In a fictional conversation designed to appeal to both working teachers and social philosophers, three educators take up the question of whether critical thinking itself can, or should, be taught independently of an explicit consideration of issues related to social justice. One, a thoughtful but somewhat traditional Enlightenment rationalist, sees critical thinking as a neutral set of skills and dispositions, essentially unrelated to the conclusions of morality, problems of social organization, or the content of any particular academic discipline. A second (...) interlocutor, steeped in “critical” pedagogy of Paulo Freire, insists that the problem is the pose of neutrality itself. On this view, all honest and effective approaches to teaching must confront the hegemony of unjust relationships, institutions, and conceptual schemes. The third character attempts to resolve the tension between these two opposed camps. (shrink)

In a fictional conversation designed to appeal to both working teachers and social philosophers, three educators take up the question of whether critical thinking itself can, or should, be taught independently of an explicit consideration of issues related to social justice. One, a thoughtful but somewhat traditional Enlightenment rationalist, sees critical thinking as a neutral set of skills and dispositions, essentially unrelated to the conclusions of morality, problems of social organization, or the content of any particular academic discipline. A second (...) interlocutor, steeped in “critical” pedagogy of Paulo Freire, insists that the problem is the pose of neutrality itself. On this view, all honest and effective approaches to teaching must confront the hegemony of unjust relationships, institutions, and conceptual schemes. The third character attempts to resolve the tension between these two opposed camps. (shrink)

This dialogue discusses a proposal for the legalization of torture under specific circumstances and contrasts it with arguments for a total ban on torture. We consider three types of objection: first, that the difficulty of having adequate knowledge renders the stock “ticking bomb” scenario such a low-probability hypothetical as to present no realistic threat to a policy banning all torture; second, that empirically the information gleaned from torture is so unlikely to be reliable that it could not justify the moral (...) risk; and third, that sanctioning torture, even if only under the most extreme circumstances, would generate a ‘culture of torture,’ hence undermining fragile advances in international human rights rooted in unwavering commitment to human dignity. Compelling as these arguments appear, not all the conversants are wholly convinced by them; to this extent the dialogue ends aporetically. (shrink)

This dialogue discusses a proposal for the legalization of torture under specific circumstances and contrasts it with arguments for a total ban on torture. We consider three types of objection: first, that the difficulty of having adequate knowledge renders the stock “ticking bomb” scenario such a low-probability hypothetical as to present no realistic threat to a policy banning all torture; second, that empirically the information gleaned from torture is so unlikely to be reliable that it could not justify the moral (...) risk; and third, that sanctioning torture, even if only under the most extreme circumstances, would generate a ‘culture of torture,’ hence undermining fragile advances in international human rights rooted in unwavering commitment to human dignity. Compelling as these arguments appear, not all the conversants are wholly convinced by them; to this extent the dialogue ends aporetically. (shrink)

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Background: In the last two decades, nursing authors have published ethical analyses of palliative sedation—an end-of-life care practice that also receives significant attention in the broader medical and bioethics literature. This nursing literature is important, because it contributes to disciplinary understandings about nursing values and responsibilities in end-of-life care. Research aim: The purpose of this project is to review existing nursing ethics literature about palliative sedation, and to analyze how nurses’ moral identities are portrayed within this literature. Research design: We (...) reviewed discussion papers, written by nurses about the ethics of palliative sedation, which were cited in MEDLINE, CINAHL, Nursing and Allied Health, or Philosopher’s Index (search date March 2018). Twenty-one papers met selection criteria. We performed a comprehensive review and analysis (using the Qualitative Analysis Guide of Leuven), of the values, responsibilities, and relationships reflected in authors’ portrayal of the nursing role. Findings: Two different tones are apparent in the extant nursing ethics literature. One is educational, while the other is critically reflective. Irrespective of tone, all authors agree on the alleviation of suffering as a fundamental nursing responsibility. However, they differ in their analysis of this responsibility in relation to other values in end-of-life care, including those that depend on consciousness. Finally, authors emphasize the importance of subjective and experience-based understandings of palliative sedation, which they argue as depending on nurses’ proximity to patients and families in end-of-life care. Discussion and conclusion: Based on our findings, we develop three recommendations for future writing by nurses about palliative sedation. These relate to the responsibility of recognizing how consciousness might matter in (some) peoples’ moral experiences of death and dying, to the importance of moral reflectiveness in nursing practice, and to the value of a relational approach in conceptualizing the nursing ethics of palliative sedation. (shrink)

This chapter contains sections titled: The Tree and the Bean The Taste Test A Way Out of Relativism Other Considerations Try It Yourself!

Postmodern art theory is an anomaly in the history of art theory.

Background: Legislative changes are resulting in assisted death as an option for people at the end of life. Although nurses’ experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses’ experiences of caring for people who request this option. Aim: To synthesize what has been learned about nurses’ experiences of caring for patients who request assisted death and to highlight what is morally at stake for nurses who (...) undertake this type of care. Design: Qualitative meta-synthesis. Methods: Six databases were searched: CINAHL, Medline, EMBASE, Joanna Briggs Institute, PsycINFO, and Web of Science. The search was completed on 22 October 2014 and updated in February 2016. Of 879 articles identified from the database searches, 16 articles were deemed relevant based on inclusion criteria. Following quality appraisal, 14 studies were retained for analysis and synthesis. Results: The moral experience of the nurse is defined by a profound sense of responsibility, shaped by contextual forces that nurses navigate in everyday end-of-life care practice, and sustained by intra-team moral and emotional support. Discussion: The findings of this synthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The findings further demonstrate that to fully appreciate the ethics of assisted death from a nursing standpoint, it is necessary to understand the broader constraints on nurses’ moral agency that operate in everyday end-of-life care. Ethical considerations: Research ethics board approval was not required for this synthesis of previously published literature. Conclusion: In order to understand how to enact ethical practice in the area of assisted death, the moral experiences of nurses should be investigated and foregrounded. (shrink)

Contrary to what many philosophers believe, Calvinism neither makes the problem of evil worse nor is it obviously refuted by the presence of evil and suffering in our world. Or so most of the authors in this book claim. While Calvinism has enjoyed a resurgence in recent years amongst theologians and laypersons, many philosophers have yet to follow suit. The reason seems fairly clear: Calvinism, many think, cannot handle the problem of evil with the same kind of plausibility as other (...) more popular views of the nature of God and the nature of God's relationship with His creation. This book seeks to challenge that untested assumption. With clarity and rigor, this collection of essays seeks to fill a significant hole in the literature on the problem of evil. (shrink)

Delirium, a common syndrome in terminally ill people, presents specific challenges to a good death in end‐of‐life care. This paper examines the relational engagement between hospice nurses and their patients in a context of end‐of‐life delirium. Ethnographic fieldwork spanning 15 months was conducted at a freestanding residential hospice in eastern Canada. A shared value system was apparent within the nursing community of hospice; patients’ comfort and dignity were deemed most at stake and therefore commanded nurses’ primary attention. This overarching commitment (...) to comfort and dignity shaped all of nursing practice in this hospice, including practices related to end‐of‐life delirium. The findings of this study elaborate the ways in which hospice nurses interpreted and responded to the discomfort of their patients in delirium, as well as the efforts they made to understand their patients’ subjective experiences and to connect with them in supportive ways. In addition to what is already known about clinical assessment and treatment of delirium in palliative care settings, the findings of this study offer points of reflection for nurses anywhere who are contending with the relational challenges that delirium presents in end‐of‐life care. (shrink)

Acculturation is the process through which an individual's cultural behaviors and values change via contact with a majority or host culture. Although some individuals accomplish acculturation smoothly, most experience psychological stress during the acculturation process. When psychologists encounter individuals struggling to acculturate, they are mandated by ethical guidelines and principles to help through several steps: (a) recognize their own biases, beliefs, and attitudes that may influence their work with the acculturating individual; (b) develop competence to work with individuals whose cultural (...) beliefs and practices differ from their own; (c) counsel the acculturating individual using scientifically supported techniques; and (d) intervene without discrimination or disrespect. Two case studies are presented to illustrate how psychologists can ethically and effectively encourage mentally healthy acculturation. Keywords: acculturation, ethics, cultural differences. (shrink)

This is a deceptively profound, compact book that can be inscribed in the grand tradition of philosophical dialogue. It confronts naive realism and radical constructivism, arriving at a seemingly workable conciliatory position.

BackgroundRobust ethics consultation services cannot be sustained by all hospitals; consultative service from a high-volume center via teleconferencing is an attractive alternative. This pilot study was conceived to explore the feasibility and understand the practical implications of offering such a service.MethodsHigh-definition videoconferencing was used to provide real-time interaction between the rounding clinicians and a remote clinical ethicist. Data collection included: (1) evaluation of the hardware and software required for teleconferencing, and (2) comparison of ethics trigger counts between the remote and (...) on-site ethicist during rounds.ResultsIssues with audio represented the majority of technical problems. Once technical difficulties were addressed, the onsite ethicist’s count of “triggers” was not statistically different from the count of the remote ethicist.ConclusionRemote clinical ethics rounding is feasible when the equipment is optimized. Remote ethicists can identify similar numbers of “triggers” for possible ethical issues when compared to on-site ethicist numbers. (shrink)

ObjectivesIn 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia. Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec position themselves regarding the practice of VAE in the context of the new provincial legislation?MethodsWe used interpretive description, an inductive methodology to answer research questions about clinical practice. A total of (...) 18 palliative care physicians participated in semistructured interviews at two university-affiliated hospitals in Quebec.ResultsParticipants positioned themselves in opposition to euthanasia. Their justifications were framed within their professional commitment to not hasten death, which sat in tension with the value of patients’ autonomy to choose how to die. Participants described VAE as unacceptable if it impeded opportunities to evaluate and alleviate suffering. Further, they contested government rhetoric that positioned VAE as a way to improve end-of-life care. Participants felt that VAE would diminish the potential of palliative care to relieve suffering. Dilemmas were apparent in their narratives, about reconciling respect for patient autonomy with broader palliative care values, and the value of accompanying and not abandoning patients who make requests for VAE while being committed to neither prolonging nor hastening death.ConclusionsThis study provides insight into nuanced positions of experienced palliative care physicians in Quebec and confirms expected tensions between an important stakeholder and the practice of VAE as guided by the new legislation. (shrink)

Upshot: This is a deceptively profound, compact book that can be inscribed in the grand tradition of philosophical dialogue. It confronts naive realism and radical constructivism, arriving at a seemingly workable conciliatory position.

The understanding of decision-making systems has come together in recent years to form a unified theory of decision-making in the mammalian brain as arising from multiple, interacting systems (a planning system, a habit system, and a situation-recognition system). This unified decision-making system has multiple potential access points through which it can be driven to make maladaptive choices, particularly choices that entail seeking of certain drugs or behaviors. We identify 10 key vulnerabilities in the system: (1) moving away from homeostasis, (2) (...) changing allostatic set points, (3) euphorigenic signals, (4) overvaluation in the planning system, (5) incorrect search of situation-action-outcome relationships, (6) misclassification of situations, (7) overvaluation in the habit system, (8) a mismatch in the balance of the two decision systems, (9) over-fast discounting processes, and (10) changed learning rates. These vulnerabilities provide a taxonomy of potential problems with decision-making systems. Although each vulnerability can drive an agent to return to the addictive choice, each vulnerability also implies a characteristic symptomology. Different drugs, different behaviors, and different individuals are likely to access different vulnerabilities. This has implications for an individual's susceptibility to addiction and the transition to addiction, for the potential for relapse, and for the potential for treatment. (shrink)

Much of the sustained attention on pandemic preparedness has focused on the ethical justification for plans for the “crisis” phase of a surge when, despite augmentation efforts, the demand for life...

An infinite number of elastically colliding balls is considered in a classical, and then in a relativistic setting. Energy and momentum are not necessarily conserved globally, even though each collision does separately conserve them. This result holds in particular when the total mass of all the balls is finite, and even when the spatial extent and temporal duration of the process are also finite. Further, the process is shown to be indeterministic: there is an arbitrary parameter in the general solution (...) that corresponds to the injection of an arbitrary amount of energy (classically), or energy-momentum (relativistically), into the system at the point of accumulation of the locations of the balls. Specific examples are given that illustrate these counter-intuitive results, including one in which all the balls move with the same velocity after every collision has taken place. (shrink)

Although research has found that long-term mindfulness meditation practice promotes executive functioning and the ability to sustain attention, the effects of brief mindfulness meditation training have not been fully explored. We examined whether brief meditation training affects cognition and mood when compared to an active control group. After four sessions of either meditation training or listening to a recorded book, participants with no prior meditation experience were assessed with measures of mood, verbal fluency, visual coding, and working memory. Both interventions (...) were effective at improving mood but only brief meditation training reduced fatigue, anxiety, and increased mindfulness. Moreover, brief mindfulness training significantly improved visuo-spatial processing, working memory, and executive functioning. Our findings suggest that 4 days of meditation training can enhance the ability to sustain attention; benefits that have previously been reported with long-term meditators. (shrink)

An actual infinity of colliding balls can be in a configuration in which the laws of mechanics lead to logical inconsistency. It is argued that one should therefore limit the domain of these laws to a finite, or only a potentially infinite number of elements. With this restriction indeterminism, energy nonconservation and creatio ex nihilo no longer occur. A numerical analysis of finite systems of colliding balls is given, and the asymptotic behaviour that corresponds to the potentially infinite system is (...) inferred. (shrink)

Understanding the mechanisms of early embryonic patterning and the timely allocation of specific cells to embryonic regions and fates as well as their development into tissues and organs, is a fundamental problem in Developmental Biology. The classical explanation for this process had been built around the notion of positional information. Accordingly the programmed appearance of sources of Morphogens at localized positions within a field of cells directs their differentiation. Recently, the development of organs and tissues from unpatterned and initially identical (...) stem cells (adult and embryonic) has challenged the need for positional information and even the integrity of the embryo, for pattern formation. Here we review the emerging area of organoid biology from the perspective of Developmental Biology. We argue that the events underlying the development of these systems are not purely linked to “self‐organization,” as often suggested, but rather to a process of genetically encoded self‐assembly where genetic programs encode and control the emergence of biological structures. (shrink)

Business students have long been noted for their differential proclivity to engage in academic misconduct. Unfortunately, the potential for misconduct has been exacerbated in recent years by rapid advances in technology, easy access to information, competitive pressures, and the proliferation of websites that provide students access to information that allows them to directly circumvent the learning process. Using a convenience sample of 631 students matriculating in various business majors at four U.S. universities and structural equations modeling procedures, this study assesses (...) the effects of psychological factors on business students’ propensities to utilize the services of homework assistance websites. Specifically, we examine how “Dark Triad” personality traits (i.e., narcissism, Machiavellianism, and psychopathy) interact with Fraud Diamond elements to influence student decisions to engage the services of these websites. We find that each Dark Triad trait exerts a significant influence on at least one of the Fraud Diamond elements, which in turn have a significant direct or indirect positive association with students’ reported intentions to utilize, and reported utilization of, these websites. (shrink)

The prevailing “segregated model” for understanding clinical research sharply separates it from clinical care and subjects it to extensive regulations and guidelines. This approach is based on the fact that clinical research relies on procedures and methods—research biopsies, blinding, randomization, fixed treatment protocols, placebos—that pose risks and burdens to participants in order to collect data that might benefit all patients. Reliance on these methods raises the potential for exploitation and unfairness, and thus points to the need for independent ethical review (...) and more extensive informed consent. In contrast, it is widely assumed that clinical care does not raise these ethical concerns because it is designed to promote the best interests of individual patients. The segregation of clinical research from clinical care has been largely effective at protecting research participants. At the same time, this approach ignores the fact that several aspects of standard clinical care, such as clinician training and scheduling, also pose some risks and burdens to present patients for the benefit of all patients. We argue that recently proposed learning health care systems offer a way to address this concern, and better protect patients, by developing integrated review and consent procedures. Specifically, current approaches base the need for independent ethical review and more extensive informed consent on whether an activity is categorized as clinical research or clinical care. An ethically sounder approach, which could be incorporated into learning health care systems, would be to base the need for independent ethical review and more extensive informed consent on the extent to which an activity poses risks to present patients for the benefit of all patients. (shrink)

This work emerged from funded research examining collaboration among stake-holder organizations present at three U.S. nuclear weapons complex sites. The authors examine issues such as how and why stakeholder groups form collaborative alliances when dealing with the target organization, what leaders of stakeholder organizations actually think about when collaborating to deal with the target organization, and what outcomes result from the collaboration process. Drawing on stakeholder theory and research in interorganizational collaboration, the authors used an inductive, interview-based methodology to build (...) a model of collaboration among nonprofit stakeholder groups. The model contributes to the descriptive stream of stakeholder theory and, in turn, has implications for the instrumental stream. The model also offers implications for future researchers, leaders of stakeholder alliances, and leaders of target organizations. (shrink)