Policy often focuses on reducing health care disparities through interventions at the patient and provider level. While unquestionably important, system-wide reforms to reduce uninsurance, improve geographic availability of services, increase workforce diversity, and promote clinical best practices are essential for progress in reducing disparities.

As this nation embarks on new efforts to reform the U.S. health system, we face a critical unfinished agenda from the mid- 1960s: persistent racial, ethnic, and socioeconomic disparities in health and health care. Medicaid, Medicare, and Community Health Centers — public programs with very different legislative histories and financing mechanisms — were the first federally funded, nationwide efforts to improve health care access for low-income and elderly Americans. Members of racial and ethnic minority groups also greatly benefited from these (...) efforts because recipients of federal funds, such as Medicare, were required to comply with the newly passed Civil Rights Act of 1964, which barred racial discrimination. Unquestionably, government played a major role in the gains in health care access that have occurred in the last half century. Yet today all Americans do not have the same opportunities for health, access to care, or quality of care when they receive it. (shrink)

Reflections on moral discourse and its contexts are provided and the authors discuss the nature and tasks of moral philosophy. The collection creates a dialogue between different philosophical views.

Descartes's concept of the mind, as distinct from the body with which it forms a union, set the agenda for much of Western philosophy's subsequent reflection on human nature and thought. This is the first book to give an analysis of Descartes's pivotal concept that deals with all the functions of the mind, cognitive as well as volitional, theoretical as well as practical and moral. Focusing on Descartes's view of the mind as intimately united to and intermingled with the body, (...) and exploring its implications for his philosophy of mind and moral psychology, Lilli Alanen argues that the epistemological and methodological consequences of this view have been largely misconstrued in the modern debate. Informed by both the French tradition of Descartes scholarship and recent Anglo-American research, Alanen's book combines historical-contextual analysis with a philosophical problem-oriented approach. It seeks to relate Descartes's views on mind and intentionality both to contemporary debates and to the problems Descartes confronted in their historical context. By drawing out the historical antecedents and the intellectual evolution of Descartes's thinking about the mind, the book shows how his emphasis on the embodiment of the mind has implications far more complex and interesting than the usual dualist account suggests. (shrink)

Drawing on constructionist theory, this study examines how the media portrayed five public reporting events initiated by the Fair Labor Association (FLA), considering whether the coverage encourages or discourages companies from undertaking a reporting initiative as part of their ethical management. Media coverage was limited but generally favorable across all five events. Coverage frequently included claims made by FLA spokespersons and provided basic facts about the organization and its activities. Extensive detail about labor violations found by monitors was often included. (...) Additional media coverage centered around themes of public reporting and transparency, an assessment of the FLA’s work, brand accountability and responsibility of corporations with regard to working conditions and labor standards, and specifics about the factory monitoring and partnering with factories and NGOs that is necessary to achieve change. Counter-claims brought question to the FLA’s efforts. Explanations about why the social condition exists were fairly limited, and thus, provided little insight into how the problems might be resolved. We discuss managerial implications regarding public reporting initiatives and media coverage, particularly regarding the countering effects of positive coverage and diminishing news stories. (shrink)

This paper presents an overview of the key ethical questions of performing gene editing research on military service members. The recent technological advance in gene editing capabilities provided by CRISPR/Cas9 and their path towards first-in-human trials has reinvigorated the debate on human enhancement for non-medical purposes. Human performance optimization has long been a priority of military research in order to close the gap between the advancement of warfare and the limitations of human actors. In spite of this focus on temporary (...) performance improvement, biomedical enhancement is an extension of these endeavours and the ethical issues of such research should be considered. In this paper, we explore possible applications of CRISPR to military human gene editing research and how it could be specifically applied towards protection of service members against biological or chemical weapons. We analyse three normative areas including risk–benefit analysis, informed consent, and inequality of access as it relates to CRISPR applications for military research to help inform and provide considerations for military institutional review boards and policymakers. (shrink)

This is the first book to give an analysis of Descartes's pivotal concept that deals with all the functions of the mind, cognitive as well as volitional, ...

Discussions of the account of judgment offered in the Fourth Meditation tend to focus on its role in Descartes' epistemology and his response to skepticism. The main focus of the Fourth Meditation is the true and the false, and it completes the discussion conducted in the Second and Third Meditation about truth and falsity and the proper use of the truth rule. This chapter summarizes Descartes' view of the nature of judgment before examining more closely the account of the will (...) unfolding in the Fourth Meditation, and the kind of indifference Descartes appeals to in defending his controversial doctrine of free choice. Descartes' problematic account of the will and its freedom is developed in an epistemological and theodical context, the aim being to warrant the truth rule and, perhaps even more importantly, to draw a line between God's and our own responsibility for our cognitive errors. (shrink)

Mentoring Away the Glass Ceiling in Academia: A Cultured Critique describes how women of diverse backgrounds perceive their mentoring experiences or the lack of mentoring experiences in the academy. This book provides a space for envisioning strategies and practices to improve mentoring practices and the collegiate environment.

Much has changed in maternal-fetal medicine since the early 2000s, when the previous ethical frameworks for fetal therapy trials were established. We applaud Hendriks and colleagues for taking on t...

Today the halls of Technology, Entertainment, and Design and Davos reverberate with optimism that hacking, brainstorming, and crowdsourcing can transform citizenship, development, and education alike. This article examines these claims ethnographically and historically with an eye toward the kinds of social orders such practices produce. This article focuses on a hackathon, one emblematic site of social practice where techniques from information technology production become ways of remaking culture. Hackathons sometimes produce technologies, and they always, however, produce subjects. This article argues (...) that the hackathon rehearses an entrepreneurial citizenship celebrated in transnational cultures that orient toward Silicon Valley for models of social change. Such optimistic, high-velocity practice aligns, in India, with middle-class politics that favor quick and forceful action with socially similar collaborators over the contestations of mass democracy or the slow construction of coalition across difference. (shrink)

This chapter contains section titled: Introductory Remarks The Cartesian Background Impressions and Ideas Passions as Reflective Impressions Direct and Indirect Passions Association and the Individuation of Passions Perception and Perceiving Passions and Moral Sentiments Notes References Further reading.

At least 177 scales are available to researchers who want to measure religiosity, but questions exist as to exactly what these scales are measuring and in whom they are measuring it. A review of these scales found a lack items designed to measure ethical action in society or the world as a prophetic response to the experience of the divine. Instead, the vast majority of scales focus on internal experiences and beliefs or institutional relationships. A review of scale norm groups (...) found that norm groups often are not fully described, particularly in the area of race/ethnicity, and when they are described, they reveal an over-reliance on convenience samples of college students and an under-representation of racial/ethnic minority groups. Examples of scales with more fully described and more representative norm groups are given, and recommendations are offered for researchers using and developing religiosity scales. (shrink)

Hume is famous for his criticism of substantial minds, free will, and self-consciousness—central elements in traditional philosophical accounts of persons. His empiricism dissolves self-inspecting minds into heaps of distinct perceptions and turns cognitive faculties into successions of causally related, discrete impressions and ideas. Whatever regularities the complex ideas and their bundles or heaps display are explained by laws of association of ideas, which are supposed to play the same role in the mental world as Newton’s laws of gravitation play in (...) physical nature. This paper explores some strands of the new science of man proposed in Hume’s Treatise, in particular his account of personal identity.. (shrink)

The quality of early childhood education and care (ECEC) is important for children’s development. One instrument that was developed to assess an aspect of ECEC quality is the Classroom Assessment Scoring System for pre-kindergarten children (CLASS Pre-K). We examined the factorial validity of the instrument using data from 177 German preschool classrooms. The three-factor teaching through interaction model (Hamre et al., 2013) was contrasted to a one-factor, a two-factor, and a bifactor model as proposed by Hamre et al. (2014). Our (...) results indicated that the three-factor structure with the domains of emotional support, classroom organization, and instructional support fit the data best. The fit of the teaching through interaction model was satisfying after adding a cross-loading of the dimension language modeling on emotional support, and two correlated residuals. Evidence of convergent and discriminant validity are provided. In terms of factor structure and pattern score comparisons, the results were similar to previous U.S. and German studies. The discussion concerns the justifiability of the factor model revisions and draws directions for further research. We concluded that our study offers further evidence of the applicability of the CLASS Pre-K for the assessment of teacher-child interaction quality in the German context. (shrink)

Nietzsche and Freud saw Christianity as metaphysical escapism, with Nietzsche calling the religion a "Platonism for the masses" and faulting Paul the apostle for negating more immanent, material modes of thought and political solidarity. Integrating this debate with the philosophies of difference espoused by Gilles Deleuze, Michel Foucault, Jacques Derrida, Jacques Lacan, and Pier Paolo Pasolini, Ward Blanton argues that genealogical interventions into the political economies of Western cultural memory do not go far enough in relation to the imagined (...) founder of Christianity. Blanton challenges the idea of Paulinism as a pop Platonic worldview or form of social control. He unearths in Pauline legacies otherwise repressed resources for new materialist spiritualities and new forms of radical political solidarity, liberating "religion" from inherited interpretive assumptions so philosophical thought can manifest in risky, radical freedom. (shrink)

Domestic violence is a growing societal concern that often spills over into the workplace. However, employers are not recognizing the spillover of domestic violence as a workplace issue. This is problematic considering the serious financial, legal, and ethical consequences for organizations. We analyzed six cases involving domestic violence that were litigated under specific legal bases: Violence Against Women Act, discrimination laws including Title VII, Family and Medical Leave Act, Americans with Disabilities Act, Social Security Disability, Occupational Safety and Health Act, (...) and associated state and municipal ordinances. We chose cases that illustrate the problems of companies meeting the legal standards but not necessarily reaching ethical expectations. Our approach is congruent with the perspective that both legal and ethical analyses should be used in organizational decision making. We suggest for future research the analysis of additional litigated cases, other ethical perspectives, and additional sources of data. In addition, we suggest that companies who are striving for corporate social responsibility should integrate the ethical treatment of domestic violence victims. (shrink)

Modern American nursing has an extensive ethical heritage literature that extends from the 1870s to 1965 when the American Nurses Association issued a policy paper that called for moving nursing education out of hospital diploma programs and into colleges and universities. One consequence of this move was the dispersion of nursing libraries and the loss of nursing ethics textbooks, as they were largely not brought over into the college libraries. In addition to approximately 100 nursing ethics textbooks, the nursing ethics (...) heritage literature also includes hundreds of journal articles that are often made less accessible in modern databases that concentrate on the past 20 or 30 years. A second consequence of nursing’s movement into colleges and universities is that ethics was no longer taught by nursing faculty, but becomes separated and placed as a discrete ethics course in departments of philosophy or theology. These courses were medically identified and rarely incorporated authentic nursing content. This shift in nursing education occurs contemporaneously with the rise of the field of bioethics. Bioethics is rapidly embraced by nursing, and as it develops within nursing, it fails to incorporate the rich ethical heritage, history, and literature of nursing prior to the development of the field of bioethics. This creates a radical disjunction in nursing’s ethics; a failure to more adequately explore the moral identity of nursing; the development of an ethics with a lack of fit with nursing’s ethical history, literature, and theory; a neglect of nursing’s ideal of service; a diminution of the scope and richness of nursing ethics as social ethics; and a loss of nursing ethical heritage of social justice activism and education. We must reclaim nursing’s rich and capacious ethics heritage literature; the history of nursing ethics matters profoundly. (shrink)

This paper reflects on the status of Descartes' notion of the mind-body union as an object of knowledge in the framework of his new philosophy of nature, and argues that it should be taken seriously as representing a third kind of real thing or reality—that of human nature. Because it does not meet the criteria of distinctness that the two natures composing it—those of thinking minds and extended bodies— meet, the phenomena referred to it, which are objects of psychology as (...) traditionally understood, fall outside the scope of clear and distinct perception required for knowledge. The prospects for rationalist psychology are bleak, since because of the mind-body union so little of the contents of the human mind are accessible to rational inspection or introspection. Mechanistic natural philosophy on the other hand gives us knowledge only of the physiological and corporeal aspects of the phenomena Descartes classifies as mental. What pertains to the mind-body union can only be known through the senses, moreover, we learn to conceive the mind-body union only through daily experience (“usant seulement de la vie et des conversations ordinaries”, AT 3, 695). I discuss the nature of this experience, and the sense in which Cartesian psychology without being part of his philosophy of nature in the strict sense of the term, can still be seen as a naturalist undertaking in a more traditional sense of nature where life, sentience, reasoning and rational action are all seen as natural phenomena. (shrink)

In this introduction, we address some of the complexities associated with the emergence of medicine’s bodies, not least as a means to ‘working with the body’ rather than simply producing a critique of medicine. We provide a brief review of some of the recent discussions on how to conceive of medicine and its bodies, noting the increasing attention now given to medicine as a technology or series of technologies active in constituting a multiplicity of entities – bodies, diseases, experimental objects, (...) the individualization of responsibility for health and even the precarity of life. We contrast what feminist theorists in the tradition of Judith Butler have referred to as the question of matter, and Science and Technology Studies with its focus on practice and the nature of emergence. As such we address tensions that exist in analyses of the ontological status of ‘the body’ – human and non-human – as it is enacted in the work of the laboratory, the randomized controlled trial, public health policy and, indeed, the market that is so frequently entangled with these spaces. In keeping with the recent turns toward ontology and affect, we suggest that we can regard medicine as concerned with the contraction and reconfiguration of the body’s capacities to affect and be affected, in order to allow for the subsequent proliferation of affects that, according to Bruno Latour, marks corporeal life. Treating both contraction and proliferation circumspectly, we focus on the patterns of affects wrought in particular by the abstractions of medicine that are described in the contributions to this special issue. Drawing on the work of A.N. Whitehead, we note how abstractions such as ‘medical evidence’, the ‘healthy human body’ or the ‘animal model’ are at once realized and undercut, mediated and resisted through the situated practices that eventuate medicine’s bodies. Along the way, we touch on the implications of this sort of perspective for addressing the distribution of agency and formulations of the ethical and the political in the medical eventuations of bodies. (shrink)

This paper explores Spinoza’s therapy of passions and method of salvation through knowledge and love of God. His optimism about this method is perplexing: it is not even clear how his God, who is unlike any traditional notion of divinity, can be loved. Sorting out Spinoza’s view involves distinguishing an ethics of bondage from another of freedom, and two corresponding notions of love of God. The paper argues that the highest kind of love—‘pure intellectual love of God’—should not be understood (...) as an affect at all, but instead as unimpeded intellectual activity. This suggestion requires reconsidering Spinoza’s account of cognition, particularly his use of the Cartesian notions of objective and formal reality which are not only central to his theory of ideas but constitute the foundations of his salvation project. (shrink)

At least 177 scales are available to researchers who want to measure religiosity, but questions exist as to exactly what these scales are measuring and in whom they are measuring it. A review of these scales found a lack items designed to measure ethical action in society or the world as a prophetic response to the experience of the divine. Instead, the vast majority of scales focus on internal experiences and beliefs or institutional relationships. A review of scale norm groups (...) found that norm groups often are not fully described, particularly in the area of race/ethnicity, and when they are described, they reveal an over-reliance on convenience samples of college students and an under-representation of racial/ethnic minority groups. Examples of scales with more fully described and more representative norm groups are given, and recommendations are offered for researchers using and developing religiosity scales. (shrink)

Discharge planning for vulnerable infants and children is a collaborative, inter-disciplinary, decision-making activity that is grounded in the ethical complexities of clinical practice. Although it is a psychosocial intervention that frequently causes moral distress for professionals and has the potential to inflict harm on children and their families, the process has received little attention from ethicists. An ongoing study of the transition of technology-dependent children from hospital to home suggests that the ethical issues embedded in the discharge-planning process may be (...) concealed by dominant cultural values, institutional policies, clinical standards, historical precedents, and legal regulations. (shrink)

Constructing Race on the Borders of Europe investigates the visual imagery (in painting, photography, prints, film, and design) of race construction primarily in Scandinavia and the empires of Austro-Hungary, Germany, and Russia at a time when the disciplines of ethnography and anthropology were expanding and publications on race were debating competing theories of biological, geographic, linguistic, and cultural determinants. These regions, while on the periphery of continental Europe, largely marginalized in the scholarship of nineteenth-century art history, and ignored by Edward (...) Said (Orientalism 1978), have been central locations for theorizing white identity and for containing diverse ethnic populations that have generated substantive ethnographic study and regional conflicts since the eighteenth century. This anthology explores art that engaged with ethnography and anthropology to shape visual representations of subordinate ethnic populations and material cultures, both indigenous (Roma, Sámi, Inuit, and Celts) and migrant or colonial (Muslims and Blacks), chiefly between 1850 and 1930, but extending into the early twenty-first century. The essays in this book contribute to postcolonial research by documenting colonial-style treatment of minority groups and by seeking to qualify binary systems through explorations of anomalies, complexities, and contradictions that emerge when seen from the perspective of the fine and applied arts. This book presents a range of different artistic voices that responded to ethnographic and anthropological information by producing images or objects that adopted, altered, or critiqued that information. The authors seek to uncover instances of connections and variability, to establish the fabricated nature of ethnic identity, and to challenge the certainties of racial categorization. (shrink)

An oversize volume celebrates the National Ranching Heritage Center, a museum and historical park located on the northern edge of the Texas Tech University campus in Lubbock, established to preserve the history of ranching, pioneer life, and the development of the livestock industry in North America.

This paper examines Descartes's third primary notion and the distinction between different kinds of knowledge based on different and mutually irreducible primary notions. It discusses the application of the notions of clearness and distinctness to the domain of knowledge based on that of mind-body union. It argues that the consequences of the distinctions Descartes is making with regard to our knowledge of the human mind and nature are rather different from those that have been attributed to Descartes due to the (...) influential Rylean picture of Cartesian mind-body dualism. (shrink)

There are two main strands in the afterlife of Descartes’s famous redefinition of mind in terms of thinking likely to color one’s reading of his notion of mind or self. The one stressed most by his posterity and developed from early on in the empiricist tradition sees consciousness as its main characteristic. The other focuses on reason and rationality. This paper discusses the textual support for the first reading promoted by Ryle and his followers and aligns itself with the second (...) arguing that it is the exercise of its rational, cognitive capacities that are essential to the Cartesian mind and not consciousness, which is merely a presupposition for its rational activity. It examines the interrelation and respective roles of awareness on the one hand, and reason on the other in Descartes’s account of mind or self. But it also suggests that the role given by Descartes to the will in judgment and his separation of will and intellect into two distinct powers may be seen as contributing to a transformation of the very notion of reason and of self as a cognitive and moral agent. (shrink)

United States law recognizes adult reproductive liberty and many states view surrogacy services through that lens. During the COVID-19 pandemic in March, 2020, New York State enacted the Child–Pare...

The ArgumentThis article uses the history of early sound recording technology in the united States between 1878 and 1915 to show how published discourse contributed to the way the talking machine was defined and situated as a commercially viable product. Comparing the published accounts of Edison's phonograph and Berliners gramophone in popular scientific articles between 1878 and 1896 illustrates that technological advances in sound recording technology take on important cultural meanings. Critical to these meanings is the way in which the (...) technological “fidelity” is linguistically transformed into an aesthetic quality, projected and interpreted within demonstrable values of musical culture. Beginning in 1902, the Victor Talking Machine Company, formed to market the gramophone, took advantage of these cultural meanings to claim a technological advantage over Edison's cylinder recorder. Whose voice was recorded became part of the claim to technological superiority. The Victor Company succeeded in capitalizing “Culture” by promoting their recordings of opera stars like Enrico Caruso as technologically and culturally faithful to live musical performance and as a democratically available access to a privileged lifestyle. Thus did the Victor Company use a terrier and a tenor to legitimate their talking machine as an American musical instrument. (shrink)

This paper discusses the interrelations between three aspects of human emotions: their intentionality, their expressivity and their moral significance. It distinguishes three kinds of philosophical views of emotions: the cognitivist (classically held by the Stoics), the emotivist which reduces emotions to non-intentional bodily sensations and physiological states, and the moral phenomenologist, the latter being held by Annette Baier, whose work is the focus of the discussion. Her view, which represents an original development of ideas found in Descartes and Hume, avoids (...) the reductionism of congitivist and emotivist accounts. The paper gives special attention to her notion of 'deep' objects of emotions and to her account of the expressivity of emotions, arguing that while the first is problematic, the second is a significant contribution to our understanding of the role of emotions in our moral lives. (shrink)