Objectives—While clinical practice is complicated by many ethical dilemmas, clinicians do not often request ethics consultations. We therefore investigated what triggers clinicians' requests for ethics consultation. Design—Cross-sectional telephone survey.Setting—Internal medicine practices throughout the United States.Participants—Randomly selected physicians practising in internal medicine, oncology and critical care.Main measurements—Socio-demographic characteristics, training in medicine and ethics, and practice characteristics; types of ethical problems that prompt requests for consultation, and factors triggering consultation requests. Results—One hundred and ninety of 344 responding physicians (55%) reported requesting ethics (...) consultations. Physicians most commonly reported requesting ethics consultations for ethical dilemmas related to end-of-life decision making, patient autonomy issues, and conflict. The most common triggers that led to consultation requests were: 1) wanting help resolving a conflict; 2) wanting assistance interacting with a difficult family, patient, or surrogate; 3) wanting help making a decision or planning care, and 4) emotional triggers. Physicians who were ethnically in the minority, practised in communities under 500,000 population, or who were trained in the US were more likely to request consultations prompted by conflict. Conclusions—Conflicts and other emotionally charged concerns trigger consultation requests more commonly than other cognitively based concerns. Ethicists need to be prepared to mediate conflicts and handle sometimes difficult emotional situations when consulting. The data suggest that ethics consultants might serve clinicians well by consulting on a more proactive basis to avoid conflicts and by educating clinicians to develop mediation skills. (shrink)

The practice of nonphysician ethicist-consultants giving ethics advice concerning the appropriate medical treatment of patients in hospitals is a relatively recent development. Although only a minority of hospitals make substantial use of any formal ethics consulting service, the number is growing and apparently will continue to do so. Indeed, at least among urban teaching hospitals, some sort of ethics consulting service is increasingly commonplace.

Clinical Study Agreements can have profound effects both on the protection of human subjects and on the independence of investigators to conduct research with scientific integrity. Sponsors, institutions, and even investigators may fail to give adequate attention to these issues in the negotiation of CSAs. Despite the key role of CSAs in structuring ethically important aspects of research, they remain largely unregulated and unreviewed for adherence to ethical norms. Academic institutions routinely enter into research contracts that fail to meet adequate (...) ethical standards. This is a failing that can have serious consequences.Accordingly, it is necessary that some independent body have the authority both to review research contracts for compliance with norms of subject protection and ethical integrity, and to reject studies that fail to meet ethical standards. Such review should take place prior to the start of research, not later. Because of its expertise and authority, the institutional ethics review board is the appropriate body to undertake such review. Much recent commentary has focused on contractual restrictions on the investigator’s freedom to publish research findings. The Olivieri experience, and that of other investigators, has brought freedom of publication issues into sharp focus. Clinical study agreements also raise a number of other ethical issues relating to human subjects and research integrity, however, including disclosures relating to patient safety, data analysis and reporting, budget, confidentiality, and premature termination of the study. This paper describes the ethical issues at stake in structuring such agreements and suggests ethical standards to guide institutional ethics review. (shrink)

Les premiers travaux réalisés sur les effets du confinement du printemps 2020 sur les enfants ont établi que ceux qui étaient en résidence alternée l’avaient mieux vécu que les autres. L’objectif de cet article est de comprendre pourquoi. À partir de l’enquête Sapris et plus particulièrement du sous-échantillon des enfants âgés de 8-9 ans des cohortes Elfe et Epipage2, nous comparons les conséquences du confinement sur les enfants selon la structure familiale dans laquelle ils vivaient. Continu dans les familles nucléaires, (...) le temps familial est habituellement beaucoup plus fractionné entre les résidences des parents pour les enfants de familles séparées. Le confinement est venu transformer les expériences habituelles du temps familial pour les enfants, aussi bien dans son organisation que dans sa texture. Il a modifié leur cadre de vie ordinaire, en réorganisant leurs occupations au quotidien et en modifiant leurs relations avec leurs parents. En observant particulièrement les différences apparues entre les résidences alternées qui ont continué et celles qui ont été interrompues, nous montrons que si les mouvements réguliers des enfants ont pu constituer une respiration bienvenue pour les différents acteurs concernés, les alternances interrompues ont ouvert des espaces exceptionnels dans lesquels il a été possible de renouer avec des formes passées de continuité familiale. (shrink)

One of the world’s largest collections of European modern art, held by Centre Georges Pompidou, was displayed for the first time in a thematically-curated exhibition, The Big Bang. This review article evaluates the merits and permutations of thematic curation, in lieu of The Big Bang’s relation to previous instances of thematic curation of significant museum collections, most notably at the Museum of Modern Art and Tate Modern. The Big Bang is also considered against the ideological underpinnings of both thematic and (...) chronological curation, and their implications for the future. (shrink)

“For this reason, since the day we heard about you, we have not stopped praying for you. We continually ask God to fill you with the knowledge of his will through all the wisdom and understanding that the Spirit gives, so that you may live a life worthy of the Lord and please him in every way: bearing fruit in every good work, growing in the knowledge of God, being strengthened with all power according to his glorious might so that (...) you may have great endurance and patience, and giving joyful thanks to the Father, who has qualified you to share in the inheritance of his holy people in the kingdom of light. For he has rescued us from the dominion of darkness and brought us into the kingdom of the Son he loves, in whom we have redemption, the forgiveness of sins.” “And this is my prayer: that your love may abound more and more in knowledge and depth of insight, so that you may be able to discern what is best and may be pure and blameless for the day of Christ, filled with the fruit of righteousness that comes through Jesus Christ–-to the glory and praise of God.” 1. (shrink)

Bajo el título «Utopías, distopías y otras nostalgias», la cuarta edición del Congreso de Pensamiento Interdisciplinar, organizado por alumnos del grado de Filosofía, Política y Economía de la Alianza 4 Universidades, abordó el controvertido fenómeno woke, una supuesta mezcla de izquierda identitaria y progresismo políticamente correcto al que se acusa de promover la censura y la llamada «cultura de la cancelación». Sobre esta cuestión conversaron la escritora y filósofa Elizabeth Duval, la investigadora Ayme Román y el director académico y (...) profesor del Instituto Superior de Sociología, Economía y Política (ISSEP), Miguel Ángel Quintana Paz, en un debate moderado por dos de los alumnos organizadores del congreso, Guzmán Díez e Isabel Rodríguez. (shrink)

C'est en réponse aux effets délétères du progrès que se conçoit la notion salutaire de "Tradition". Ce terme, issu du latin tradere qui signifie "transmettre", recouvre l'ensemble des valeurs et des réalités immuables à travers le temps. Loin d'engager la tension purement manichéenne entre le spirituel et le temporel, l'appel de la Tradition conduit, au contraire, à réintroduire dans la société et l'Histoire religion et mode de vie différencié. Combat perdu d'avance? Utopie vouée à la dérision ou quête spirituelle portée (...) par l'exigence et la hauteur de vues? Arnaud Guyot-Jeannin en révèle l'ambition particulière et la sensibilité hors norme, à travers douze portraits singuliers, pour la plupart marqués par une conversion éclatante au catholicisme et un désir de réenchanter le monde, d'en retrouver les racines sacrées, profondes et universelles. De Vladimir Soloviev à Tolkien en passant par René Guénon, Simone Weil, Chesterton ou Gustave Thibon, l'auteur nous offre un vrai plaisir de découverte et de méditation. (shrink)

Our response to Sara Fry's paper focuses on the difficulty of understanding her insistence on the fundamental character of caring in a theory of nursing ethics. We discuss a number of problems her text throws in the way of making sense of this idea, and outline our own proposal for how caring's role may be reasonably understood: not as an alternative object of value, competing with autonomy or patient good, but rather as an alternative way of responding toward that which (...) is of value. (shrink)

BackgroundAssociations were examined between author-reported uses of reporting guidelines to prepare JNCI: Journal of the National Cancer Institute (JNCI) submissions, editorial decisions, and reviewer ratings for adherence to reporting guidelines and clarity of presentation.MethodsAt submission, authors were asked if they used reporting guidelines to prepare their manuscript and, if so, which one(s). Reviewers rated adherence to reporting guidelines and clarity of presentation. Data were gathered using a customized Editorial Manager Enterprise Analytics Report for submissions with first or final decisions that (...) were submitted between November 1, 2015, and April 30, 2017. Manuscript types that would benefit from the use of reporting guidelines were included. All reviews were included in the analyses. Numerical values were given to each answer (yes, 1; no, 0) or reviewer rating (not applicable, 0; fair, 1; poor, 2; good, 3; very good, 4; and outstanding, 5), and scores were compared using two-sided t tests.ResultsOf 2209 submissions included in the analysis, 1144 (51.8%) indicated that at least one reporting guideline was used. The STROBE guidelines were the most common (n = 531, 24.0%). Of the 2068 (93.6%) submissions that were rejected, 1105 (50.1%) indicated using reporting guidelines and 963 (43.6%) did not (mean [SD] scores of rejected vs not rejected, 0.53 [0.50] vs 0.49 [0.50], P =.47). Of the 1033 ratings for adherence to reporting guidelines, mean (SD) scores for not rejected vs rejected submissions were 3.2 (1.61) vs 2.9 (1.57) (P =.005), and mean (SD) scores for reporting guidelines use vs no use were 3.1 (1.48) vs 2.9 (1.70) (P =.01). Of the 1036 ratings for clarity of presentation, mean (SD) scores for not rejected vs rejected submissions were 3.6 (1.00) vs 3.1 (1.08) (P <.001), whereas mean (SD) scores for reporting guidelines use vs no use were 3.3 (1.04) vs 3.3 (1.10) (P =.64).ConclusionsAmong these JNCI submissions, reporting the use of reporting guidelines was not associated with editorial decisions or with reviewer ratings for clarity of presentation. Reviewer ratings for adherence to guidelines and clarity of presentation were associated with editorial decisions after peer review, and ratings for adherence to guidelines were associated with reported use of reporting guidelines. (shrink)

Our response to Sara Fry's paper focuses on the difficulty of understanding her insistence on the fundamental character of caring in a theory of nursing ethics. We discuss a number of problems her text throws in the way of making sense of this idea, and outline our own proposal for how caring's role may be reasonably understood: not as an alternative object of value, competing with autonomy or patient good, but rather as an alternative way of responding toward that which (...) is of value. (shrink)

What are the implications of Fides et Ratio for religious pluralism? The constructed context of this encyclical is a world characterized by diversity, and so the text argues for universal reason that can bridge this diversity. Yet the subtext reveals a singular truth associated with holiness that functions to limit diversity in a problematic way. This paper will explore both text and subtext in the multiple layers of this encyclical to illuminate its construction of religious pluralism. The conclusion of this (...) paper aims to highlight discussions of religious pluralism that recognize multiple rationalities and holiness embodied in practice. (shrink)

The first aim of simulation in virtual environment is to help biologists to have a better understanding of the simulated system. The cost of such simulation is significantly reduced compared to that of in vivo simulation. However, the inherent complexity of biological system makes it hard to simulate these systems on non-parallel architectures: models might be made of sub-models and take several scales into account; the number of simulated entities may be quite large. Today, graphics cards are used for general (...) purpose computing which has been made easier thanks to frameworks like CUDA or OpenCL. Parallelization of models may however not be easy: parallel computer programing skills are often required; several hardware architectures may be used to execute models. In this paper, we present the software architecture we built in order to implement various models able to simulate multi-cellular system. This architecture is modular and it implements data structures adapted for graphics processing units architectures. It allows efficient simulation of biological mechanisms. (shrink)

The well-being of learning and of being taught is a fundamental question that can arise for school teachers. When is this questioning good for teachers. We will analyze the memories of students from 2016 to 2021 in order to highlight the specificities of appropriation of this question of the good for future school teachers. We will compare the pre-health crisis to the research conducted during this crisis. By the methodology of the textometric analysis of memories and by the analysis of (...) the countertransference elements of the teacher-researchers, we will seek to specify the blocking points and the blind zones linked to the anxieties around this notion of the well-being to be learned and to teach. (shrink)

This study investigated contributions of pre-service teachers’ endogenous and exogenous instrumentalities, their intrinsic and extrinsic motivations, and their use of self-regulation strategies to explain the extent to which they used strategies to purposefully integrate their knowledge across courses. With a total of 254 pre-service teachers’ survey-responses, results of a hierarchical multiple regression analysis indicated that their endogenous instrumentality of their current coursework, their use of metacognitive strategies and their use of deeper cognitive learning strategies contributed to explaining their use of (...) extensive knowledge integration strategies for completing coursework. Our results suggest that to develop pre-service teachers’ teaching expertise, they may need to have a strong understanding that the current course conte... (shrink)

Modern sovereignty is anthropocentric, constituted and organized by reference to human beings alone. Although a metaphysical assumption, anthropocentrism is of immense practical import, enabling modern states to command loyalty and resources from their subjects in pursuit of political projects. It has limits, however, which are brought clearly into view by the authoritative taboo on taking UFOs seriously. UFOs have never been systematically investigated by science or the state, because it is assumed to be known that none are extraterrestrial. Yet in (...) fact this is not known, which makes the UFO taboo puzzling given the ET possibility. Drawing on the work of Giorgio Agamben, Michel Foucault, and Jacques Derrida, the puzzle is explained by the functional imperatives of anthropocentric sovereignty, which cannot decide a UFO exception to anthropocentrism while preserving the ability to make such a decision. The UFO can be "known" only by not asking what it is. (shrink)

Research shows that commitment-based interventions are among the most effective strategies to encourage pro-environmental behaviors, but methods to elicit commitments from a large number of individuals are often costly and unrealistic. Predictions requests—a commitment-type strategy—are an effective mass-communication strategy and have the potential to influence pro-environmental behavior among large audiences. This research is the first to demonstrate that prediction requests in a consumer behavior context influence preference for environmentally friendly products. In addition, this research examines the role of individual and (...) contextual factors in influencing the efficacy of prediction requests. Study 1 shows that exposure to an advertisement with a prediction request leads to increased preferences for environmentally sustainable household cleaning products, compared to a control advertisement, and that this effect is greater when the prediction request is paired with an audience cue . Study 2 indicates that the effect of prediction requests on preference for sustainable products is greater for individuals with interdependent self-construal. Substantive implications and directions for future research are discussed. (shrink)

Social representations of addiction and the resulting stigmatization have been widely described and studied in the literature, but their effects are no less problematic. These representations, which also occur in care settings, generate a climate of distrust which damages the therapeutic relationship, and its ethical quality. This article, combining clinical experience and an ethical stance, offers an original, innovating approach to the existence of distrust in care relationships in the area of addiction. Pragmatic approaches deriving from the human sciences and (...) analytical philosophy provide an invitation to escape from the demanding climate of mistrust, and to take the gamble on trust so as to improve the quality of interactions between protagonists in care. In complementary fashion, a sociology of action can combat the disquiet generated by distrust through a new commitment to innovating forms of action. This “poetic” mode of action is legitimized by the reflection that backs it up, and by its presentation to peers qualified to approve it. Finally, continental moral philosophy underlines the importance of a carefully weighed commitment on the part of caregivers and addicted patients towards promises aiming to support a sincere care relationship, without damaging the therapeutic dynamic or the ethical quality by providing too many safety nets. This reflection is intended to achieve better identification of the clinical and ethical issues raised by mistrust, and inclusion of these aspects in the training of personnel and in care provision planning. (shrink)

In Vanuatu, small-scale farmers’ subsistence still largely relies on the sustainable use and maintenance of a wide-ranging biodiversity out of which root and tuber crops provide the bulk of daily subsistence. In neighboring countries, foreign influence since the first European contacts, further associated changes and the introduction of new crop species have induced a loss of cultivated diversity. This paper presents a baseline study of the diversity of root and tuber crops in ten communities throughout Vanuatu. In a context where (...) the smallholders’ agrosystems are increasingly considered as key components for the global conservation of crop genetic resources, this study provides clues to better understand the effective roles of biodiversity in traditional agrosystems. It also provides insights on the rationale behind the constitution of agricultural portfolios and discusses how the cultivated diversity allows communities to cope with changes and pressures. The paper also shows that recently introduced crops neither seem to have compromised agricultural diversity nor drastically changed the agrosystems in Vanuatu. On the contrary, such crops are used by farmers to strengthen the resilience of their agrosystems. A discussion then presents the idea of continuity through change and novelty as a critical factor for resilience. The paper concludes by discussing the role of indigenous agriculture and culture in ensuring food security and in development strategies in a larger context. (shrink)