To better understand the available publications addressing ethical issues in rural health care we sought to identify the ethics literature that specifically focuses on rural America. We wanted to determine the extent to which the rural ethics literature was distributed between general commentaries, descriptive summaries of research, and original research publications. We identified 55 publications that specifically and substantively addressed rural health care ethics, published between 1966 and 2004. Only 7 (13%) of these publications were original research articles while (12) (...) 22% were descriptive summaries of research and 36 (65%) were general commentaries. The majority of publications examined (55%) were clinically focused while 27% addressed organizational ethics and 18% addressed ethical ramifications of rural health care policy at a national or community level. Our findings indicate that there are a limited number of publications focusing on rural health care ethics, suggesting a need for scholars and researchers to more rigorously address rural ethics issues. (shrink)

When students are meaningfully involved and emotionally invested in content, they learn more and perform better. In 20 strategies for increasing student engagement, Dr. William N. Bender provides practical examples, guidelines, and the research behind his teaching tips to help educators focus on specific strategies for engaging students in the classroom. In today's rigorous educational landscape, even the most effective teachers are working to polish their practice. Bender offers a wealth of ways to develop intensive, attention-grabbing instructional techniques that (...) foster high levels of student achievement.--from book cover. (shrink)

This paper is concerned with the normative content of Kant's formula of humanity (FH). More specifically, does FH, as some seem to think, imply the specific and rigid prescriptions in 'standard' deontological theories? To this latter question, I argue, the answer is 'no'. I propose reading FH largely through the formula of autonomy and the formula of the kingdom of ends, where I understand FA to describe the nature of the capacity of humanity-a capacity for self-governance. The latter, I suggest, (...) is akin to the capacity for planning and intentional action described in Michael Bratman's work. A significant part of what FH requires, I then propose, is that we exercise these capacities for planning in such a way that we accommodate and coordinate with the (permissible) plans and intentions of others. Kant himself, as do many commentators, emphasizes the idea that our human capacities give us a distinctive kind of value. On my interpretation, by contrast, what is fundamentally important is not the value of the capacities but rather what they make possible: distinctive ways of mistreating (using) persons, but also a distinctive kind of morally desirable relationship. CiteULike Connotea Del.icio.us What's this? (shrink)

An experimenting society is one in which policy-relevant knowledge is created. It is then critically assessed and communicated in real-life or natural settings, with the aim of discovering new forms of public action to improve the problem-solving capacities of society. This latest volume of the distinguished Policy Studies Review Annual series probes, evaluates, and augments the work of Donald T. Campbell on an experimental societies. A basic assumption of this volume is that Campbell's perspective supplies a useful way to address (...) increasingly complex and seemingly unmanageable problems facing the United States and other postindustrial societies. This volume is also the fourteenth festschrift to be issued by Transaction. The focus is on theoretical as well as practical options for creating an experimenting society. The rationale for this focus is the belief, increasingly -shared in the social science and policy-making communities alike, that researchers are essentially ignorant about how to solve many of the most pressing larger problems of this epoch. This frank recognition of ignorance is a prerequisite of genuine scientific and professional curiosity, without which knowledge gains are next to impossible to achieve, and a'precondition of an experimenting society. Contributors to this original volume include: Steve-Fuller, Duncan MacRae, Jr., Anthony S. Bryk, Robert A. Beauregard, Rita Mae Kelly, Peter Gregware, Burkart Holzner, B. Guy Peters, C. West Churchman, and Ian I. Mitroff. Their multidisciplinary competencies are at once philosophical, methodological, and substantive. They address such questions as: What new or bold policies are available in domains such as education, science, and urban development? In what ways can theoretical knowledge and practical action be fused so as to illuminate or alleviate policy problems? What should be done? Included are excerpts from Campbell's foundational paper "The Experimenting Society," as well as a recent article entitled "Methods for the Experimenting Society," which circulated in unpublished form for many years. An unusual feature of the book is Campbell's responses to those who have addressed his work with candor and intelligence. It will be of interest to policy studies scholars, sociologists, and social scientists. (shrink)

In this manuscript, the author demonstrates how a new idea of the future came into being in eighteenth-century France with the development of modern biological, economic, and social engineering. With the emergence of these practices, the future transformed from something that was largely believed to be predetermined and beyond significant human intervention into something that could be significantly affected through actions in the present. Focusing on the second-half of the century, The author argues that specific mechanisms for constructing the future (...) first arose through the development of practices and instruments aimed at countering degeneration. In their attempts to regenerate a healthy natural state, Enlightenment philosophes created the means to exceed previously recognized limits and create a future that was not merely a recuperation of the past, but was fundamentally different from it. The new active orientation to the future that emerged from these practices was not something that was explicitly articulated during the Enlightenment. Instead this practical orientation must be seen as an implicit understanding of historical temporality. Historical actors often had a tacit knowledge of time--one that they worked with--without necessarily being fully aware of it or articulating it explicitly in their writing. The full articulation of the new idea of the future did not occur until the French Revolution, but the practical understanding of it that developed during the Enlightenment played an important role in making possible the French revolutionaries' unprecedented attempts to remake the world completely anew. (shrink)

The rural health context in the United States presents unique ethical challenges to its approximately 60 million residents, who represent about one quarter of the overall population and are distributed over three-quarters of the country’s land mass. The rural context is not only identified by the small population density and distance to an urban setting but also by a combination of social, religious, geographical, and cultural factors. Living in a rural setting fosters a sense of shared values and beliefs, a (...) strong work ethic, self-reliance, and a tendency for close-knit extended social structures where overlapping relationships are commonplace. (shrink)

Utilitarianism is subject to objections of at least three kinds: It is wrong about the nature of the fundamental property in virtue of which wrong acts are wrong. It is self-defeating in the sense that acting as it requires will actually undermine the goal of maximization. The acts it requires are, intuitively, wrong. In the book under review, Bailey replies to objections of all three kinds, but especially to the third.

The purpose of this study was to assess the presence of ethics committees in rural critical access hospitals across the United States. Several studies have investigated the presence of ethics committees in rural health care facilities. The limitation of these studies is in the definition of ‘rural hospital’ and a regional or state focus. These limitations have created large variations in the study findings. In this nation-wide study we used the criteria of a critical access hospital (CAH), as defined by (...) the Medicare Rural Hospital Flexibility Program (Flex Program, 2007), to bring consistency and clarity to the assessment of the presence of ethics committees in rural hospitals. The Flex Monitoring Team conducted a national telephone survey of 381 CAH administrators throughout the United States. The survey covered a wide variety of questions concerning hospitals’ community benefit, impact activities, and whether the hospital had a formally established an ethics committee. About 230 (60%) of the respondents indicated they had a formally established ethics committee or ethics consultation program at their CAH. The prevalence of ethics committees declined as the CAH location became increasingly rural along a rural–urban continuum. Unlike CAHs, all rural Department of Veterans Affairs Medical Centers have ethics committees. The results of this study provide an understanding of the limited presence of ethics committee in rural America and the need to consider new approaches for providing ethics assistance. A virtual ethics committee network may be the most efficient and effective way of providing rural hospitals access to a knowledgeable ethics committee or consultant. (shrink)

This paper addresses two questions. First, how different is the ideal underlying deliberative democracy from the ideal expressed in contemporary liberal theory, especially contractualist theory and "political liberalism"? Second, what specific institutional prescriptions, if any, follow from deliberative democracy? It is argued that the deliberative ideal has become quite abstract and, in fact, does not differ significantly from many forms of contemporary liberalism. Moreover, it is something of an open question just what institutions best realize this ideal. Specifically, the ideal (...) does not necessarily require conventional, majoritarian institutions. (shrink)

The ethical standard for informed consent is fostered within a shared decision-making process. SDM has become a recognized and needed approach in health care decision-making. Based on an ethical foundation, the approach fosters the active engagement of patients, where the clinician presents evidence-based treatment information and options and openly elicits the patient’s values and preferences. The SDM process is affected by the context in which the information exchange occurs. Rural settings are one context that impacts the delivery of health care (...) and SDM. Rural health care is significantly influenced by economic, geographical and social characteristics. Several specific distinctive features influence rural health care decision-making—poverty, access to health care, isolation, over-lapping relationships, and a shared culture. The rural context creates challenges as well as fosters opportunities for the application of SDM as a natural dynamic within the rural provider–patient relationship. To fulfill the ethical requirements of informed consent through SDM, it is necessary to understand its inherent challenges and opportunities. Therefore, rural clinicians and ethicists need to be cognizant of the impact of the rural setting on SDM and use the insights as an opportunity to achieve SDM. (shrink)