In this paper, we report on the development and validity of the Professional Decision-Making in Research measure, a vignette-based test that examines decision-making strategies used by investigators when confronted with challenging situations in the context of empirical research. The PDR was administered online with a battery of validity measures to a group of NIH-funded researchers and research trainees who were diverse in terms of age, years of experience, types of research, and race. The PDR demonstrated adequate reliability and parallel form (...) correlation. As hypothesized, the PDR was significantly negatively correlated with narcissism, cynicism, moral disengagement, and compliance disengagement; it was not correlated with socially desirable responding. In regression analysis, the strongest predictors of higher PDR scores were low compliance disengagement, speaking English as a native language, conducting clinical research with human subjects, and low levels of narcissism. Given that the PDR was written at an eighth grade reading level to be suitable for use with English as a second language participants and that only one-fourth of items focused on clinical research, further research into the possible roles of culture and research ethics training across specialties is warranted. This initial validity study demonstrates the potential usefulness of the PDR as an educational outcome assessment measure and a research instrument for studies on professionalism and integrity in research. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Editors’ NoteJames M. DuBois, Ana S. Iltis, and Heidi A. WalshFrom childhood, David Slakter had undergone tests and invasive procedures to monitor his nephritis. It was not a surprise when in 2015, doctors told him he needed a kidney transplant. The wife of a childhood friend was a close match and gave him one of her kidneys. Before his transplant, aerobic exercise was difficult; a few months after transplant, (...) Slakter could ride his bike, hike, and work out with a personal trainer. He no longer had to weigh food or gauge his potassium consumption, a concern for people with kidney failure. For Slakter, “life post-transplant has been a significant improvement.”Individuals or family members of those who have received an organ transplant from a living or deceased donor share their stories in this issue of Narrative Inquiry in Bioethics. The symposium is titled “Receiving the Gift of Life: Stories from Organ Transplant Recipients.” Organ transplantation can extend an individual’s life by decades. It can also greatly improve an individual’s quality of life, as was Slakter’s experience. At the same time, organ transplantation is expensive and stressful. Recipients can experience complications, including organ rejection, and there are few appealing alternatives.After her heart transplant, author Leilani R. Graham required four open-heart surgeries, ECMO, and an intra-aortic balloon pump. She experienced delirium, necrotizing pneumonia, and severe muscular atrophy that required her to re-learn how to walk. She struggled with weight gain, explosive mood swings, hair loss, and was terrified that her body would reject the new heart. For Graham, “[Transplant] was not the miracle [she] was hoping for.” Graham says she felt unprepared for and inadequately informed about what to expect after her transplant, which left her “battered, beaten, and bruised” with a 12-inch line from neck to navel and “bullet holes” up and down her torso from the chest tubes. When reflecting on her experience post-transplant, Graham says, “It wasn’t the physical trauma that hurt the most. It was that no one seemed surprised [by the aftereffects of transplant].” Seemingly no one, that is except Graham, who calls on transplant providers to “prioritize empathy.”The symposium editors are Jason T. Eberl and Tristan McIntosh. Three commentary articles, written by Macey Leigh Levan, Heather Lannon, and Vidya A. Fleetwood, Roslyn B. Mannon & Krista L. Lentine, offer important insights into the authors’ stories. The editors thank Mid-America Transplant, the UCSF Lung Transplant Program, Donor Connect, William L. Freeman, MD, MPH, MJIL, CIP, Janet Monk, and the individuals who gave anonymous donations to support the publication of this issue, an open-access VOICES edition of the symposium, and accompanying teaching guides.The research article in this issue, “‘A Shell of My Former Self’: Using Figurative Language to Promote Communication about Patient Suffering,” was written by Tyler Tate, Elizabeth Stein, and Robert A. Pearlman. The relief of suffering is a primary goal of medicine. However, the authors note that clinicians often miss or ignore suffering because they focus on the causes rather than the experience of suffering, or the subjective nature of suffering makes it difficult to discuss. The authors believe that “the key to communicating about suffering lies in finding [End Page vii] the right kind of words to describe the experience” and say that figurative language offers a promising approach. In their research, the authors performed qualitative analysis on 52 works of literature and identified 254 excerpts of figurative language with themes of non-physical or psychological suffering. The authors found 13 salient themes: brokenness, diminishment, disorientation, drowning, emptiness, imprisonment, battle, darkness, isolation, invisibility, lifelessness, punishment, and torture. The authors reiterate that developing a shared language of suffering could foster a therapeutic patient-clinician relationship and improve clinicians’ ability to recognize and address a patient’s experience of suffering.María Susana Ciruzzi wrote the first of two case studies included in this issue. “The Sword of King Solomon” addresses a tragic and difficult subject—how to navigate the situation posed by conjoined twins when “any decision will produce damage and suffering.” The case involves two infant male patients born at 37 weeks gestation as omphalo-ischiopagus conjoined twins... (shrink)

Surgeons share their challenges and dilemmas in making ethical decisions in these twelve personal stories. The three commentary articles draw out the lessons the stories address. The commentators come from diverse backgrounds including sociology, bioethics, nursing, and surgery.

We take another look at “Just-So” solar neutrino oscillations, characterizing them by the energy Eπ/2 at which the distance-varying angle is π/2, instead of by the usual Δm 2 . The rising spectrum recently observed by SuperKamiokande is consistent with an Eπ/2 ∼6–9 MeV and marginally with 48 MeV. The pp neutrinos must then be reduced to one-half the standard solar model prediction, and 7Be neutrinos must make up a significant part of the SAGE and GALLEX gallium signal. For Eπ/2 (...) close to 9 and 48 MeV, the 7Be neutrinos will also show a large seasonal variation, emphasizing the importance of direct measurements of the 7Be neutrinos. (shrink)

Employing the techniques of modern economic analysis, Professor Buchanan reveals the conceptual basis of an individual's social rights by examining the ...

This book defends the view that any adequate account of rational decision making must take a decision maker's beliefs about causal relations into account. The early chapters of the book introduce the non-specialist to the rudiments of expected utility theory. The major technical advance offered by the book is a 'representation theorem' that shows that both causal decision theory and its main rival, Richard Jeffrey's logic of decision, are both instances of a more general conditional decision theory. The book solves (...) a long-standing problem for Jeffrey's theory by showing for the first time how to obtain a unique utility and probability representation for preferences and judgements of comparative likelihood. The book also contains a major new discussion of what it means to suppose that some event occurs or that some proposition is true. The most complete and robust defence of causal decision theory available. (shrink)

The primary purpose of Hosea's ministry was to provide a testimony that would effect reconciliation between Yahweh and Israel—during and beyond judgment.

The seven ethical issues and principles explored in the target article (i.e., privacy, responsibility, access, stigma, user control, family impact, enhancement) reflect important considerations for...

In classical theism, God is typically conceived of as having the attribute of omnipresence. However, this attribute often falls prey to two puzzles, the immateriality puzzle and the intensity puzzle. A recent explication of omnipresence by Hud Hudson falls short of solving these puzzles. By attending to key narratives in the Hebrew Scriptures, I argue that one ought to conceive of God’s presence at a location as God’s acting at that location. Thus, God’s omnipresence is God’s acting at all locations.

The family of a patient who is unconscious and respirator-dependent has made a decision to discontinue medical treatment. The patient had signed a donor card. The family wants to respect this decision, and agrees to non-heart-beating organ donation. Consequently, as the patient is weaned from the ventilator, he is prepped for organ explantation. Two minutes after the patient goes into cardiac arrest, he is declared dead and the transplant team arrives to begin organ procurement. At the time retrieval begins, it (...) is not certain that the patient's brain is dead or that cardiac function cannot be restored. Procurement follows uneventfully, and two transplantable kidneys are retrieved. (shrink)

This article engages two fundamentally different kinds of so-called natural law arguments in favor of specific moral absolutes: Elizabeth Anscombe's claim that certain actions are known to be intrinsically wrong through intuition, and John Finnis's claim that such actions are known to be wrong because they involve acting directly against a basic human good. Both authors maintain, for example, that murder and contraceptive sexual acts are known to be wrong, always and everywhere, through their respective epistemological lens. This article uses (...) the counter-example of anesthesia to challenge these two approaches to substantiating natural law claims. The paper concludes by rejecting the view shared by Professors Finnis and Anscombe that once one rejects these foundations for moral absolutes, one is left with moral subjectivism. In fact, one is left with moral absolutes of a more restricted nature, which are known philosophically, and with more robust moral absolutes held on religious grounds. Virtues are needed in the moral life, among other reasons, because such norms require discernment and integrity for their correct application. (shrink)

The family of a patient who is unconscious and respirator-dependent has made a decision to discontinue medical treatment. The patient had signed a donor card. The family wants to respect this decision, and agrees to non-heart-beating organ donation. Consequently, as the patient is weaned from the ventilator, he is prepped for organ explantation. Two minutes after the patient goes into cardiac arrest, he is declared dead and the transplant team arrives to begin organ procurement. At the time retrieval begins, it (...) is not certain that the patient's brain is dead or that cardiac function cannot be restored. Procurement follows uneventfully, and two transplantable kidneys are retrieved.Many people now consider such cases of non-heart-beating organ donation to be ethically permissible. However, widespread disagreement persists as to how such practices are to be justified and whether such practices are compatible with the Uniform Declaration of Death Act. In this paper, I argue that non-heart-beating organ donation can be ethically justified, that in the justified cases the patients are in fact dead, and that the early declarations of death required for such donation do comply with the UDDA. (shrink)

This volume offers an array of newly commissioned essays, addressing the topic of love in the Christian tradition. Drawn from a range of expert theologians and philosophers in contemporary analytic and non-analytic theology, these essays join current debates within the theology of love, and aim to propose new avenues for future research. Including the last essay written by Marilyn McCord Adams, Love, Divine and Human deals with a rich variety of issues related to divine and human love. The broad scope (...) of the book includes divine transcendence and its methodological bearing on the doctrine of divine love, the nature and scope of divine love, the interrelation between God's love and wrath, the plausibility of an impassable God of love, and the application of various conceptions of divine love to the problem of divine hiddenness, human ethics, and human free will, among other topics. This unified collection of cutting-edge papers will advance discussion for all those focused on the theology of love. (shrink)

Software application ontologies have the potential to become the keystone in state-of-the-art information management techniques. It is expected that these ontologies will support the sort of reasoning power required to navigate large and complex terminologies correctly and efficiently. Yet, there is one problem in particular that continues to stand in our way. As these terminological structures increase in size and complexity, and the drive to integrate them inevitably swells, it is clear that the level of consistency required for such navigation (...) will become correspondingly difficult to maintain. While descriptive semantic representations are certainly a necessary component to any adequate ontology-based system, so long as ontology engineers rely solely on semantic information, without a sound ontological theory informing their modeling decisions, this goal will surely remain out of reach. In this paper we describe how Language and Computing nv (L&C), along with The Institute for Formal Ontology and Medical Information Sciences (IFOMIS), are working towards developing and implementing just such a theory, combining the open software architecture of L&C’s LinkSuiteTM with the philosophical rigor of IFOMIS’s Basic Formal Ontology. In this way we aim to move beyond the more or less simple controlled vocabularies that have dominated the industry to date. (shrink)

Andy Egan has recently produced a set of alleged counterexamples to causal decision theory in which agents are forced to decide among causally unratifiable options, thereby making choices they know they will regret. I show that, far from being counterexamples, CDT gets Egan's cases exactly right. Egan thinks otherwise because he has misapplied CDT by requiring agents to make binding choices before they have processed all available information about the causal consequences of their acts. I elucidate CDT in a way (...) that makes it clear where Egan goes wrong, and which explains why his examples pose no threat to the theory. My approach has similarities to a modification of CDT proposed by Frank Arntzenius, but it differs in the significance that it assigns to potential regrets. I maintain, contrary to Arntzenius, that an agent facing Egan's decisions can rationally choose actions that she knows she will later regret. All rationality demands of agents it that they maximize unconditional causal expected utility from an epistemic perspective that accurately reflects all the available evidence about what their acts are likely to cause. This yields correct answers even in outlandish cases in which one is sure to regret whatever one does. (shrink)

Based on the author's more than 50 years of experience as a professional historian in academic and other capacities, Being a Historian is addressed to both aspiring and mature historians. It offers an overview of the state of the discipline of history today and the problems that confront it and its practitioners in many professions. James M. Banner, Jr. argues that historians remain inadequately prepared for their rapidly changing professional world and that the discipline as a whole has yet (...) to confront many of its deficiencies. He also argues that, no longer needing to conform automatically to the academic ideal, historians can now more safely and productively than ever before adapt to their own visions, temperaments, and goals as they take up their responsibilities as scholars, teachers, and public practitioners. Critical while also optimistic, this work suggests many topics for further scholarly and professional exploration, research, and debate. (shrink)