This article explores the ethical principles of prescribing in Sickle Cell Disease. The first two sections of the article provide detailed scientific justification for the last section of the manuscript, which explores and discusses the ethical principles.

Sickle cell disease is an autosomal recessive hemoglobinopathy found mainly in populations of African and Mediterranean descent, including approximately 100,000 Americans. It is also very common in Spanish-speaking regions of Central America, South America, and parts of the Caribbean, in Saudi Arabia, and in India and Sri Lanka. The disorder is characterized most commonly by lifelong recurrent unpredictable vaso-occlusive pain that may be disabling, and by chronic tissue damage and organ dysfunction. There are several genotypes of the disease. Although SCD (...) pain frequency generally varies between genotypes, it also varies between subjects even within genotype. It may worsen from childhood to adulthood. It may vary by gender. Its location, timing, and severity may be unpredictable.Until recently, pain in SCD had been characterized as episodes that were acute, periodic, and relatively rare. Crises were viewed as usually associated with hospitalization. Many patients utilized hospital or emergency care for pain once per year or less, so painful episodes in SCD were called vaso-occlusive “crises.”. (shrink)

Disputes between those holding differing political views are ubiquitous and deep-seated, and they often follow common, recognizable lines. The supporters of tradition and stability, sometimes referred to as conservatives, do battle with the supporters of innovation and reform, sometimes referred to as liberals. Understanding the correlates of those distinct political orientations is probably a prerequisite for managing political disputes, which are a source of social conflict that can lead to frustration and even bloodshed. A rapidly growing body of empirical evidence (...) documents a multitude of ways in which liberals and conservatives differ from each other in purviews of life with little direct connection to politics, from tastes in art to desire for closure and from disgust sensitivity to the tendency to pursue new information, but the central theme of the differences is a matter of debate. In this article, we argue that one organizing element of the many differences between liberals and conservatives is the nature of their physiological and psychological responses to features of the environment that are negative. Compared with liberals, conservatives tend to register greater physiological responses to such stimuli and also to devote more psychological resources to them. Operating from this point of departure, we suggest approaches for refining understanding of the broad relationship between political views and response to the negative. We conclude with a discussion of normative implications, stressing that identifying differences across ideological groups is not tantamount to declaring one ideology superior to another. (shrink)

In recent years there has been an increasing awareness that a comprehensive understanding of language, cognitive and affective processes, and social and interpersonal phenomena cannot be achieved without understanding the ways these processes are grounded in bodily states. The term ‘embodiment’ captures the common denominator of these developments, which come from several disciplinary perspectives ranging from neuroscience, cognitive science, social psychology, and affective sciences. For the first time, this volume brings together these varied developments under one umbrella and furnishes a (...) comprehensive overview of this intellectual movement in the cognitive-behavioral sciences. (shrink)

We describe the ethics consultation service (ECS) at the Cleveland Clinic and report on its activities over a 24-month period in which 478 consultations were performed. To our knowledge, this is the largest case series of ethics consultations reported to date. Established more than 25 years ago, the ECS at the Cleveland Clinic is staffed by multiple consultants with advanced training in bioethics. Several of these ethicists work closely with specialized clinical units and research departments, where they participate in multidisciplinary (...) meetings and provide specialized assistance. This combination of historical experience, large numbers of consultation requests, and specialized clinical ethicists suggests that the experience at the Cleveland Clinic may be helpful to ethicists and others who may be considering how to structure and sustain a vibrant ECS. Our results highlight the diversity of activities performed by a high-volume ECS at a tertiary care facility. Our hope in sharing the inner workings of the ECS at the Cleveland Clinic is to promote dialogue on common practices and approaches across medical institutions that support ethics consultation. (shrink)

Civilization, Modernity, and Critique provides the first comprehensive, cutting edge engagement with the work of one of the most foundational figures in civilizational analysis: Johann P. Arnason. In order to do justice to Arnason's seminal and wide-ranging contributions to sociology, social theory and history, it brings together distinguished scholars from a variety of disciplinary backgrounds and geographical contexts. Through a critical, interdisciplinary dialogue, it offers an enrichment and expansion of the methodological, theoretical, and applicative scope of civilizational analysis, by addressing (...) some of the most complex and pressing problems of contemporary global society. A unique and timely contribution to the ongoing task of advancing the project of a critical theory of society, this volume will appeal to scholars of sociology and social theory with interests in historical sociology, critical theory and civilizational analysis. (shrink)

A model of autobiographical remembering and the creation of personal culture is proposed. In this model we hypothesize that autobiographical memories are instantiations--objectifications as in metaphors or idioms-constituted through reconstructive processes that come to be recognized as self. Such memories are subsequently subjectified as personal culture. Our emphasis is on the functions and uses of autobiographical remembering, especially in interaction with others, where reconstructed memories are marked with affective significance. We propose that memories become autobiographical as a function of how (...) they are used--to establish and maintain intimacies or to calm ourselves during times of hightened anxiety-and signified by affect and emotion. From an object-relations theory perspective, autobiographical memories are seen as transitional phenomena (selfobjects) that reconstitue caregiving relationships both when we are alone and when we are interacting with others. (shrink)

The corporate social responsibility literature recognizes that firms’ existing CSR reputation can serve as a safeguard from the impact of reputation-damaging events on a firm’s social legitimacy. However, the literature has yet to focus on the extent to which CSR activities can help mitigate such damage, post-event. This article examines how a firm’s social actions following a product recall facilitate the recovery of its diminished social legitimacy. We test our predictions using a sample of 197 product recalls involving 168 publicly (...) traded corporations from 1999 to 2009 and demonstrate that the speed of the CSR response, the frequency of CSR activities, and the intensity of CSR activities have a significant effect on firm recovery following crisis. The effects were most pronounced in instances where the magnitude of the recall was most severe. The visibility of the recall has a limited impact on post-event recovery. We discuss our contributions to research on strategic CSR and recovery. (shrink)

It is generally accepted that appropriate documentation of activities and recommendations of ethics consultants in patients’ medical records is critical. Despite this acceptance, the bioethics literature is largely devoid of guidance on key elements of an ethics chart note, the degree of specificity that it should contain, and its stylistic tenor. We aim to provide guidance for a variety of persons engaged in clinical ethics consultation: new and seasoned ethics committee members who are new to ethics consultation, students and trainees (...) in clinical ethics, and those who have significant experience with ethics consultation so that they can reflect on their practice. Toward the goal of promoting quality charting practices in ethics consultations, we propose recommendations on a broad array of questions concerning clinical ethics consultation chart notes, including whether and when to write a chart note, and practical considerations for the tenor, purpose, and content of a chart note. Our broader aim is to promote discussion about good charting practices in clinical ethics, with the hope of contributing to clear standards of excellence in clinical ethics consultation. (shrink)

In late January of 1987, the State Treasurer of Pennsylvania, R. Budd Dwyer, shot himself to death in front of a dozen reporters and camera crews during a news conference in his office. Much was subsequently made in the popular press, and within the profession, about the difficult ethical decision television journalists were faced with in determining how much of the very graphic suicide tape to air. A review of the literature in this area suggests, however, that journalists have established (...) a set of relatively detailed conventions for dealing with events involving graphic depictions of death. Analysis of the Dwyer tape and interviews conducted with Pennsylvania television news directors show that eighteen of the twenty stations in the state that carry news used basically the same type and amount of footage in their evening newscasts. One decided to use no tape. One showed the moment of death. When the story broke around noon, two additional stations showed the moment of suicide, but they revised their story for the evening program. In addition, the wide majority of news directors interviewed said they had little difficulty in deciding how to edit the tape. The processing of the Dwyer story suggests that any ethical dilemmas faced by journalists during decision making were put aside for later consideration. The material was edited quickly and according to similar patterns, or conventions, around the state. The study suggests greater attention be given to the definition and interaction of personal professional values, in the ethical sense, and norms of news processing, in the sociological sense. (shrink)

Responding to Randall and Gibson''s (1990) call for more rigorous methodologies in empirically-based ethics research, this paper develops propositions — based on both previous ethics research as well as the larger organizational behavior literature — examining the impact of attitudes, leadership, presence/absence of ethical codes and organizational size on corporate ethical behavior. The results, which come from a mail survey of 149 companies in a major U.S. service industry, indicate that attitudes and organizational size are the best predictors of ethical (...) behavior. Leadership and ethical codes contribute little to predicting ethical behavior. The paper concludes with an assessment of the relevant propositions, as well as a delineation of future research needs. (shrink)

Drawing on early work on ethical leadership, we argue that when leaders engage in leader moral hypocrisy (i.e., ethical promotion without ethical demonstration), followers can experience psychological reactance—a negative response to a perceived restriction of freedom—which can have negative downstream consequences. In a survey of employee–manager dyads (study 1), we demonstrate that leader moral hypocrisy is positively associated with follower psychological reactance, which increases follower deviance. In two subsequent laboratory experiments, we find similar patterns of results (study 2) and explore (...) potential alternative mechanisms (study 3). We demonstrate in a final experiment with working adults that the relationship between leader moral hypocrisy and psychological reactance is partly explained by increased perceptions of a leader’s use of power (study 4). We discuss the implications of our findings and advocate for further understanding of the risks associated with psychological reactance in response to leaders and other workplace situations. (shrink)

Because men are overrepresented within positions of power, men are perceived as the default in academia. Androcentric bias emerges whereby research by men and/or dominated by men is perceived as higher quality and gains more attention. We examined if these androcentric biases materialize within fields that study bias. How do individuals in close contact with psychology view psychology research outlets with titles including the words women, gender, sex, or feminism or contain the words men or masculinity versus psychology journals that (...) publish other-specialized research, and do these perceptions differ in the general public? While the men-related journal was less meritorious than its other-specialty journal, evidence emerged supporting androcentric bias such that the men-related journal was more favorable than the other sex/gender-related journals. Further, undergraduate men taking psychology classes rated sex/gender-related versus other-specialty journals as less favorable, were less likely to recommend subscription, and rated the journals as lower quality. Low endorsement of feminist ideology was associated with less support for sex/gender-related journals versus matched other-specialty journals. Decreased subscription recommendations for sex/gender-related journals were mediated by decreased favorability and quality beliefs, especially for men and those low in feminist ideology. However, we found possible androcentric-interest within the public sphere. The public reach of articles published in sex/gender-related was greater than other-specialty journals. The consequences of these differential perceptions for students versus the public and the impact on women’s advancement in social science and psychological science are discussed. (shrink)