Volume 20, Issue 7, July 2020, Page 153-155.

During the Covid‐19 pandemic, as resources dwindled, clinicians, health care institutions, and policymakers have expressed concern about potential legal liability for following crisis standards of care (CSC) plans. Although there is no robust empirical research to demonstrate that liability protections actually influence physician behavior, we argue that limited liability protections for health care professionals who follow established CSC plans may instead be justified by reliance on the principle of reciprocity. Expecting physicians to do something they know will harm their patients (...) causes moral distress and suffering that may leave lasting scars. Limited liability shields are both appropriate and proportionate to the risk physicians are being asked to take in such circumstances. Under certain narrow circumstances, it remains unclear that the standard of care is sufficiently flexible to protect physicians from liability. Given this uncertainty, the likelihood that physicians would be sued for such an act, and their desire for such immunity, this limited protection is morally legitimate. (shrink)

Ten years ago, Megan Shinal sought the care of neurosurgeon Steven Toms for the surgical treatment of a recurrent nonmalignant tumor in the pituitary region of her brain. In their twenty-minute meeting, Shinal did not make a final decision about which surgical approach she wished to pursue. Subsequently, she spoke with Tom's physician assistant once by phone and once in person, when she signed the consent form, which did not appear to designate which surgical approach she had chosen. During the (...) operation—a total resection—Toms perforated Shinal's carotid artery, resulting in hemorrhage, stroke, brain injury, and partial blindness. The jury found that Toms had fulfilled his informed-consent obligations prior to performing the resection; however, in June 2017, the Supreme Court of Pennsylvania overturned the decision, relying on the Pennsylvania Medical Care Availability and Reduction of Error Act. The court found that the language of the act is unambiguous in its requirement that “a physician's duty to provide information to a patient sufficient to obtain her informed consent is non-delegable.” Presumably, this rule of nondelegation applies beyond the surgical theater to other major treatment decisions. And it is unclear whether it applies to other professionals in a subordinate position to the treating physician, such as residents and fellows. (shrink)

American history has been rife with human subjects research scandals, particularly those that involve “vulnerable” populations. State and federal laws and regulations often do not provide any special oversight mechanisms or protections to ensure the ethical and safe inclusion of cognitively impaired adults in research. At the New York State level, repeated efforts have been made to regulate research involving individuals who lack consent capacity. In January 2014, the New York State Task Force on Life and the Law released its (...) Report and Recommendations for Research with Human Subjects Who Lack Consent Capacity, which represents the most recent step in a decades-long process in the state to develop oversight mechanisms that are appropriately sensitive to the fine line between protecting a vulnerable population and impeding the advancement of research. These recommendations may serve as a model for research policy in other states and at the federal level, particularly in light of shifting societal concerns and changing political winds. (shrink)

Despite existing federal and state law and regulation, new human subjects research scandals involving “vulnerable” populations continue to surface. Although existing oversight mechanisms were enacted to ensure voluntary informed consent for participants and institutional review board oversight of HSR, these laws and regulations do not provide any special oversight mechanisms or protections to ensure the ethical and safe inclusion of cognitively impaired adults. The absence of rules to ensure consistently ethical conduct of research involving adults who lack consent capacity may (...) either lead to exploitation of this vulnerable population or the dearth of important research into the broad range of diseases that impair cognition. In other words, while some institutions and investigators are conducting research with this group without guidance, others are taking an extremely conservative approach and are excluding these individuals from research. Without safeguards that are adequate and robust but not overly burdensome, conducting research involving this population is ethically and legally challenging. (shrink)

Genetic testing has led to the establishment of the concept of the “previvor”: someone who is not yet sick, but who has a genetic predisposition to disease. The previvor experience demonstrates how the practice of medicine and medical decision making is evolving to render current law and policy increasingly inapplicable to modern medical practice. The introduction of previvorship to the medical landscape raises special issues for the physician-patient relationship and the legal doctrine of informed consent. It challenges some of the (...) most basic assumptions underlying the doctrine, is representative of the doctrine’s declining utility, and is illustrative of the need to transition to a shared decision-making model. Thus, we should begin to envision a legal doctrine that supports a robust shared decision-making approach to address individual preferences and values, the increasing complexity of risk/benefit assessment, and inherent (and sometimes irreducible) uncertainty. Such an approach should emphasize a new, more expansive, and inclusive model of illness. (shrink)

In Saks v. Franklin Covey Co., the Court of Appeals for the Second Circuit held that the American with Disabilities Act, Title VII of Civil Rights Act of 1964, the Pregnancy Discrimination Act, and New York state law do not proscribe an employer's self-insured employee health plan from excluding surgical impregnation procedures from its coverage. Although the court found that infertility qualifies as a disability under the ADA, it restricted required coverage of certain infedty treatments.Title I of the ADA prohibits (...) an employer from discriminating on the basis of disability “in regard to … fringe benefits available by virtue of employment, whether or not administered by the covered entity.” The ADA defines “disability” as “a physical or mental impairment that substantially limits one or more major life activities.” In Bragdon v. Abbott, the U.S. Supreme Court found that reproduction was a major life activity under the ADA. (shrink)

In Saks v. Franklin Covey Co., the Court of Appeals for the Second Circuit held that the American with Disabilities Act, Title VII of Civil Rights Act of 1964, the Pregnancy Discrimination Act, and New York state law do not proscribe an employer's self-insured employee health plan from excluding surgical impregnation procedures from its coverage. Although the court found that infertility qualifies as a disability under the ADA, it restricted required coverage of certain infedty treatments.Title I of the ADA prohibits (...) an employer from discriminating on the basis of disability “in regard to … fringe benefits available by virtue of employment, whether or not administered by the covered entity.” The ADA defines “disability” as “a physical or mental impairment that substantially limits one or more major life activities.” In Bragdon v. Abbott, the U.S. Supreme Court found that reproduction was a major life activity under the ADA. (shrink)

Morain and colleagues (2019) advocate rethinking the rather dogmatic guidance from both regulatory authorities and professional associations cautioning physician-investigators against obtaining inf...

In Kentucky Association of Health Plans, Inc. v. Miller,, the Supreme Court unanimously held that states’ “any willing provider” laws are not preempted by the Employee Retirement Income Security Act of 1974. The Court ruled that states can regulate their health maintenance organizations, and thus upheld a Kentucky law that requires insurers to reimburse services of any health care provider who is willing and able to meet established criteria. The Supreme Court has heard several cases related to ERISA in the (...) last few years, and other such cases are working their way through the court system. Coupled with this most recent decision in Miller, the Supreme Court may significantly alter the shape of the insurance industry. (shrink)

In Kentucky Association of Health Plans, Inc. v. Miller,, the Supreme Court unanimously held that states’ “any willing provider” laws are not preempted by the Employee Retirement Income Security Act of 1974. The Court ruled that states can regulate their health maintenance organizations, and thus upheld a Kentucky law that requires insurers to reimburse services of any health care provider who is willing and able to meet established criteria. The Supreme Court has heard several cases related to ERISA in the (...) last few years, and other such cases are working their way through the court system. Coupled with this most recent decision in Miller, the Supreme Court may significantly alter the shape of the insurance industry. (shrink)

Effective November 1, 2002, the federal Department of Health and Human Services reclassified developing fetuses as “unborn children,” thereby providing health insurance benefits for prenatal care under the State Children's Health Insurance Program. By broadening the current definition of “child” —and thus expanding SCHIP insurance coverage — DHHS hopes to increase the number of low-income pregnant women who receive prenatal services. As noted by one commentator, the new rule represents the first time “any federal policy has defined childhood as beginning (...) at conception.”In an attempt to improve access to publicly funded health insurance for poor children not covered by Medicaid, Congress established SCHIP a 10-year, $40 billion program jointly funded by federal and state governments. Through a series of block grants, SCHIP allows states to either expand income-eligibility for their existing Medicaid program or to create a separate child health program to decrease the number of uninsured poor and near-poor children. (shrink)

Effective November 1, 2002, the federal Department of Health and Human Services reclassified developing fetuses as “unborn children,” thereby providing health insurance benefits for prenatal care under the State Children's Health Insurance Program. By broadening the current definition of “child” —and thus expanding SCHIP insurance coverage — DHHS hopes to increase the number of low-income pregnant women who receive prenatal services. As noted by one commentator, the new rule represents the first time “any federal policy has defined childhood as beginning (...) at conception.”In an attempt to improve access to publicly funded health insurance for poor children not covered by Medicaid, Congress established SCHIP a 10-year, $40 billion program jointly funded by federal and state governments. Through a series of block grants, SCHIP allows states to either expand income-eligibility for their existing Medicaid program or to create a separate child health program to decrease the number of uninsured poor and near-poor children. (shrink)

Sugar, pork, beer, corn, cider, scrapple, and hoppin' John all became staples in the diet of colonial America. The ways Americans cultivated and prepared food and the values they attributed to it played an important role in shaping the identity of the newborn nation. In A Revolution in Eating, James E. McWilliams presents a colorful and spirited tour of culinary attitudes, tastes, and techniques throughout colonial America. Confronted by strange new animals, plants, and landscapes, settlers in the colonies and West (...) Indies found new ways to produce food. Integrating their British and European tastes with the demands and bounty of the rugged American environment, early Americans developed a range of regional cuisines. From the kitchen tables of typical Puritan families to Iroquois longhouses in the backcountry and slave kitchens on southern plantations, McWilliams portrays the grand variety and inventiveness that characterized colonial cuisine. As colonial America grew, so did its palate, as interactions among European settlers, Native Americans, and African slaves created new dishes and attitudes about food. McWilliams considers how Indian corn, once thought by the colonists as "fit for swine," became a fixture in the colonial diet. He also examines the ways in which African slaves influenced West Indian and American southern cuisine. While a mania for all things British was a unifying feature of eighteenth-century cuisine, the colonies discovered a national beverage in domestically brewed beer, which came to symbolize solidarity and loyalty to the patriotic cause in the Revolutionary era. The beer and alcohol industry also instigated unprecedented trade among the colonies and further integrated colonial habits and tastes. Victory in the American Revolution initiated a "culinary declaration of independence," prompting the antimonarchical habits of simplicity, frugality, and frontier ruggedness to define American cuisine. McWilliams demonstrates that this was a shift not so much in new ingredients or cooking methods, as in the way Americans imbued food and cuisine with values that continue to shape American attitudes to this day. (shrink)

Social problems such as racism, sexism, and inequality are often cited as structural rather than individual in nature. What does it mean to invoke a social structural explanation, and how do such explanations relate to individualistic ones? This article explores recent philosophical debates concerning the nature and usages of social structural explanation. I distinguish between two central kinds of social structural explanation: those that are autonomous from psychology, and those that are not. This distinction will help clarify the explanatory power (...) that each type of SSE has, points of convergence with methodological traditions such as critical theory and rational choice theory, and the difficulties that each type of SSE faces. (shrink)

The article explores the place of affect in community relations with respect to trauma following the closure of a steelworks for a working-class community in the South Wales valleys in 2002. A review of sociological approaches to community demonstrates the poor handling of relational and affective aspects which, it is argued, are central to the way in which community relations were formed and provided a safe and containing skin against the uncertainty of industrial production. Using psychoanalytic approaches to affect which (...) stress the importance of skin, particularly the work of Bick, Tustin, Winnicott and Anzieu, the article explores how a sense of a containing skin provides a feeling of ontological security for a community beset by uncertainty and insecurity. It is argued that, following the closure of the steelworks in 2002, this skin is ruptured and that it is difficult for the members of the community to find a way forward. Using examples taken from psychosocial interviews with community members, the case is made for a range of affective relations and practices through which the skin is created. The absence of these practices and relations creates a profound sense of lack of safety and fear of death within the inhabitants, which needs to be addressed, but is rarely discussed in approaches to community or regeneration. (shrink)

To what extent should we focus on implicit bias in order to eradicate persistent social injustice? Structural prioritizers argue that we should focus less on individual minds than on unjust social structures, while equal prioritizers think that both are equally important. This article introduces the framework of transactive memory into the debate to defend the equal priority view. The transactive memory framework helps us see how structure can emerge from individual interactions as an irreducibly social product. If this is right, (...) then debiasing interventions are structural interventions. One upshot is that the utility of the individual versus structural distinction is not apparent for the purposes of intervention. (shrink)

This book focuses on some of the most pressing methodological, ethical, and technique-philosophical questions that are connected with the concept of artificial autonomous systems. (Series: Hermeneutics and Anthropology / Hermeneutik und ...

As of this writing, twenty‐one states have passed laws barring transgender youth‐athletes from competing on public‐school sports teams in accordance with their gender identity. Proponents of these regulations claim that transgender females in particular have inherent physiological advantages that threaten a “level playing field” for their cisgender competitors. Existing evidence is limited but does not support these restrictions. Gathering more robust data will require allowing transgender youth to compete (rather than preemptively barring them), but even if trans females are shown (...) to retain some advantage, this would not have greater moral significance than the many other “fair” physical and economic advantages found across sports. These regulations deprive transgender youth, an exceptionally vulnerable population, from the vast physical, mental, and social benefits of sports. While we advocate for transgender inclusion under our current, gender‐segregated model of sport, we propose changes to the overarching structure that would promote a more inclusive and fairer athletic environment. (shrink)

It is commonly accepted that what we ought to do collectively does not imply anything about what each of us ought to do individually. According to this line of reasoning, if cooperating will make no difference to an outcome, then you are not morally required to do it. And if cooperating will be personally costly to you as well, this is an even stronger reason to not do it. However, this reasoning results in a self-defeating, yet entirely predictable outcome. If (...) everyone is rational, no one will cooperate, resulting in an aggregate outcome that is devastating for everyone. This dismal analysis explains why climate change and other collective action problems are so difficult to ameliorate. The goal of this paper is to provide a different, exploratory framework for thinking about individual reasons for action in collective action problems. I argue that the concept of commitment gives us a new perspective on collective action problems. Once we take the structure of commitment into account, this activates requirements of diachronic rationality that give individuals instrumental reasons to cooperate in collective action problems. (shrink)

Just war thinking serves a social and psychological role that international law cannot fill. Law is dispassionate and objective, while just war thinking accounts for emotions and the situatedness of individuals. While law works on us externally, making us accountable to certain people and institutions, just war thinking affects us internally, making us accountable to ourselves. Psychologically, an external focus leads to feelings of shame, while an inward focus generates feelings of guilt. Philosophers have long recognized the importance of these (...) two moral emotions. Recently, psychologists have found that feelings of guilt are linked to positive social outcomes, such as the desire for reconciliation and reparation, while shame generates anger and hostility. Just war thinking, as an inward-looking tradition, has a special relationship with guilt. By focusing on moral emotions, just war thinking can move beyond the law in four ways, by developing an ethic of accountability, by providing a foundation for addressing moral injury, by providing a common language for discussing the costs of war, and for identifying ethical problems in radically new contexts. (shrink)

(2014). Tin Men: Ethics, Cybernetics and the Importance of Soul. Journal of Military Ethics: Vol. 13, No. 1, pp. 3-19. doi: 10.1080/15027570.2014.908011.

This paper argues that some widely used laws of implication are false, and arguments based upon them invalid. These laws are Exportation, Commutation, (as well as various restricted forms of these), Exported Syllogism and Disjunctive Syllogism. All these laws are false for the same reason – that they license the suppression or replacement in some position of some class of propositions which cannot legitimately be suppressed or replaced. These laws fail to preserve the property of sufficiency of premiss set for (...) conclusion. They are false, and can be seen to be false, independently of their respon- sibility for the paradoxes. Hence the main ‘independent’ argument for the paradoxes – that they follow from an allegedly immaculate set of laws – is undermined. Counterexamples to all these laws are produced. (shrink)

The most widely debated conception of democracy in recent years is deliberative democracy--the idea that citizens or their representatives owe each other mutually acceptable reasons for the laws they enact. Two prominent voices in the ongoing discussion are Amy Gutmann and Dennis Thompson. In Why Deliberative Democracy?, they move the debate forward beyond their influential book, Democracy and Disagreement.What exactly is deliberative democracy? Why is it more defensible than its rivals? By offering clear answers to these timely questions, (...) class='Hi'>Gutmann and Thompson illuminate the theory and practice of justifying public policies in contemporary democracies. They not only develop their theory of deliberative democracy in new directions but also apply it to new practical problems. They discuss bioethics, health care, truth commissions, educational policy, and decisions to declare war. In "What Deliberative Democracy Means," which opens this collection of essays, they provide the most accessible exposition of deliberative democracy to date. They show how deliberative democracy should play an important role even in the debates about military intervention abroad.Why Deliberative Democracy? contributes to our understanding of how democratic citizens and their representatives can make justifiable decisions for their society in the face of the fundamental disagreements that are inevitable in diverse societies. Gutmann and Thompson provide a balanced and fair-minded approach that will benefit anyone intent on giving reason and reciprocity a more prominent place in politics than power and special interests. (shrink)

How should you live? Should you devote yourself to perfecting a single talent or try to live a balanced life? Should you lighten up and have more fun, or buckle down and try to achieve greatness? Should you try to be a better friend? Should you be self-critical or self-accepting? And how should you decide among the possibilities open to you? Should you consult experts, listen to your parents, or should you do lots of research? Should you make lists of (...) pros and cons, or go with your gut? These are not questions that can be answered in general or in the abstract. Rather, these questions are addressed to the first person point of view, to the perspective each of us occupies when we reflect on how to live without knowing exactly what we're aiming for. To answer them, this book focuses on the process of living one's life from the inside, rather than on defining goals from the outside. Drawing on traditional philosophical sources as well as literature and recent work in social psychology, this book argues that to live well, we need to develop reflective wisdom: to care about things that will sustain us and give us good experiences, to have perspective on our successes and failures, and to be moderately self-aware and cautiously optimistic about human nature. Further, we need to know when to think about our values, character, and choices, and when not to. A crucial part of wisdom, the book maintains, is being able to shift perspectives: to be self-critical; to be realistic; to examine life when reflection is appropriate, but not when we should lose ourselves in experience. (shrink)

Theorists of legal translation generally describe it as an interdisciplinary activity whose methodology draws deeply upon comparative law. In practice, how can we apply this theoretical paradigm to translator training? This article examines methods of integrating comparative law with the acquisition of knowledge and know-how that constitute the translator’s core competences, emphasizing the resolution of legal terminology problems resulting from incongruencies between legal systems. Given that the goal is to compare law for the purposes of translation, it is useful to (...) approach these problems from a functionalist viewpoint, principally through confronting a range of cases and situations likely to challenge the professional translator. Therefore, the author proposes including, along with other teaching methods, targeted work on terminological problems which necessitate the study of comparative law. A set of learning activities is presented for that purpose. (shrink)

Constructive (productive) thinking in the critical philosophy of Hermann Cohen differs significantly from the seemingly similar speculative thinking in J. G. Fichte’s Science of Knowledge (Wissenschaftslehre) (1794/95). The fundamental characteristics of scientific thinking in Cohen’s teaching include: purity, focus on the “fact of science”, the origin (Ursprung), the infinitesimal method, continuity, movement, production, correlation, intensive magnitude, interrelation of thinking and being. According to Cohen, scientific thinking can only be pure and generated by the origin. The origin is continuous action (movement) (...) of thinking to separate the united and bind the divided content. In this process, thinking and being are correlative. Infinitely small reality contains thinking and being simultaneously as a union and in a divided form. The infinitesimal method is thinking that continuously carries out a) the operations of opposing itself as pure thinking to the results of its own production; b) the coincidence of itself with the products of its own generation. Infinitesimal thinking seeks to eliminate the difference between self and being. Nevertheless, being constantly retains autonomy. Being does not merge with thinking and is not absorbed by it. In Fichte’s Science of Knowledge pure thinking moves in a logical circle, having no access into real being. In an effort to break out of this circle and find its causality, thinking turns not to the being of the world of phenomena, but to the Absolute I. Such a speculative approach to consciousness, thinking and being has little in common with Cohen’s critical position. (shrink)

Price is a central analytic concept in both neoclassical and old institutional economics. Combining the social network perspective with old and new institutionalist approaches to price formation, this article examines technological, economic, institutional, and political factors that shaped the earliest pricing systems for electricity used in the United States, between 1882 and 1910. We show that certain characteristics of electricity supply led to ambiguities in how the product should be priced, which created a politics of pricing among electricity producers. In (...) particular, we investigate why the “Wright system,” arguably inferior in productive efficiency to other alternatives, was widely adopted by 1900. We argue that this outcome resulted in part from the political and organizational clout of its supporters, as well as from their particular conceptions of the boundaries and future of the industry itself. The Wright system best suited the “growth dynamic” strategy promoted by the managers of large central stations in their fierce competition with smaller and more decentralized installations. Thus, even in this apparently highly technical and mainly economic issue of how to price the product, there was ample room for social construction and political manipulation. The outcome reached was by no means inevitable and had a highly significant impact on the shape of the American industrial infrastructure. (shrink)

What is well-being? This is one of humanity's oldest and deepest questions; Valerie Tiberius offers a fresh answer. She argues that our lives go well to the extent that we succeed in what matters to us emotionally, reflectively, and over the long term. So when we want to help others achieve well-being, we should pay attention to their values.

The number of distributors selling Fair Trade products is constantly increasing. What are their motivations to distribute Fair Trade products? How do they organise this distribution? Do they apply and communicate the Fair Trade values? This research, based on five case studies in Switzerland, aims at understanding and structuring the strategies and the managerial practices related to Fair Trade product distribution, as well as analysing if they denote an engagement with Fair Trade principles. The results show a high heterogeneity of (...) strategies and engagement. In general, strategies implemented by mainstream actors contribute to increase Fair Trade global sales but do not convey the transformative message of Fair Trade through their engagement. The latter is rather communicated through alternative channels. Problems and potential solutions to this issue are discussed. (shrink)

Freedom of conscience is a core element of human rights respected by most European countries. It allows abortion through the inclusion of a conscience clause, which permits opting out of providing such services. However, the grounds for invoking conscientious objection lack clarity. Our aim in this paper is to take a step in this direction by carrying out a systematic review of reasons by midwives and nurses for declining, on conscience grounds, to participate in abortion. We conducted a systematic review (...) of ethical arguments asking, “What reasons have been reported in the argument based literature for or against conscientious objection to abortion provision by nurses or midwives?” We particularly wanted to identify any discussion of the responsibilities of midwives and nurses in this area. Search terms were conscientious objection and abortion or termination and nurse or midwife or midwives or physicians or doctors or medics within the dates 2000–2016 on: HEIN legal, Medline, CINAHL, Psychinfo, Academic Search Complete, Web of Science including publications in English, German and Dutch. Final articles were subjected to a rigorous analysis, coding and classifying each line into reason mentions, narrow and broad reasons for or against conscientious objection. Of an initial 1085 articles, 10 were included. We identified 23 broad reasons, containing 116narrow reasons and 269 reason mentions. Eighty one narrow reasons argued in favour of and 35 against conscientious objection. Using predetermined categories of moral, practical, religious or legal reasons, “moral reasons” contained the largest number of narrow reasons. The reasons and their associated mentions in this category outnumber those in the sum of the other three categories. We identified no absolute argument either for or against conscientious objection by midwives or nurses. An invisibility of midwives and nurses exists in the whole debate concerning conscientious objection reflecting a gap between literature and practice, as it is they whom WHO recommend as providers of this service. While the arguments in the literature emphasize the need for provision of conscientious objection, a balanced debate is necessary in this field, which includes all relevant health professionals. (shrink)

Hermeneutic research in nursing: developing a Gadamerian‐based research method This paper takes the stance that although there are many different approaches to phenomenological and hermeneutic research, some of these have become blurred due to multiple interpretations of translated materials. Working from original texts by the German philosophers, this paper reconsiders the relevance of phenomenology and hermeneutics to nursing research. We trace the development of Gadamer's philosophy in order to propose a research method based in this tradition. Five steps have been (...) identified as a guide for nurse researchers. These are deciding upon a question, identification of preunderstandings, gaining understanding through dialogue with participants, gaining understanding through dialogue with text and establishing trustworthiness. (shrink)

Feminist Political Theory provides both a wide-ranging history of western feminist thought and a lucid analysis of contemporary debates. It offers an accessible and thought-provoking account of complex theories, which it relates to 'real-life' issues such as sexual violence, political representation and the family. This timely new edition has been thoroughly updated to incorporate the most recent developments in feminism and feminist scholarship throughout, in particular taking into account the impact of black and postmodern feminist thought on feminist political theory.

Most studies investigating the relationship between cultural constructs and ethical perception have focused on individual- and societal-level values without much attention to other type of cultural constructs such as social beliefs. In addition, we need to better understand how social beliefs are linked to ethical perception and the level of analysis at which social beliefs may best predict ethical perceptions. This research contributes to the cross-cultural ethical perception literature by examining the relationship of individual-level social cynicism belief, one of five (...) universally endorsed social beliefs, together with individual social dominance orientation and the perception of unethical behavior. By means of two studies, we examine these relationships across societies that significantly differ on societal-level social cynicism belief. Using 371 business students from Russia and the U.S. in Study 1 and 268 professionals from Portugal and the U.S. in Study 2, we found that individual-level social cynicism belief was positively associated with social dominance orientation. Social dominance orientation, in turn, mediated the relationship between individual social cynicism belief and the perception of unethical behavior. Although we found significant societal-level differences in social cynicism belief in both studies, the relationships between individual-level social cynicism belief, social dominance orientation, and the perception of unethical behavior were structurally equivalent across societies in both studies, suggesting that societal-level differences did not significantly affect these relationships. Implications for cross-cultural business ethics research and practice are discussed. (shrink)

The healthcare environment is knowledge driven and knowledge and human resource dependent. Despite the paucity of evidence on which to shape and evaluate organizational change, health‐care in Canada has undergone many changes in the last 15 years. In the pursuit of enhanced productivity, healthcare administrators have turned to industrial and engineering models. Using available Canadian research and policy reports, and where necessary, American literature, this paper describes the impact of re‐engineering on nursing and on the relationship between nursing and patient (...) outcomes. It also identifies emerging trends and ways forward. (shrink)

ZusammenfassungDer Beitrag bringt Gründe für die These vor, dass aktive Sterbehilfe – die Tötung eines einwilligungsfähigen Patienten auf sein ausdrückliches, ernsthaftes und stabiles Verlangen hin – unter bestimmten Umständen moralisch erlaubt ist und rechtlich erlaubt sein sollte. Autonome Personen haben ein zentrales, von ihrem Anspruch auf Wahrung ihrer Menschenwürde geschütztes Interesse daran, „ihren” Tod sterben zu können. Aus diesem geschützten Interesse resultieren Dispositionsbefugnisse über das eigene Sterben, die auch das Recht beinhalten, sich hierzu der freiwillig geleisteten Hilfe Dritter zu bedienen. (...) Soweit das Argument eines möglichen Missbrauchs erlaubter aktiver Sterbehilfe ernst zu nehmen ist, stehen wir jedoch einer unausweichlich dilemmatischen Entscheidung gegenüber, die das bisherige Verständnis des Menschenwürdeprinzips des Grundgesetzes in Frage stellt. Dieser Konflikt kann, wenn überhaupt, nur durch rechtlich institutionalisierte Verfahren zur Prüfung jedes Einzelfalles gelöst werden. (shrink)