Background: Not all patients are considered equal. For patients who are considered to be “very important persons,” care can be different from that of other patients with advantages of greater access to resources, special attention from staff, and options for luxurious hospital amenities. While very important person care is common and widely accepted by healthcare administration, it has negative implications for both very important person and non-very important person patients, supports care disparities and inequities, and can create serious ethical dilemmas (...) for healthcare professionals. Very important person care can also result in negative care outcomes for its recipients. Objective: This article sought to explore the implications and ethical considerations of very important person care within the context of United States healthcare system, and integrate bioethical principles and American Nurses Association Code of Ethics for Nurses to influence recommendations for managing ethical dilemmas associated with very important person care. Method: A synthesis of the literature on very important person care was undertaken for this article. Ethical considerations: Ethical conduct was considered and respected when performing the literature review, referencing sources, and establishing authorship. Findings: According to the published literature, very important person care bares both positive and negative implications for patients, and negative implications for nurses. Nurses are the most affected by the demands from their administrators to provide special care and attention to patients in the “very important person” category and their families. Very important person care can be disruptive, disorienting, challenging, and stressful to nurses. Conclusion: While physicians and other healthcare professionals have commented on very important person care, limited work has been done in nursing. There have not been any empirical studies on very important person care. Therefore, in order to minimize the negative implications of very important person care, studies of this phenomenon are warranted. Exposing very important person care is important in the development of an ethical healthcare system. Moreover, understanding the ethical principles surrounding the concept of very important person care will empower nurses to effectively manage conflicts and ethical dilemmas that arise with very important person care. (shrink)

Abstract:This symposium includes thirteen personal narratives from people who have received at least one organ transplant from a living or deceased donor. These narratives foster better understanding of the experiences of life-saving organ recipients and their families, including post-transplant difficulties experienced—sometimes requiring multiple transplants. This issue also includes three commentaries by Macey L. Levan, Heather Lannon, and Vidya Fleetwood, Roslyn B. Mannon & Krista L. Lentine. Dr. Levan is a living kidney donor and associate professor of surgery and population health. (...) She writes and teaches on organ transplant and has expertise and experience in governance at the federal level as a member of the board of directors for the U.S. Organ Procurement and Transplantation Network. Dr. Lannon is a social worker and transplant advocate. Her work and interest in the topic were inspired by her husband who needed a heart transplant. Dr. Fleetwood is a surgeon specializing in liver transplantation, pancreas transplantation, kidney transplantation, as well as living donor nephrectomy. Dr. Mannon is a nephrologist and professor of medicine, pathology and microbiology. Her work focuses on understanding and improving long-term kidney transplant outcomes for patients, donors, and caregivers. Dr. Lentine is a nephrologist specializing in treatment of adult patients with kidney disease. She is a researcher and co-chaired the international work group that developed guidelines for living donor kidney transplantation. (shrink)

Recoiling from the power that Athenian democracy placed in the hands of the poor, the founding fathers of the United States took Athens as primarily an anti-model, whereas nineteenth-century defenders of slavery found Athens a very congenial model indeed, seeming as it did to lend a mantle of legitimacy to an unspeakable practice. After a “honeymoon period” in which democracy was idealized as the only legitimate form of government, now at the outset of the twenty-first century the alliance of democracy (...) with a capitalism that often proves heartless to the less fortunate has raised some troubling questions about democracy itself. Despite its small size, classical Athens offers valuable guidance for tempering current difficulties in both the United States and elsewhere by adopting and adapting the selection of some officials by sortition, direct election by popular vote of elected officials, a rigorous system of accountability, and the fostering of civic and community values. (shrink)

Our ability to attend selectively to our surroundings - noticing things that matter, ignoring those that don't - is crucial if we are to negotiate the world around us. This is the first book in years to explore just how our attention can be influenced by time, and how our own perception of time can be influenced by what we attend to.

Dispositional forgiveness is positively associated with many facets of wellbeing and has protective implications against depression and anxiety in adolescents. However, little work has been done to examine neurobiological aspects of forgiveness as they relate to clinical symptoms. In order to better understand the neural mechanisms supporting the protective role of forgiveness in adolescents, the current study examined the middle frontal gyrus, which comprises the majority of the dorsolateral prefrontal cortex and is associated with cognitive regulation, and its relationship to (...) forgiveness and clinical symptoms in a sample of healthy adolescents. In this cross-sectional study, larger MFG volume was significantly associated with higher self-reported dispositional forgiveness scores and lower levels of depressive and anxiety symptoms. Forgiveness mediated the relationship between MFG volume and both depressive and anxiety symptom levels. The mediating role of forgiveness in the relationship between MFG volume and clinical symptoms suggests that one way that cognitive regulation strategies supported by this brain region may improve adolescent mental health is via increasing a capacity for forgiveness. The present study highlights the relevance of forgiveness to neurobiology and their relevance to emotional health in adolescents. Future longitudinal studies should focus on the predictive quality of the relationship between forgiveness, brain volume and clinical symptoms and the effects of forgiveness interventions on these relationships. (shrink)

In this paper, we identify and discuss some of the ethical problems associated with digital sensors used to detect water contamination and air pollution in the United States. Such safety devices are often deployed unsystematically and with questionable efficacy, thereby structuring the life chances of people in unequal ways. Whereas most technological infrastructures are hidden from view . or at least from active awareness . until they cease to function, those infrastructures meant to monitor and/or regulate largely "invisible" public health (...) dangers resist public awareness even when they fail. Because such detection systems tend to indivi-dualize responsibility for reducing risk, the systems may normalize and perhaps exacerbate root problems of contamination and unequal exposure. One ethical challenge is to render such systems and their failures legible. (shrink)

For years, phenomenological psychiatry has proposed that distortions of the temporal structure of consciousness contribute to the abnormal experiences described before schizophrenia emerges, and may relate to basic disturbances in consciousness of the self. However, considering that temporality refers mainly to an implicit aspect of our relationship with the world, disturbances in the temporal structure of consciousness remain difficult to access. Nonetheless, previous studies have shown a correlation between self disorders and the automatic ability to expect an event in time, (...) suggesting timing is a key issue for the psychopathology of schizophrenia. Timing disorders may represent a target for cognitive remediation, but this requires that disorders can be demonstrated at an individual level. Since cognitive impairments in patients with schizophrenia are discrete, and there is no standardized timing exploration, we focused on timing impairments suggested to be related to self disorders. We present the case report of AF, a 22 year old man suffering from schizophrenia, with no antipsychotic intake. Although AF shows few positive and negative symptoms and has a normal neurocognitive assessment, he shows a high level of disturbance of Minimal Self Disorders (SDs) (assessed with the EASE scale). Moreover, AF has a rare ability to describe his self and time difficulties. An objective assessment of timing ability (variable foreperiod task) confirmed that AF had temporal impairments similar to those previously described in patients, i.e., a preserved ability to distinguish time intervals, but a difficulty to benefit from the passage of time to expect a visual stimulus. He presents additional difficulties in benefitting from temporal cues and adapting to changes in time delays. The impairments were ample enough to yield significant effects with analyses at the individual level. Although causal relationships between subjective and objective impairments cannot be established, the results show that exploring timing deficits at the individual level is possible in patients with schizophrenia. Besides, the results are consistent with hypotheses relating minimal self disorders (SDs) to timing difficulties. They suggest that both subjective and objective timing investigations should be developed further so that their use at an individual level can be generalized in clinical practice. (shrink)

The last thirty years have seen a resurgence of interest in virtue among philosophers, psychologists, and educators. This co-authored book brings an interdisciplinary response to the study of virtue: it not only provides a framework for quantifying virtues, but also explores how we can understand virtue in a philosophically-informed way that is compatible with the best current thinking in personality psychology. The volume presents a major contribution to theemerging science of virtue and character measurement.

Recent scholarship (Goodwin & Darley, 2008) on the meta-ethical debate between objectivism and relativism has found people to be mixed: they are objectivists about some issues, but relativists about others. The studies discussed here sought to explore this further. Study 1 explored whether giving people the ability to identify moral issues for themselves would reveal them to be more globally objectivist. Study 2 explored people's meta-ethical commitments more deeply, asking them to provide verbal explanations for their judgments. This revealed that (...) while people think they are relativists, this may not always be the case. The explanations people gave were sometimes rated by outside (blind) coders as being objective, even when given a relativist response. Nonetheless, people remained meta-ethical pluralists. Why this might be is discussed. (shrink)

This study explored the lived experience of security and contentment, and their absence, for latency-aged children living in shared-time parenting arrangements following their parents’ separation. A descriptive phenomenological methodology was utilized. Sixteen children living in shared-time were interviewed about their experiences of two phenomena: “feeling secure and content living in shared-time” and “not feeling secure and content living in shared-time.” The eight richest protocols were selected for analysis. The two resultant general structures and their core constituents are presented, and individual (...) variations discussed. Central to each phenomenon is the parent/s’ capacity, or incapacity, to create and sustain a physical and emotional space in which the child feels secure and held in the mind, feels the arrangements are responsive to their needs, feels free to access the “absent” parent, and experiences integration between the two parental homes. Implications for phenomenological human science research are considered, including the use of descriptive phenomenology with children. (shrink)

The new field of experimental philosophy has emerged as the methods of psychological science have been brought to bear on traditional philosophical issues. Oxford Studies in Experimental Philosophy will be the place to go to see outstanding new work in the field. It will feature papers by philosophers, papers by psychologists, and papers co-authored by people in both disciplines. The series heralds the emergence of a truly interdisciplinary field in which people from different disciplines are working together to address a (...) shared set of questions. The inaugural volume is roughly structured into four sections. The first three papers focus on recent developments in moral psychology, a topic that has seen lively debate and a great deal of progress over the last decade. The second section highlights three contributions that bring new methods to moral psychology: formal modeling and special populations. The third section brings together four papers that adopt an experimental philosophy approach to novel topics, including intuitive dualism, generics, joint action, and happiness. And the last two papers provide critical and historical context to the development of experimental philosophy. (shrink)

Background: Priority setting is necessary in current healthcare services. Discussion of fair process has highlighted the value of developing reasons for allocation decisions on the basis of experience gained from real cases.Aim: To identify the reasons that those with experience of real decision-making concerning resource allocation think relevant in deciding on the priority of a new but expensive drug treatment.Methods: Semistructured interviews with members of committees with responsibility for making resource allocation decisions at a local level in the British National (...) Health Service, analysed using modified grounded theory.Results: 22 interviews were carried out. 14 reasons were identified. Four reasons were almost universally considered most important: cost effectiveness; clinical effectiveness; equality and gross cost. No one reason was considered dominant. Some considerations, such as political directives and fear of litigation, were thought by many participants to distort decision-making. There was a substantial lack of agreement over the relevance of some reasons, such as the absence of alternative treatment for the condition.Conclusions: There is a clear consensus on the importance and role of a limited number of reasons in allocation decisions among participants. A focus on the process of decision-making, however, does not obviate the need for those involved in the process to engage with problematical ethical issues, nor for the importance of further ethical analysis. (shrink)

Nelson et al. (2023) make a unique contribution, raising key questions and considerations about the value of lived experiences as they pertain to normative debates in bioethics. The authors grapple...

The purpose of this study is to take preliminary steps to unify psychoacoustic techniques with reaction-time methodologies to address the perceptual mechanisms responsible for the detection of one vs. multiple sounds. We measured auditory redundancy gains for auditory detection of pure tones widely spaced in frequency using the tools of Systems Factorial Technology to evince the system architecture and workload capacity in two different scenarios. We adopted an experimental design in which the presence or absence of a target at each (...) of two frequencies was combined factorially with two stimulus levels. Replicating previous work, results did not allow an assessment of system architecture due to a failure to observe factor influence at the level of distribution ordering for dual-target stimuli for both SOFT and LOUD scenarios. All subjects demonstrated very modest redundancy gains for the dual-target compared to the single-target stimuli, and results were similar for both LOUD and SOFT. We propose that these results can be predicted by a mental architecture that falls into the class of integrated subadditive parallel systems, using a well-supported assumption that reaction time is driven by loudness. We demonstrate that modeled loudness of the experimental sounds is highly correlated with mean reaction time, and we provide a proof-of-concept model based on Steven’s Power law that predicts both a failure of distributional ordering for dual-target stimuli and very modest redundancy gains. (shrink)

Ethics education in higher education often uses a model that allows students to apply ethical theories to a hypothetical dilemma in order to make a decision. However, it is rare that students directly experience the effects of unethical decision making by others. This paper presents an in-class exercise that provides a concrete experience. The exercise gives students the experience of being the victim of unethical behavior, and subsequently allows them to apply basic ethicaltheories to a real life situation. It is (...) suitable for courses in legal environment of business, ethics, and organizational behavior, at the undergraduate or graduate level. When used in a business ethics class, more emphasis can be placed on developing various ethical constructs. A narrative for how this exercise was used in an undergraduate Legal Environment of Business class is provided, along with a list of other experiential exercises that are available to teach ethics. (shrink)

Examines theism versus atheism as depicted in the re-imagined sci-fi series Battlestar Galactica.

It is a common socio-moral practice to appeal to reasons as a guiding force for one’s actions. However, it is an intriguing possibility that this practice is based on fiction: reasons cannot or do not motivate the majority of actions—especially moral ones. Rather, pre-reflective evaluative processes are likely responsible for moral actions. Such a view faces two major challenges: i.) pre-reflective judgements are commonly thought of as inflexible in nature, and thus they cannot be the cause of the varied judgements (...) people rely on in everyday life, and ii.) if reflective reason-based judgements do not play a strong causative role in judgement, why do people rely on the articulation of reasons in their moral practices? We argue that the pre-reflective judgements motivating moral actions are embodied in nature. The experience of the rightness of an action that drives a person to act depends on the sensorimotor interactions that have cultivated an agent’s perspective on the world. These interactions are embedded in relational contexts, relative to which judgements are individuated. Because of this relational embeddedness they are more flexible than they are commonly thought to be, enabling us to explain the variety of human behavior by appealing to them. The Anglo-European practice of appealing to reason as if they were propositional belief-statements motivating actions can be accounted for as nothing more than an idiosyncratic way of constructing narratives to clarify and express the relational context of intentional actions. (shrink)

Background: When adolescent boys experience close, secure relationships with their parents and peers, the implications are potentially far reaching, including lower levels of mental health problems in adolescence and young adulthood. Here we use rare prospective intergenerational data to extend our understanding of the impact of adolescent attachments on subsequent postpartum mental health problems in early fatherhood.Methods: At age 17–18 years, we used an abbreviated Inventory of Parent and Peer Attachment to assess trust, communication, and alienation reported by 270 male (...) participants in their relationships with mothers, fathers, and peers. More than a decade later, we assessed the adult males, now fathers, at 12 months postpartum for symptoms of depression, anxiety, and stress. Logistic regression was used to examine the extent to which attachment dimensions predicted paternal postpartum mental health, adjusting for potential confounding, and with assessment for interactions between parent and peer attachments.Results: Trust in mothers and peers, and good communication with fathers during adolescence, were associated with 5 to 7 percentage point reductions in postpartum mental health symptoms in early fatherhood. Weak evidence of parent-peer interactions suggested secure attachments with either parent or peer may compensate for an insecure attachment with the other.Conclusions: Our results suggest that fostering trust and communication in relationships that adolescent boys have with parents and peers may have substantial effects on rates of paternal postpartum mental health problems. The protective benefits may be preventative in intergenerational cycles of risk for mental health problems. (shrink)

ABSTRACT We appreciate and respond to Cokelet’s thoughtful criticisms of our book. First, he points to deliberative forms of practical wisdom as objectionable to anti-rationalist’s. In response, we point to non-conscious (yet complex) forms of deliberation that occur as individuals automatically process and respond to virtue-relevant stimuli. Second, Cokelet states that reflecting upon one’s life as a whole may be unnecessary and ineffective for virtue development. We clarify that reflection is not the only means of virtue cultivation, and even flawed (...) reflection is likely helpful. Finally, Cokelet recommends aiming for ‘theoretical neutrality’ by recasting these core tenets as empirical hypotheses. We argue against a neutral perspective that accommodates antirationalist views that we think are on the wrong track. Non-neutral claims help generate testable empirical hypotheses that can move virtue science forward. (shrink)

Our primary aim in this paper is to sketch the account of virtue that we think most amenable to virtue measurement. Our account integrates Whole Trait Theory from psychology with a broadly neo-Aristotelian approach to virtue. Our account is ‘ecumenical’ in that it has appeal for a wide range of virtue ethicists. According to WTT, a personality trait is composed of a set of situation-specific trait-appropriate responses, which are produced when certain “social-cognitive” mechanisms are triggered by the perception of trait-relevant (...) stimuli in a person’s external and/or internal environment. Moving from this starting point, we discuss our conception of a virtue and respects in which it both aligns with and diverges from Aristotle’s conception. We discuss roles for practical wisdom and motivation in our conception of virtue, and highlight respects in which WTT provides an amenable empirical framework into which key Aristotelian elements can be integrated. We conclude with brief remarks about our conception as an empirically adequate and measurable account. (shrink)

Our primary aim in this paper is to sketch the account of virtue that we think most amenable to virtue measurement. Our account integrates Whole Trait Theory from psychology with a broadly neo-Aristotelian approach to virtue. Our account is ‘ecumenical’ in that it has appeal for a wide range of virtue ethicists. According to WTT, a personality trait is composed of a set of situation-specific trait-appropriate responses, which are produced when certain “social-cognitive” mechanisms are triggered by the perception of trait-relevant (...) stimuli in a person’s external and/or internal environment. Moving from this starting point, we discuss our conception of a virtue and respects in which it both aligns with and diverges from Aristotle’s conception. We discuss roles for practical wisdom and motivation in our conception of virtue, and highlight respects in which WTT provides an amenable empirical framework into which key Aristotelian elements can be integrated. We conclude with brief remarks about our conception as an empirically adequate and measurable account. (shrink)

Our primary aim in this paper is to sketch the account of virtue that we think most amenable to virtue measurement. Our account integrates Whole Trait Theory from psychology with a broadly neo-Aristotelian approach to virtue. Our account is ‘ecumenical’ in that it has appeal for a wide range of virtue ethicists. According to WTT, a personality trait is composed of a set of situation-specific trait-appropriate responses, which are produced when certain “social-cognitive” mechanisms are triggered by the perception of trait-relevant (...) stimuli in a person’s external and/or internal environment. Moving from this starting point, we discuss our conception of a virtue and respects in which it both aligns with and diverges from Aristotle’s conception. We discuss roles for practical wisdom and motivation in our conception of virtue, and highlight respects in which WTT provides an amenable empirical framework into which key Aristotelian elements can be integrated. We conclude with brief remarks about our conception as an empirically adequate and measurable account. (shrink)

Our primary aim in this paper is to sketch the account of virtue that we think most amenable to virtue measurement. Our account integrates Whole Trait Theory from psychology with a broadly neo-Aristotelian approach to virtue. Our account is ‘ecumenical’ in that it has appeal for a wide range of virtue ethicists. According to WTT, a personality trait is composed of a set of situation-specific trait-appropriate responses, which are produced when certain “social-cognitive” mechanisms are triggered by the perception of trait-relevant (...) stimuli in a person’s external and/or internal environment. Moving from this starting point, we discuss our conception of a virtue and respects in which it both aligns with and diverges from Aristotle’s conception. We discuss roles for practical wisdom and motivation in our conception of virtue, and highlight respects in which WTT provides an amenable empirical framework into which key Aristotelian elements can be integrated. We conclude with brief remarks about our conception as an empirically adequate and measurable account. (shrink)

This edited collection examines the means to create, maintain, and enhance positive educational experiences at colleges and universities in the United States and abroad with personal accounts, case studies, models, programs, and other frameworks written by practitioners in higher education.

This volume examines some of the most contentious social justice issues present in the corpus of Augustine's writings. Whether one is concerned with human trafficking and the contemporary slave trade, the global economy, or endless wars, these essays further the conversation on social justice as informed by the writings of Augustine of Hippo.

In 2018-2019, at the Keck School of Medicine of the University of Southern California, we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients’ life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the “life narrative protocol” from multiple stakeholder positions and characterize participants’ experiences of the clinical and pedagogical implications of the LNP. Students were recruited from (...) KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students’, patients’, and staff’s perspectives. Three themes emerged from the thematic analysis: patients’ life narratives conveyed their unique life experiences and voices; the protocol could result in wide-ranging effects on HIV care; the LNP enabled students to contribute value to patients’ healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented. (shrink)

Business and love appear to have little to do with each other. We hold the opposite to be true if the concept of love in business draws from two corresponding grammars. This paper contributes to the ‘agenda for growth and affirmation of people and the environment’ in business. By focusing on the grammars of love and business we operationalize the concept of love in ways that business executives, managers and employees can understand, adopt, and implement. With references to the theory (...) and practice of management and organizations, we aim to contribute to expanding the theory and practice of responsible organizations and their leaders caring for others. (shrink)