Background:Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas.Aims:To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice.Design:An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general hospital in England were interviewed, (...) using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification.Participants and context:Participants were interviewed about their contribution to the resolution of ethical dilemmas within the context of working in an acute hospital ward. Participants were recruited from all settings working with patients of any age and any diagnosis.Ethical considerations:Ethical approval was obtained from the local National Research Ethics Committee.Findings:Four major themes emerged: ‘best for the patient’, ‘accountability’, ‘collaboration and conflict’ and ‘concern for others’. Moral distress was also evident in the literature and findings, with moral dissonance recognised and articulated by more experienced nurses. The relatively small, single-site sample may not account for the effects of organisational culture on the results; the findings suggested that professional relationships were key to resolving ethical dilemmas.Discussion:Nurses use their moral reasoning based on their beliefs and values when faced with ethical dilemmas. Subsequent actions are mediated though ethical decision-making frames of reference including deontology, consequentialism, the ethics of care and virtue ethics. Nurses use these in contributing to the resolution of these dilemmas. Nurses require the skills to develop and maintain professional relationships for addressing ethical dilemmas and to engage with political and organisational macro- and micro-decision-making.Conclusion:Nurses’ professional relationships are central to nurses’ contributions to the resolution of ethical dilemmas. (shrink)

BackgroundThe evolution of the female orgasm in humans and its role in romantic relationships is poorly understood. Whereas the male orgasm is inherently linked to reproduction, the female orgasm is not linked to obvious reproductive or survival benefits. It also occurs less consistently during penetrative sex than does the male orgasm. Mate-choice hypotheses posit that the wide variation in female orgasm frequency reflects a discriminatory mechanism designed to select high-quality mates.ObjectiveWe aimed to determine whether women report that their orgasm frequency (...) varies between partners, whether this variation reflects mates' personal characteristics, and whether this variation reflects own and partner sexual behaviour during intercourse.DesignWe collected survey data from 103 women who rated the extent to which their orgasm frequency varied between partners, the characteristics of previous sexual partners who induced high-orgasm frequency and those who induced low-orgasm frequency,... (shrink)

This handbook presents a comprehensive introduction to the core areas of philosophy of education combined with an up-to-date selection of the central themes. It includes 95 newly commissioned articles that focus on and advance key arguments; each essay incorporates essential background material serving to clarify the history and logic of the relevant topic, examining the status quo of the discipline with respect to the topic, and discussing the possible futures of the field. The book provides a state-of-the-art overview of philosophy (...) of education, covering a range of topics: Voices from the present and the past deals with 36 major figures that philosophers of education rely on; Schools of thought addresses 14 stances including Eastern, Indigenous, and African philosophies of education as well as religiously inspired philosophies of education such as Jewish and Islamic; Revisiting enduring educational debates scrutinizes 25 issues heavily debated in the past and the present, for example care and justice, democracy, and the curriculum; New areas and developments addresses 17 emerging issues that have garnered considerable attention like neuroscience, videogames, and radicalization. The collection is relevant for lecturers teaching undergraduate and graduate courses in philosophy of education as well as for colleagues in teacher training. Moreover, it helps junior researchers in philosophy of education to situate the problems they are addressing within the wider field of philosophy of education and offers a valuable update for experienced scholars dealing with issues in the sub-discipline. Combined with different conceptions of the purpose of philosophy, it discusses various aspects, using diverse perspectives to do so. Contributing Editors: Section 1: Voices from the Present and the Past: Nuraan Davids Section 2: Schools of Thought: Christiane Thompson and Joris Vlieghe Section 3: Revisiting Enduring Debates: Ann Chinnery, Naomi Hodgson, and Viktor Johansson Section 4: New Areas and Developments: Kai Horsthemke, Dirk Willem Postma, and Claudia Ruitenberg. (shrink)

BackgroundMulti-centre studies generally cost more than single-centre studies because of larger sample sizes and the need for multiple ethical approvals. Multi-centre studies include clinical trials, clinical quality registries, observational studies and implementation studies. We examined the costs of two large Australian multi-centre studies in obtaining ethical and site-specific approvals.MethodsWe collected data on staff time spent on approvals and expressed the overall cost as a percent of the total budget.ResultsThe total costs of gaining approval were 38 % of the budget for (...) a study of 50 centres (mean cost AUD $6960 per site) and 2 % for a study of 11 centres (mean cost AUD $2300 per site). Seventy-five and 90 % of time was spent on repeated tasks, respectively, and many time-consuming tasks, such as reformatting documents, did nothing to improve the study design or participant safety.ConclusionsImprovements have been made to the ethical approval application system, but more gains could be made without increasing risks of harm to research participants. We propose that ethical review bodies and individual sites publish statistics on how long they take to process approvals which could then be nationally benchmarked. (shrink)

Empirical research in this field has underlined the diversity of the cohabitation population, the existence of the common law marriage myth and the lack of consensus on the best way forward for reform of the law in England and Wales. Against the backdrop of the English Law Commission’s on-going project on cohabitation law, this article will explore the reasons found by recent research for people’s choice of cohabitation over marriage, the interrelationship between commitment and economic vulnerability and the tension in (...) feminist debates as to whether an extension of rights for opposite-sex cohabitants that are analogous to married spouses (either by an opt-in model or opt-out model) might be an appropriate solution or a reinforcement of patriarchal marriage values. It will also consider, given recent research findings and other initiatives aimed at raising awareness about the legal differences between different styles of cohabitation relationship, law’s dual and conflicting role in shaping regulated family structures whilst both protecting vulnerable family members inside and outside such structures and at the same time also offering socially acceptable standards of dispute resolution in this most personal of spheres. (shrink)

We propose that marketing of unhealthy foods and beverages to Black and Latino consumers results from the intersection of a business model in which profits come primarily from marketing an unhealthy mix of products, standard targeted marketing strategies, and societal forces of structural racism, and contributes to health disparities.

We used Discursive Psychology to study the claims and arguments which occur when ‘the child’s best interests’ is produced as a resource in family mediation settings. Analysis draws on data from three pairs of separated or separating parents attempting to resolve child contact or residency disputes through mediation. Our analysis focuses on the tendency of claims to the abstract notion of the child’s best interests to exacerbate conflict, especially as parents drew on conflicting research in this area. Changing expectations of (...) fathering could be observed in the men’s argumentative positioning, and this was taken up in different ways by ex-partners and by mediators. Participants aligned themselves with mediators’ statements by picking up details of mediators’ language, hampering mediators’ attempted neutrality. The problematic nature of acknowledging the intensity of emotions in this process was also highlighted. (shrink)

Certified nursing assistants (CNAs) provide the majority of direct care to nursing home residents in the United States and, therefore, are keys to ensuring optimal health outcomes for this frail older adult population. These diverse direct care workers, however, are often not recognized for their important contributions to older adult care and are subjected to poor working conditions. It is probable that social‐based discrimination lies at the core of poor treatment toward CNAs. This review uses perspectives from critical social theory (...) to explore the phenomenon of social‐based discrimination toward CNAs that may originate from social order, power, and culture. Understanding manifestations of social‐based discrimination in nursing homes is critical to creating solutions for severe disparity problems among perceived lower‐class workers and subsequently improving resident care delivery. (shrink)

Next SectionPublic and healthcare professionals differ in their attitudes towards euthanasia and physician-assisted suicide (PAS), the legal status of which is currently in the spotlight in the UK. In addition to medical training and experience, religiosity, locus of control and patient characteristics (eg, patient age, pain levels, number of euthanasia requests) are known influencing factors. Previous research tends toward basic designs reporting on attitudes in the context of just one or two potentially influencing factors; we aimed to test the comparative (...) importance of a larger range of variables in a sample of nursing trainees and non-nursing controls. One hundred and fifty-one undergraduate students (early-stage nursing training, late-stage nursing training and non-nursing controls) were approached on a UK university campus and asked to complete a self-report questionnaire. Participants were of mixed gender and were on average 25.5 years old. No significant differences in attitude were found between nursing and non-nursing students. There was a significant positive correlation between higher religiosity and positive attitude toward euthanasia (r=0.19, p<0.05) and a significant negative relationship between internal locus of control and positive attitude toward PAS (r=−0.263, p<0.01). Multivariate analyses revealed differing predictor models for attitudes towards euthanasia and PAS, and confirm the importance of individual differences in determining these attitudes. The unexpected direction of association between religiosity and attitudes may reflect a broader cultural shift in attitudes since earlier research in this area. Furthermore, these findings suggest it possible that experience, more than training itself, may be a bigger influence on attitudinal differences in healthcare professionals. (shrink)

Since the introduction and widespread adoption of chemical herbicides, “weed management” has become almost synonymous with “herbicide management.” Over-reliance on herbicides and herbicide-resistant crops has given rise to herbicide resistant weeds. Integrated weed management (IWM) identifies three strategies for weed management— biological-cultural, chemical-technological, mechanical-physical—and recommends combining all three to mitigate herbicide resistance. However, adoption of IWM has stalled, and research to understand the adoption of IWM practices has focused on single stakeholder groups, especially farmers. In contrast, decisions about weed management (...) often occur within a social ecosystem where multiple stakeholder groups co-create knowledge and practices. To more holistically investigate perceptions and decision-making related to herbicide resistant weed management, we conducted 23 in-depth interviews in combination with Q methodology with farmers and public-/private-sector agricultural professionals in the state of Georgia (U.S.). Our investigation focused on the management of an increasingly herbicide resistant weed, Palmer amaranth, which enabled broader conversations about agricultural systems, farmer livelihoods, and sustainability. Factor and thematic analyses allowed us to identify and characterize two distinct typologies: one primarily valued agronomic efficiency and relied upon chemical-technological management practices, while the other valued diversifying weed management strategies as the pathway to agronomic and economic success. Typologies diverged substantially in attitudes toward the three weed management strategies, the role of technology, and systems management generally. These two viewpoints have implications for how we understand underlying stakeholder motivations and choices around weed management strategies, both of which are crucial in promoting and supporting farmer use of diverse, ecologically-sound, weed management strategies. (shrink)

This article shares reflections from members of the community of philosophers of education in the United States and Canada who were invited to express their insights in response to the theme ‘Snaps...

Glioblastoma is a brain tumor condition marked by rapid neurological and clinical demise, resulting in disproportionate disability for those affected. Caring for this group of patients is complex, intense, multidisciplinary in nature, and fraught with the need for expensive treatments, surveillance imaging, physician follow-up, and rehabilitative, psychological, and social support interventions. Few of these patients return to the workforce for any meaningful time frame, and because of the enormity of the financial burden that patients, their caregivers, and society face, utilization (...) reviews become the focus of ethical scrutiny. (shrink)

While primary malignant brain tumors account for only two percent of all adult cancers, these neoplasms cause a disproportionate amount of cancer-related disabilities and death. The five-year survival rates for brain tumors are the third lowest among all types of cancer. Malignant gliomas comprise the most common types of primary central nervous system tumors and have a combined incidence of five to eight cases per 100,000 people. The median survival rate of conservatively treated patients with malignant gliomas is 14 weeks; (...) with surgical resection alone, 20 weeks; with surgery and radiation, 36 weeks; and with the addition of newer biochemotherapies such as temozolomide and bevacizumab, upward of 14-18 months.The profound cost of caring for terminally ill patients with primary malignant brain tumors raises ethical considerations for the American public; the stewardship of health care dollars for the population at large maintains a juxtaposed tension against a dynamic, necessary balance of hope, care, rehabilitation and research efforts for affected patients and their advocates. (shrink)

We define an order independent version of default unification on typed feature structures. The operation is one where default information in a feature structure typed with a more specific type, will override default information in a feature structure typed with a more general type, where specificity is defined by the subtyping relation in the type hierarchy. The operation is also able to handle feature structures where reentrancies are default. We provide a formal semantics, prove order independence and demonstrate the utility (...) of this version of default unification in several linguistic applications. First, we show how it can be used to define multiple orthogonal default inheritance in the lexicon in a fully declarative fashion. Secondly, we show how default lexical specifications (introduced via default lexical inheritance) can be made to usefully persist beyond the lexicon and interact with syntagmatic rules. Finally, we outline how persistent default unification might underpin default feature propagation principles and a more restrictive and constraint-based approach to lexical rules. (shrink)

Renaissance philosopher, mathematician, and theologian Nicholas of Cusa (1401-1464) said that there is no proportion between the finite mind and the infinite. He is fond of saying reason cannot fully comprehend the infinite. That our best hope for attaining a vision and understanding of infinite things is by mathematics and by the use of contemplating symbols, which help us grasp "the absolute infinite". By the late 19th century, there is a decisive intervention in mathematics and its philosophy: the philosophical mathematician (...) Georg Cantor (1845-1918) says that between the realm of the finite and the absolute infinite, there is an intermediate realm partaking in properties in a certain sense of both the finite and the infinite: the transfinite realm. Like the finite, the transfinite realm is a realm of mathematical objects, numbers, and knowledge. Like the absolute infinite, the transfinite is a form of infinity insofar as transfinite sets and numbers transcend any finite number. Echoing Cusanus and neo-Platonism, Cantor says that the transfinite sequence of all ordinals is a symbol of the absolutely infinite, that is, God. This paper considers how the doctrine of symbolism and the philosophers' different commitments to the laws of logic, especially the Law of Non-Contradiction (LNC), enables these thinkers to articulate a transcendental apophatic approach to divinity. (shrink)

Renaissance philosopher, mathematician, and theologian Nicholas of Cusa (1401-1464) said that there is no proportion between the finite mind and the infinite. He is fond of saying reason cannot fully comprehend the infinite. That our best hope for attaining a vision and understanding of infinite things is by mathematics and by the use of contemplating symbols, which help us grasp "the absolute infinite". By the late 19th century, there is a decisive intervention in mathematics and its philosophy: the philosophical mathematician (...) Georg Cantor (1845-1918) says that between the realm of the finite and the absolute infinite, there is an intermediate realm partaking in properties in a certain sense of both the finite and the infinite: the transfinite realm. Like the finite, the transfinite realm is a realm of mathematical objects, numbers, and knowledge. Like the absolute infinite, the transfinite is a form of infinity insofar as transfinite sets and numbers transcend any finite number. Echoing Cusanus and neo-Platonism, Cantor says that the transfinite sequence of all ordinals is a symbol of the absolutely infinite, that is, God. Moreover, Cantor envisioned his transfinite set theory (Mengenlehre) as providing the analytical methods and techniques necessary for a comprehensive, organic, non-reductive description of nature, a Naturphilosophie. Thus Cantor’s novel mathematics is presented as part of a long tradition, to which Cusanus, Bruno, Spinoza, Leibniz and others belong, in which the infinity and infinite character of organic life forms is appreciated, and is in some sense a mirror or symbol of the divine. The doctrine of symbolism and their different approach to the laws of logic present in both the work of Cusanus and Cantor enables these thinkers to articulate a transcendental apophatic approach to divinity. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Earthquake of 1906, the Christian Anarchy of Dorothy Day, and the Opened “Tomb” of René GirardAnn W. Astell (bio)The autobiographical writings of Dorothy Day (1897–1980) feature a childhood memory of catastrophe and conversion, her traumatic experience at age eight of the earthquake that rocked San Francisco and Oakland in 1906, leaving half of San Francisco in ruins and sending 50,000 refugees in flight from the burning city, many (...) of them in ferries across the bay. Day’s observations of the spontaneous behavior of people who helped one another at that time of crisis guided her later in dealing with the great crash of 1929 and the subsequent economic depression, during which, in 1933, she cofounded with Peter Maurin (1877–1949) the Catholic Worker Movement and its many Houses of Hospitality.Day’s experience of an anti-sacrificial civilization of love emerging spontaneously out of a chaotic situation of social crisis seems to challenge René Girard’s theory of the scapegoat-mechanism as the normative way of restoring order and peace to a community whose very existence is threatened by anarchy. A closer examination of Day’s experience and social thought in conversation with Girard’s reveals that Girard and Day agree about the violent origins of all culture, which Day envisages as revealed by an earthquake, Girard as concealed by a tomb—related foundational images that, as we shall see, Scripture scholars [End Page 19] find collocated especially in the final chapters of the Gospel according to St. Matthew. The difference between the two images—one natural and one man-made—should not, and indeed cannot, be overlooked, however. The earthquake and its social effect as observable phenomena force the consideration that Girard’s early formulations of his theory, which explicitly distanced it from naturalistic explanations of myth, need to be revised in a way that accords more closely with his own later, apocalyptic thought.In an article published recently in Contagion, Matthew Pattillo has shown that Girard’s writings parallel, and to some extent directly affected, those of Jacques Ellul,1 the noted Christian anarchist who cites Girard explicitly on occasion and whose many books, according to Mark and Louise Zwick, “influenced the later Catholic Worker Movement.”2 In this article, I follow Pattillo’s lead, going back in time in order to examine ways in which the mimetic theory of Girard illumines the early thought and practice of Day, highlighting the originality of Day’s Christian anarchism as a remedy for a culture founded on violence. Whereas Girard posits a prereligious phase of anarchic, contagious violence, to which the rituals and prohibitions of religious societies responded (thus distantly preparing the way for a secularized modernity in which “law and order” stand opposed to an ever-threatening “anarchy”), Day finds a freely chosen Christian anarchy the best cure for anarchic destruction and totalitarianism alike, thus forging what Pattillo calls a “‘third way’ beyond law, beyond morality, beyond chaos.”3 In the end, the prolonged crisis within which the Catholic Workers shape their anarchistic “new society” against an eschatological horizon confirms Girard’s apocalypticism, even as it serves to place it in conversation with the apocalyptic philosophy of history of the Russian philosopher Nicholas Berdyaev (1874–1949), whose thought influenced Maurin and Day.4The Earthquake and the TombFor Girard, the tomb is the real and metaphoric evolutionary origin of human civilization. “Culture,” he writes,always develops as a tomb. The tomb is nothing but the first human monument to be raised over the surrogate victim, the first, most elemental and fundamental matrix of meaning. There is no culture without a tomb, and no tomb without a culture; in the end, the tomb is the first and only [End Page 20] cultural symbol. The above-ground tomb does not have to be invented. It is the pile of stones in which the victim of unanimous stoning is buried.5Moving from its literal, historical meaning in connection with a primeval murder, Girard elaborates the metaphorical significance of the tomb for culture as a whole. As a site serving two functions simultaneously—namely, those of honoring the dead and of concealing a corpse—the tomb... (shrink)

Following the U.K. Labour government commitment to marriage in the 1998 Green Paper ‘Supporting Families’, Barlow and Duncan produced a robust critique calling for ‘realism’ in recognising that many couples are now choosing not to marry, that too many do not make informed decisions as to whether to marry or not and that, on the basis of their survey, over 40% of respondents believed that some form of family law protection would be available to them, despite their lack of (...) marital status. When added to a concern that economically vulnerable cohabiting women do not receive adequate protection in property law, it seemed all too obvious that the government commitment to marriage should be challenged. In fact, government policy does seem to have shifted somewhat when, partly as a tactical manoeuvre to help the passage of the Civil Partnership Act 2004 and specifically recognising concerns with the needs of economically vulnerable parties, the issue was referred to the Law Commission for England and Wales. This places the ‘realism’ arguments firmly within the reform agenda. However, this article argues that there is a need to look more closely at the arguments used by the ‘realists’, in particular at the evocation of the figure of Mrs. Burns. The more contemporary case of Oxley v. Hiscock is used to both raise questions about the socio-economic profiles of cohabitants, as well to question the presentation of property law as failing women (and family law as offering the protection they need). I argue that feminists should take a cautious approach in relation to the seemingly compelling argument that cohabitants will benefit from the extension of aspects of marriage law to cover property issues at the end of a relationship. (shrink)

Doxastic logic, beginning with Hintikka’s Knowledge and Belief. An Introduction to the Logic of the Two Notions, studies relations between propositions about what we believe. Using ‘a’ as a proper name like ‘Ann’, ‘→’ for ‘if’ as opposed to material implication, propositional variables such as ‘p’, ‘q’ and ‘B’ to represent the two-place relation, ‘... believes that... ’.

In Republican Guard , Nicholas Xenos describes the Straussian network and its nature, focusing upon delineating what in Leo Strauss’ writings has influenced and can tell us about the ‘character of American power today and the rhetoric through which it is enhanced and sustained.’ In the end he argues and demonstrates that Strauss’ political theory provides the means by which an imperial project can be camouflaged under the cloak of an appeal to liberal democracy. This book will be of interest (...) to students and scholars of politics and international relations. (shrink)

Dans la genese de sa constitution, la philosophie n'a pu faire l'economie d'une confrontation avec la musique qui fournissait aux anciens Grecs les schemes fondamentaux de la culture. De cette confrontation Platon est le temoin. Scindant la musique, il privilegie l'Harmonique, qui en est la partie theorique, sans toutefois lui reconnaitre la titre de science supreme. Correlativement, il condamne comme dysharmonie, tumulte fracassant et perturbateur de l'ordre cosmique, l'harmonie chromaticiste dont il s'emploie, non sans paradoxe, a decrire le detail. Par (...) cette lecture en filigrane des Dialogues de Platon, l'auteur se propose de reconstruire la pensee qui procede de l'harmonie chromaticiste et de montrer son importance dans l'elaboration de la philosophie fondatrice. Au carrefour des disciplines du savoir antique, ce livre s'adresse non seulement aux philosophes, mais aussi a tous ceux qui, musiciens ou stylisticiens, s'interessent a la forme musicale. (shrink)

Transitive inference (TI) plays a part in many aspects of reasoning, and is usually assessed using variants on a particular task dubbed the “IP-paradigm”. Advocates of this paradigm assume it ensures that subjects must use deduction to solve the inferential questions. The present task with 63 adults strengthened this claim by removing all possible perceptual cues and limiting as far as possible all cues from the training procedure itself. Response speed and accuracy were measured as premises were learned. Findings show (...) that when over-training and non-logical cues are avoided, adults nevertheless reach high levels of overall performance. However, key indexes of Lexical Marking, Relative-End-Anchoring, and Symbolic Distance are largely absent or in the opposite direction to the generally accepted view at the start of training, and are present only for response time (RT) at the end of training. The widely accepted strategy of retrieval from an integrated mental representation does emerge; but only after an initial associative process and a deductive process. Regarding three comparisons critical for demonstrating deductive TI, the inference was more demanding than its antecedents both in terms of accuracy and RT, and both after initial and final training. Existing theories of TI account for some of these findings, but what is required is a theory accommodating them all. (shrink)

Education – typically and rightly held to be an incontrovertible good – has for some time now been dominated by mass formal schooling systems. These systems routinely harm and oppress many students. I argue that they do so impermissibly, and I call this stance “educational pacifism”. I propose that Maria Montessori’s views on mass formal schooling systems broadly align with educational pacifism and that, therefore, she can be considered an educational pacifist. Finally, I claim that contemporary Montessorians ought to be (...) educational pacifists, firstly because educational pacifism makes a compelling moral argument and secondly because Montessori herself agrees with it. (shrink)

Halford et al. seek to provide a framework that unifies distinct developmental phenomena. However, in pursuit of this goal, they sidestep crucial aspects of some well-known developmental benchmarks (most notably Transitive Inference and Object Concept), and they do not acknowledge “repeated” or “direct” experience as possibly being more fundamental than relational complexity, instead, ascribe all experience a secondary role.