Professionalism, like common sense, remains a timeless ingredient in the ethically successful practice of medicine in the twenty-first century. Professional ideals are particularly relevant in times of economic and social upheaval, medicolegal crises, provider shortages, and global threats to the public health. The American Board of Internal Medicine specifies professionalism as “constituting those attitudes and behaviors that serve to maintain patient interest above physician self-interest.” Because of its transcendent nature, professionalism, like ethics, is also considered “a structurally stabilizing, morally protective (...) force in society.” Professions enjoy tremendous deference and autonomy in exchange for three unwritten but prerequisite promises: expert knowledge, self-regulation, and a fiduciary responsibility to place the needs of the client ahead of self-interest. Many educators suggest that professionalism includes additional characteristics such as honesty, altruism, temperance, commitment, integrity, and suspension of self-interest. However, there are large gaps in providing more user-friendly and operational models of professionalism to learners and evaluators at all levels of the academic hierarchy. (shrink)

Appropriate concerns about cost and unequal access to healthcare have resulted in the creation of powerful managed networks seeking to share the risks of high healthcare costs among plans, providers, and patients. Much to their credit, these managed networks have slowed the rise in healthcare spending by as much as 44% in markets with high HMO penetration. However, whether these savings will materially improve access and quality remains to be seen.

Interpretative phenomenological analysis (IPA) is an idiographic approach to qualitative research. It is widely used in psychologically-informed studies which aim to understand the meaning and context of specific experiences. In this paper, we provide some background and introduction to the principles and processes underpinning IPA research. We extend this via a practical example, reporting on selected analyses from a study which explores the phenomenology and meaning of loneliness, through interviews conducted with a group of religious women. Through our observations on (...) the complex role of absence for loneliness, we show that IPA can be a powerful tool for exploring and understanding the meaning of salient experiences. We reflect on the significance of the results for advancing theories of loneliness; and on the capacity of the IPA approach to provide researchers with an important and useful phenomenological perspective, through its emphasis on context, and its commitment to integrating convergent and divergent claims. (shrink)

Discerning the motives that lead businesspeople to make ethical decisions in economic contexts is important, for it aids the moral evaluation of such decisions. But conventional economic theory has for too long assumed an egoist model of motivation, to which many contrast an altruist view of ethical choices. The result is to see business decision making as implying dilemmas. On the other hand, we argue, if one assumes multiple motives, economic and ethical, in ordinary business decisions, a more fruitful model (...) of ethical motivation in such decisions emerges. In this paper multiple motives are assumed to be the norm in a world of large organizations, complex decisions and stakeholder management. An example of a technology acquisition decision, with environmental overtones is presented in illustration of this approach. A method for discerning motives, primarily in terms of behavioural efficacy is presented. On this basis a two step approach to morally evaluating mixed motives in business decisions is proposed. First, the fit of motives with substantive ethical values should be ascertained, and then the efficacy of moral motives in yielding ethical behaviour and outcomes should be determined. This approach, we conclude, offers a much more concrete model of the actual role of moral motives in business decision making. It also signals the importance of moral learning in organizations. (shrink)

In this paper I want to do the following things. First I want to show that in the part of the Theaetetus where the relationship between knowledge and perception is examined, the concept of knowledge that is in question is very clearly characterized. We are left in no doubt as to what is to count as knowing. Secondly I want to unravel in some detail the case that Socrates puts on Protagoras’ behalf where he draws on what Protagoras actually wrote (...) (151 E-152C); as opposed to what he may have taught secretly to his pupils (152C-160D). Thirdly I wish to argue that if we let the dialogue speak for itself, it is manifest that this case put up on Protagoras’ behalf at 151 E-152C is not overthrown; it is not even shaken. (shrink)

Zeins are a group of alcohol‐soluble proteins that are synthesized in the endosperm of developing maize seeds. These proteins are encoded by a large number of genes located on several chromosomes; based upon the number of mutants that have been isolated, zein gene regulation is complex. Comparisons of gene flanking regions reveal conserved sequences that may be important for their regulation. Studies of transformed plant tissues support the assertion that cis‐acting elements with the 5′ flanking regions of zein genes are (...) required for accurate transcription. Although the genes are transcribed in transgenic tobacco and petunia plants, they are not properly regulated. This appears to be due to transcriptional effects rather than protein or mRNA instability. (shrink)

The Statements on Responsibilities in Tax Practice (SRTPs) provide guidance to the CPA when making decisions in tax practice. Many of these decisions are ethical in nature and have implications for tax compliance. In this study, a survey methodology is used to test whether the SRTPs affect decisions that CPAs make. The findings suggest that a clear majority of CPAs follow the SRTPs when making ethical decisions relating to tax return preparation and that CPAs follow the SRTPs more often than (...) unlicensed preparers on half the issues tested. However, a statistically significant number of CPAs do not follow the SRTPs and, CPAs do not follow the SRTPs any more often than unlicensed tax preparers on three issues. (shrink)

In this paper I want to do the following things. First I want to show that in the part of the Theaetetus where the relationship between knowledge and perception is examined, the concept of knowledge that is in question is very clearly characterized. We are left in no doubt as to what is to count as knowing. Secondly I want to unravel in some detail the case that Socrates puts on Protagoras’ behalf where he draws on what Protagoras actually wrote (...) ; as opposed to what he may have taught secretly to his pupils. Thirdly I wish to argue that if we let the dialogue speak for itself, it is manifest that this case put up on Protagoras’ behalf at 151 E-152C is not overthrown; it is not even shaken.In that part of the dialogue where the question is under examination whether or not knowledge and perception are the same, Socrates uses an idealized concept of knowledge. That is, he restricts the use of the word by setting down what he will consider to be the essential characteristics of knowledge, the sufficient and necessary conditions of its being instantiated. An excellent piece of philosophical procedure. (shrink)

We describe a set of two computer‐implemented models that solve physics problems in ways characteristic of more and less competent human solvers. The main features accounting for different competences are differences in strategy for selecting physics principles, and differences in the degree of automation in the process of applying a single principle. The models provide a good account of the order in which principles are applied by human solvers working problems in kinematics and dynamics. They also are sufficiently flexible to (...) allow easy extension to several related domains of physics problems. (shrink)

It is not quite as easy to see that there is in fact no formula of this modal language having the same truth conditions (in terms of S5 Kripke semantics) as (1). This was rst conjectured by Allen Hazen2 and later proved by Harold Hodes3. We present a simple direct proof of this result and discuss some consequences for the logical analysis of ordinary modal discourse.

Because anticipated and retrospective regret play important roles in practical deliberation and motivation, better understanding them can illuminate the contours of human agency. However, the possibility of self-ignorance and the fact that we change over time can make regret—especially anticipatory regret—not only a poor predictor of where the agent will be in the future but also an unreliable indicator of where the agent stands. Granting these, this paper examines the way in which prospective and, particularly, retrospective regret can nevertheless yield (...) important insight into the sorts of creatures we are, both generally and individually. The experience of retrospective regret can show a person she values something in a way she did not know or that she is (or was) a different person than she had thought, insights which can factor into forward-looking, or prospective, deliberation. Such instances of revelatory regret reveal something to the agent about herself as agent. I examine two cases of agential self-ignorance. In the first, the experience of regret reveals what the agent values, not only to others but even to the agent himself. In the second, the agent anticipates experiencing regret for an action but does not experience the regret, suggesting that the agent did not value the rejected alternative in the way she thought. Anticipatory regret is forward-looking and can play an important role in practical deliberation. But insofar as anticipatory regret flows from one’s imperfect judgment and prospection about oneself, retrospective regret can be an important corrective in helping the agent understand her own standpoint. (shrink)

Interest in universal basic income has risen recently as an alternative to existing exchequer-sourced social security methods, such as conditional cash transfers. This article presents a survey of multiple experiments investigating the impact of basic income cash transfers on recipients while presenting a meta-analysis of the results across nine categories. Many findings indicate successful outcomes across financial security, health, and educational dimensions. Children were amongst the strongest beneficiaries of the trials and observed a 4.5 % reduction in obesity, a 19.5 (...) % increase in their normal weight-for-age, a 30 % increase in female secondary school attendance, and an increase in the educational attainment of one year in response to the cash transfers. (shrink)

The present book is intended to help students overcome difficulties by presenting Jaspers' thoughts in comparatively clear and straightforward fashion. While it denies that philosophy is "practical" in any cheap and obvious sense, it follows Jaspers in attempting to avoid the otiose and emphasize the relevance of philosophy to matters of ultimate concern. Those who wish a more theoretical and systematic presentation may well call to mind that, as Heidegger's followers express it, Jaspers, like Kierkegaard- and to some extent Sartre- (...) quite deliberately spurned the "ontological" in favor of the "ontic.". (shrink)

This study surveys the internal audit department of a large financial services organization. Respondents were challenged to recognize and evaluate ethical and unethical situations often encountered in practice. Four key demographic variables were investigated: gender, age, years of employment and peer group influence. For the most part, respondents view themselves as more ethical than their peers. There does appear to be a gender effect suggesting females' ability to identify ethical behavior better than their male counterparts. This study contributes to the (...) extant literature in that it has explored a previously unexplored profession, namely, the internal auditing profession. (shrink)

Illuminated by the writings of Edith Stein, this paper presents a model of empathy as a very particular intersubjective understanding. This is commonly a view absent from psychology literature. For Stein, empathy is the experience of experientially and directly knowing another person’s experience, as it unfolds in the present, together with the awareness of the ‘otherness’ of that experience. It can be conceptually distinguished, in terms of process and experience, from current models that propose that empathic understandings are ‘intellectual’ experiences (...) or sympathetic experiences. As such, she provides an additional or alternative aspect to understanding other people’s experiences. Our paper provides a summary of Stein’s key analytic claims about three key facets of empathy. Her views are discussed in the light of debates relevant for contemporary psychology and social cognition. (shrink)

Background:Clinical investigation is a growing field employing increasing numbers of nurses. This has created a new specialty practice defined by aspects unique to nursing in a clinical research context: the objectives, setting, and nature of the nurse–participant relationship. The clinical research nurse role may give rise to feelings of ethical conflict between aspects of protocol implementation and the duty of patient advocacy, a primary nursing responsibility. Little is known about whether research nurses experience unique ethical challenges distinct from those experienced (...) by nurses in traditional patient-care settings.Research objectives:The purpose of the study was to describe the nature of ethical challenges experienced by clinical research nurses within the context of their practice.Research design:The study utilized a qualitative descriptive design with individual interviews.Participants and research context:Participating nurses self-identified as having experienced ethical challenges during screening. The majority were Caucasian, female, and worked in outpatient settings. Approximately 50% had > 10 years of research experience.Ethical considerations:The human subjects review board approved the study. Written informed consent was obtained.Findings:Predominant themes were revealed: the inability to provide a probable good, or/do no harm, and dual obligations. The following patterns and subthemes emerged: conflicted allegiances between protocol implementation, needs of the participant, desire to advance science, and tension between the nurse–patient therapeutic relationship versus the research relationship.Discussion:Participants described ethical challenges specific to the research role. The issues are central to the nurse–participant relationship, patient advocacy, the nurse’s role in implementing protocols, and/or advancing science.Conclusion:Ethical challenges related to the specialized role of clinical research nurses were identified. More research is warranted to fully understand their nature and frequency and to identify support systems for resolution. (shrink)

This anthology brings together extracts that come from a wide variety of sources and that illustrate Western thought on the subject of humour and laughter from Antiquity to Late Modernity. The selection of texts is comprehensive, historically representative, and original, and includes writings from more than 40 different authors.

In his newly updated version of The Anatomy of a Constitutional Law Case, Alan F. Westin provides a documentary portrait of historically important constitutional law case, 'Youngstown Sheet & Tube Co. v. Sawyer, ' from its rise in a bargaining dispute in the steel industry during 1952 to the aftermath of its decision by the United States Supreme Court. Westin has added to his classic book additional materials and personal commentaries collected since the work was first published. The new information (...) covers what went on within the Truman administration, what went on within the Supreme Court when analyzing and resolving issues that come before it. Westin includes selections from transcripts, briefs and other official proceedings, adds notes describing each phase of the constitutional process, and a section of commentary and questions relating this case to others. (shrink)

What does social justice require in contemporary societies? What are the requirements of social democracy? Who and where are the individuals and groups that can carry forward agendas for progressive social transformation? What are we to make of the so-called new social movements of the last thirty years? Is identity politics compatible with egalitarianism? Can cultural misrecognition and economic maldistribution be fought simultaneously? What of the heritage of Western Marxism is alive and dead? And how is current critical social theory (...) to approach these and other questions? Much of the most productive work done in recent social theory has revolved around such issues, in particular, around those concerning the relationship between the politics of recognition and the politics of distribution. After the intense theoretical focus over the last fifteen years or so on the issues of recognition politics—multiculturalism, multi-nationalism, identity politics, group-differentiated rights, the accommodation of difference, and so on—some social theorists have worried that attention has been diverted from important issues of distributive equality—systematic impoverishment, increasing material inequality, ‘structural’ unemployment, the growth of oligarchic power, global economic segmentation, and so on. While some critics seem to have adopted a blunt ‘it’s the economy, stupid’ line of criticism,1 others have attempted to develop an overarching, integrative theoretical framework adequate to the diverse issues concerning both economic and cultural justice. For example, Axel Honneth proposes that a suitably developed and normatively robust theory of intersubjective recognition can adequately integrate an analysis of apparently diverse contemporary struggles: those for a just division of labor and hence, a fair distribution of resources and opportunities, as well as those for a culture free of identity-deforming disrespect and denigration. (shrink)

The aim of this article is to take relational ethics concepts and apply them to the context of application to research ethics committees for approval to carry out research. The process of a multinational qualitative research application is described. The article suggests that a relational ethics approach can address two issues: how qualitative proposals are interpreted by research ethics committees and how this safeguards potentially vulnerable respondents. In relational terms, the governance of a research project may be enhanced by shared (...) ownership and willingness to engage in mutual dialogue. This challenges both researchers and research ethics committees to reframe their understanding of roles and functions in the assessment of research protocols, particularly those of a qualitative nature and those that address end-of-life issues. (shrink)

Since Mueller’s 1958 article calling Hegelian dialectics a “legend,” it has been fashionable to deny that Hegel used thesis-antithesis-synthesis dialectics. But in truth, Hegel’s Phenomenology of Spirit has 28 dialectics hidden on four outline levels, and The Philosophy of History has 10 more on three outline levels. In Phenomenology’s macrodialectic, Hegel’s nonsupernatural Spirit–all reality, everything in the universe, including man and artificial objects–advances from unconscious + union (thesis) to conscious + separation (antithesis) to a synthesis of conscious (from the antithesis) (...) + union (from the thesis). Previous interpretations of Phenomenology have missed this dialectic: they have assumed that Spirit’s journey begins with consciousness, whereas the journey actually begins in the primordial state of nature, before man arrives and provides Spirit with its Mind (the collective mind of man). Mind then misperceives itself as a multitude of separate alien “objects”–things other than itself. The macrodialectic and all other dialectics are based on Christianity’s Johannine separation-and-return mythology; all Hegelian dialectics separate from a concept in the thesis, going to that something’s opposite (antithesis), and then return to the thesis concept. Thus, in Hegel’s master-and-slave dialectic (God = master, man = slave), man advances from potential + freedom to actual + bondage (religiosity) to actual + freedom (atheism). Only Marx and Tillich understood Hegelian dialectics. Marx’s basic dialectic (one of four) saw history separating from and returning to Communism, going from communal ownership + poverty (primitive communism, or gens) to private ownership + wealth (slavery, feudalism, capitalism) to communal ownership + wealth (final communism). Tillich’s basic dialectic (one of many) separates from and returns to God, advancing from Yes to God + Yes to supernaturalism (theism) to No to God + No to supernaturalism (atheism) to Yes to God + No to supernaturalism (humanism: humanity is the nonsupernatural “God above the God of theism”). (shrink)

On behalf of the Robert Wood Johnson Foundation, I want to thank the Public Health Law Association and the American Society of Law, Medicine & Ethics for your leadership and the work that both you and the Centers for Disease Control and Prevention have done to grow this field. RWJF is pleased to co-sponsor this conference.The music that opened this talk is a clip from Warren Zevon, who encouraged us musically to “send lawyers, guns and money.” Zevon was a singer/songwriter (...) and social critic whose songs often took a jaundiced, somewhat cynical point of view. Even so, I know that I am probably stretching his meaning when I think of this song. I see “lawyers, guns and money” as his take on the major drivers of how change happens in a society. (shrink)

On behalf of the Robert Wood Johnson Foundation, I want to thank the Public Health Law Association and the American Society of Law, Medicine & Ethics for your leadership and the work that both you and the Centers for Disease Control and Prevention have done to grow this field. RWJF is pleased to co-sponsor this conference.The music that opened this talk is a clip from Warren Zevon, who encouraged us musically to “send lawyers, guns and money.” Zevon was a singer/songwriter (...) and social critic whose songs often took a jaundiced, somewhat cynical point of view. Even so, I know that I am probably stretching his meaning when I think of this song. I see “lawyers, guns and money” as his take on the major drivers of how change happens in a society. (shrink)

A key philosophical feature of Peter Jackson’s film interpretation of J.R.R. Tolkien’s The Lord of the Rings is its use of fantasy to inspire a “recovery” of the actual or, in other words, a reawakening to the beauty of nature and the many possible ways of living in healthier ecological relation to the world. Though none of these ways is perfectly achieved, this pluralistic view is demonstrated in the various lifeways of Hobbits, Elves, Men, and Ents. All of the positive (...) relationships embodied in the films—to trees, mountains, horses, and vegetable gardens—involve loving care and attention, receiving nourishment and livelihood without instrumentalization, or reducing nature to mere resource. The films also vividly display a variety of ugly and destructive ways of using the land to accrue power and wealth. These noxious ways, specifically because they actively destroy the lands that they use, always need more. They will thus eventually annihilate the beautiful ways of being if they are not actively resisted. Some of those who would rather be tending their own trees, gardens, or horses or even wandering in the wild forests must therefore turn their attention to struggle and resistance instead. This is a struggle full of grief, and at times even verging on despair, but it is marked by the refusal to give up hope. Indeed, what Jackson and Tolkien have to say about hope is as important in responding to the ecological crisis as anything they have to say about nature, inasmuch as they help to remind us that even in our own times, “there is still hope.”. (shrink)

Whiskey Lao -- Fair warning -- Randomness at large -- We the addicted -- The best possible world -- The importance of being doomed -- Moral responsibility -- The upper limit to the value of possible worlds.