods designed to translate between the five most common AI ethics principles and implementable design practices. Whilst a useful starting point, that research rested on the assumption that _all_ AI practitioners are aware of the ethical implications of AI, understand their importance, and are actively seeking to respond to them. In reality, it is unclear whether this is the case. It is this limitation that we seek to overcome here by conducting a mixed-methods qualitative analysis to answer the following four questions: what do AI practitioners understand about the need to translate ethical principles into practice? What motivates AI practitioners to embed ethical principles into design practices? What barriers do AI practitioners face when attempting to translate ethical principles into practice? And finally, what assistance do AI practitioners want and need when translating ethical principles into practice? (shrink)

Auditors’ virtue comprises those qualities of character that manifest the ideals of the audit community (c.f., Maclntyre, 1984, After Virtue. (University of Notre Dame Press, Notre Dame)), and are instrumental in ensuring that auditors’ professional judgment is exercised according to a high moral standard (Thorne, 1998, Research on Accounting Ethics. (JAI Press, Greenwich, CT)). Nevertheless, the lack of valid and reliable quantitative measures of auditors’ virtue impedes research that furthers our understanding of how best to promote virtue in the audit (...) community. To address this gap, we develop two measures of auditors’ virtue. We report the results of the validity and reliability of the scales. In addition, we use the findings from the administration of these scales to professional accountants to refine and validate the theoretical characterization of virtues developed by Pincoffs (1986, Quandaries and Virtues. University Press of Kansas, Lawrence, KS) and Libby and Thorne (2004, Business Ethics Quarterly). In so doing, this study provides a foundation by which future audit research can study ways to ensure that auditors’ virtue is promoted throughout the audit community. (shrink)

This publication aims to familiarize Polish Language teachers with various issues connected with the Theatrical Education in Schools. Part 1 is an attempt to define the set role of a School Theatre Supervisor (what should be emphasized here is that the teacher’s knowledge of the subject, set designing skill, and also acting and directing skill and his/her knowledge of the pupil’s psyche at different stages in the development of an young man). Part 2 deals with the Theatrical Education as a (...) part o f Polish language lessons, set in the early 21" century Polish reality (extracts from interesting theatre lessons, dramatic elements in the lesson, activities in the theatre lessons and theatre-journalism classes). Part 3 is a proposition of how to organize work in the school drama theatre (a suggestion on practice and methodology exposing various advantages gained through the school theatre activities). (shrink)

The strict-tolerant approach to paradox promises to erect theories of naïve truth and tolerant vagueness on the firm bedrock of classical logic. We assess the extent to which this claim is founded. Building on some results by Girard we show that the usual proof-theoretic formulation of propositional ST in terms of the classical sequent calculus without primitive Cut is incomplete with respect to ST-valid metainferences, and exhibit a complete calculus for the same class of metainferences. We also argue that the (...) latter calculus, far from coinciding with classical logic, is a close kin of Priest’s LP. (shrink)

This paper discusses three research perspectives on political culture, civic culture and citizenship: the classic approach of Almond and Verba; contemporary analyses of citizenship referring to the book Civic Culture by Almond and Verba and oriented to the empirical description of social reality; and theoretical analyses of new relational sociology, oriented to the ontology and epistemology of social reality. The authors’ analysis leads to two conclusions. Firstly, it is necessary to combine these three approaches – relational social theory with empirical (...) analyses departing from methodological individualism. This requires conducting an empirical analysis, where the basic ‘analytical units’ – of collection, interpretation and generalization of data – are not separate but combined by relations and networks within which people act. Secondly, Edmund Wnuk-Lipiński’s statements are the best starting point for conducting such a new research programme. What is decisive is his systematic, theoretical interest in contemporary agency theories and relationality of citizenship, combined with innovative application of quantitative methods. (shrink)

Background Informed consent is one of the key principles of conducting research involving humans. When research participants give consent, they perform an act in which they utter, write or otherwise provide an authorisation to somebody to do something. This paper proposes a new understanding of the informed consent as a compositional act. This conceptualisation departs from a modular conceptualisation of informed consent procedures. Methods This paper is a conceptual analysis that explores what consent is and what it does or does (...) not do. It presents a framework that explores the basic elements of consent and breaks it down into its component parts. It analyses the consent act by first identifying its basic elements, namely: a) data subjects or legal representative that provides the authorisation of consent; b) a specific thing that is being consented to; and c) specific agent(s) to whom the consent is given. Results This paper presents a framework that explores the basic elements of consent and breaks it down into its component parts. It goes beyond only providing choices to potential research participants; it explains the rationale of those choices or consenting acts that are taking place when speaking or writing an authorisation to do something to somebody. Conclusions We argue that by clearly differentiating the goals, the procedures of implementation, and what is being done or undone when one consent, one can better face the challenges of contemporary data-intensive biomedical research, particularly regarding the retention and use of data. Conceptualising consent as a compositional act enhances more efficient communication and accountability and, therefore, could enable more trustworthy acts of consent in biomedical science. (shrink)

Auditors' virtue comprises those qualities of character that manifest the ideals of the audit community ), and are instrumental in ensuring that auditors' professional judgment is exercised according to a high moral standard ). Nevertheless, the lack of valid and reliable quantitative measures of auditors' virtue impedes research that furthers our understanding of how best to promote virtue in the audit community. To address this gap, we develop two measures of auditors' virtue. We report the results of the validity and (...) reliability of the scales. In addition, we use the findings from the administration of these scales to professional accountants to refine and validate the theoretical characterization of virtues developed by Pincoffs and Libby and Thorne. In so doing, this study provides a foundation by which future audit research can study ways to ensure that auditors' virtue is promoted throughout the audit community. (shrink)