Patient advocacy organizations provide patient- and caregiver-oriented education, advocacy, and support services. PAOs are formally organized nonprofit groups that concern themselves with medical conditions or potential medical conditions and have a mission and take actions that seek to help people affected by those medical conditions or to help their families. Examples of PAOs include the American Cancer Society, the National Alliance on Mental Illness, and the American Heart Association. These organizations advocate for, and provide services to, millions of people with (...) physical and mental conditions — such as cancer, mental illness, diabetes, and cardiovascular disease — via their outreach, meetings, counseling, websites, and published materials. A PAO usually seeks to raise public awareness of a disease’s symptoms, risk factors, and treatment options and promotes research to cure or to prevent that disease. (shrink)

Patient advocacy organizations (PAOs) advocate for increased research funding and policy changes and provide services to patients and their families. Given their credibility and political clout, PAOs are often successful in changing policies, increasing research funding, and increasing public awareness of medical conditions and the problems of their constituents. In order to advance their missions, PAOs accept funding, frequently from pharmaceutical firms. Industry funding can help PAOs advance their goals but can also create conflicts of interest (COI). Research indicates that (...) bias may occur, even among well-meaning professionals, when people and organizations have financial COI. Industry funding may therefore influence PAOs to act in ways that favor the interests of their donors, which may increase the risk of harm to patients. This article extends the analysis developed in the Institute of Medicine report, Conflicts of Interest in Medical Research, Education, and Practice, and applies the analysis to understand PAOs and their relationships with industry. It argues that the preferred goal of institutional COI policies should not be to promote trust, but to promote trustworthiness and appropriately placed trust. (shrink)

Well-designed pragmatic clinical trials (PCTs) are critical for improving healthcare delivery and patient outcomes (Haff and Choudhry 2018), and the article written by Garland et al. (2023) advance...

In response to the Covid‐19 pandemic, health care systems worldwide canceled or delayed elective surgeries, outpatient procedures, and clinic appointments. Although such measures may have been necessary to preserve medical resources and to prevent potential exposures early in the pandemic, moving forward, the indirect effects of such an extensive medical shutdown must not outweigh the direct harms of Covid‐19. In this essay, we argue for the reopening of evidence‐based health care with assurance provided to patients about the safety and necessity (...) of high‐value vaccinations, screenings, therapeutics, and procedures. To ensure that virtually all non‐Covid‐related services do not come to a halt again, health care systems and physician practices must preemptively increase their capacity, secure adequate personal protective equipment to safeguard health care personnel, and develop a measured approach to reclosing such routine health care, should it become necessary in the future. (shrink)

Decisions about continuing or terminating a pregnancy touch on profound, individualized questions about bodily integrity, reproductive autonomy, deeply held values regarding one's capacity for parenthood, and, in the case of a high-risk pregnancy, the risks one is willing to take to have a baby. So far as possible, reproductive decisions are made between a patient, in some cases her partner, and her medical provider. However, this standard framework cannot be applied if the patient lacks decision-making capacity. In this essay, we (...) discuss one such case that came before our clinical ethics team. We describe the challenges of respecting a patient's reproductive preferences when the patient cannot share what those preferences are, and we argue that decisions regarding reproductive health care should not be treated with exceptionalism. Rather, they should proceed under the normal processes of surrogate decision-making, including the application of substituted judgment. This approach enables us to take the patient's values into account when considering the questions implicated in reproductive health care, just as we do for other kinds of health care decisions in which a patient's deeply held values are salient. (shrink)

Volume 20, Issue 4, May 2020, Page 59-61.

Many critics of the legalization of physician‐assisted death oppose it in part because they fear it will further disadvantage those who are already economically disadvantaged. This argument points to a serious problem of how economic considerations can influence medical decisions, but in the context of PAD, the concern is not borne out. We will provide empirical evidence suggesting that concerns about money influence medical decisions throughout the full course of illness, but at the end of life, financial pressure is much (...) more likely to influence a decision to pursue or reject aggressive life‐extending care than it is to influence a request for PAD. We will also address the question of whether financial pressure as a result of being poor—particularly in the context of an inadequate social safety net—robs people of their autonomy, rendering their informed request and consent invalid. We argue that it does not. We will emphasize the impracticality and injustice of rejecting the role of poverty as a legitimate factor in decision‐making, the irrational distinction between PAD and withdrawal of life‐sustaining care, and the more appropriate focus on the great flaws in the American health care system. (shrink)

Checklists have been used to improve quality in many industries, including healthcare. The use of checklists, however, has not been extensively evaluated in clinical ethics consultation. This article seeks to fill this gap by exploring the efficacy of using a checklist in ethics consultation, as tested by an empirical investigation of the use of the checklist at a large academic medical system (Cleveland Clinic). The specific aims of this project are as follows: (1) to improve the quality of ethics consultations (...) by providing reminders to ethics consultants about process steps that are important for most patient-centered ethics consultations, (2) to create consistency in the ethics consultation process across the medical system, and (3) to establish an effective educational tool for trainers and trainees in clinical ethics consultation. The checklist was developed after a thorough literature review and an iterative process of revising and testing by a group of experienced ethics consultants. To pilot test the checklist, it was distributed to 46 ethics consultants. After a six-month pilot period in which ethics professionals used the checklist during their clinical activities, a survey was distributed to all of those who used the checklist. The 10-item survey examined consultants’ perceptions regarding the three aims listed above. Of the 25 survey respondents, 11 self-reported as experts in ethics consultation, nine perceived themselves to have mid-level expertise, and five self-reported as novices. The majority (68 percent) of all respondents, regardless of expertise, believed that the checklist could be a “helpful” or “very helpful” tool in the consultation process generally. Novices were more likely than experts to believe that the checklist would be useful in conducting consultations. The limitations of this study include: reduced generalizability given that this project was conducted at one medical system, utilized a small sample size, and used self-reported quality outcome measures. Despite these limitations, to the authors’ knowledge this is the first investigatation of the use of a checklist systematically to improve quality in ethics consultation. Importantly, our findings shed light on ways this checklist can be used to improve ethics consultation, including its use as an educational tool. The authors hope to test the checklist with consultants in other healthcare systems to explore its usefulness in different healthcare environments. (shrink)

The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving (...) the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work. (shrink)

Physicians, scholars, and policymakers continue to be concerned about conflicts of interests among health care providers. At least two main types of objections to conflicts of interest exist. Conflicts of interests may be intrinsically troublesome if they violate providers’ fiduciary duties to their patients or they contribute to loss of trust in health care professionals and the health care system. Conflicts of interest may also be problematic in practice if they bias the decisions made by providers, adversely impacting patient outcomes (...) or wastefully increasing health care costs. This latter objection may be observed in differences in the prescriptions written, procedures performed, or costs billed by health care professionals who have conflicting interests, when compared to those that do not have such financial relationships. (shrink)

Lukas J. Meier et al. offer the promise of a pathway for resolving clinical bioethical problems using an artificial intelligence interface. The ultimate goal, we assume, is...

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 41, no. 3. © 2015 by Feminist Studies, Inc. 689 Susannah Bartlow White Fear in Universities: The Story of an Assata Shakur Mural No one is going to give you the education you need to overthrow them. No one will teach you your true history, teach you your true heroes if they know that knowledge will set you free. Theory without practice is just as incomplete (...) as practice without theory. The two have to go together. —Assata Shakur, quoted on a mural at Marquette University What does it mean to whitewash? To terminate? I have been tasting and retasting these words on my tongue after a mural of Assata Shakur at Marquette University was whitewashed, and I was fired—terminated —for having supported the mural, ending a fourteen-year career in feminist academia. As the founding director of the Gender and Sexuality Resource Center (GSRC), my job was to build an academic support office for women’s, gender, and LGBTQ+ education and empowerment. In the center’s third year, Amanda Smith (a Marquette senior) and Jeanette Martín (a community artist and program assistant at the center) envisioned, planned, and executed the Assata Shakur mural project as a way to invite greater community interest. In my role as director of the center, I supported the project, communicated it to senior leaders, and spread the word about the community-painting day in late March 2015. The mural was on display for six weeks at the GSRC before a storm of  Students fill in detail of the Assata Shakur mural at Marquette University’s Gender and Sexuality Resource Center. Photograph by Amanda T. Smith. News and Views 691 media coverage in mid-May prompted the university to cover the mural in white paint and fire me for my support of the project. My experience of this process was as rapid as it sounds: I received a few phone calls alerting me that the whitewashing of the mural was imminent and that there was a formal review of my leadership decisions, and I was fired twenty-four hours later. The idiomatic usage of “whitewash” tells us that something is shameful and that it has been, or ought to be, covered up. Whose cover-up was it—and whose shame? Over the six weeks it was on display at the center, the mural invited people into a quiet space off a hallway, and it had sparked discussion among staff, faculty, and students who used the space. The mural was one of very few images of a black woman anywhere on Marquette’s campus, and it contributed to a sense among many students of color that the GSRC was a space in which they were welcomed and safe and where they could be comfortable. Yet in the distortions of white supremacy, the mural looked like a threat, rather than an intellectual and community representation central to the university itself. Other recent cases of faculty repression, from Steven Salaita to Saida Grundy and Zandria Robinson, demonstrate how concerns about liability, finances, and public perception guide administrators ’ decisions about representation on campuses. Far from being liberal utopias, or even spaces that respect speech, universities remain testing grounds when students’ or educators’ actions present direct antiracist critique. What more clear or direct example of antiracist critique than the quotes we chose for the mural: Assata Shakur’s own words asserting the importance of street smarts and intellectual prowess, naming the power invested in knowledge systems and the importance of claiming that power for ourselves? Universities are, in our time, particularly responsive to pressure from the right. Private, nonprofit, advocacy organizations troll university websites looking for evidence of liberal bias; conservative media outlets publish student bloggers who feed the fantasy that the facts of United States history, presented without whitewashing, do not belong in classrooms. In particular, those who study the lives and knowledges of historically marginalized populations are in the crosshairs of right-wing attacks. In the case of the mural—and in each of the other cases cited above— it was either a right-wing news source or a powerful donor or decision 692 News and Views maker who raised concerns about leftist bias, civility, or... (shrink)

The psychology of science typically lacks integration between cognitive and social variables. We present a new framework of team innovation in multidisciplinary science and engineering groups that ties factors from both literatures together. We focus on the effects of a particularly challenging social factor, knowledge diversity, which has a history of mixed effects on creativity, most likely because those effects are mediated and moderated by cognitive and additional social variables. In addition, we highlight the distinction between team innovative processes that (...) are primarily divergent versus convergent; we propose that the social and cognitive implications are different for each, providing a possible explanation for knowledge diversity’s mixed results on team outcomes. Social variables mapped out include formal roles, communication norms, sufficient participation and information sharing, and task conflict; cognitive variables include analogy, information search, and evaluation. This framework provides a roadmap for research that aims to harness the power of multidisciplinary teams. (shrink)

True stories about people who triumphed over seemingly impossible medical diagnoses using untraditional, inventive therapies and perseverance--and about what scientists are discovering on the psychology of healing and the mind-body connection--from the author of theNew York TimesMagazinearticle about her own son, "The Boy with the Thorn in his Joints," which led to this book about other families.

Volume 20, Issue 4, May 2020, Page 108-110.

Trust is often an assumed outcome of participation in Alternative Food Networks (AFNs) as they directly connect producers with consumers. It is based on this potential for trust “between producers and consumers” that AFNs have emerged as a significant field of food studies analysis as it also suggests a capacity for AFNs to foster associated embedded qualities, like ‘morality’, ‘social justice’, ‘ecology’ and ‘equity’. These positive benefits of AFNs, however, cannot be taken for granted as trust is not necessarily an (...) outcome of AFN participation. Using Chinese case studies of AFNs, which are characterised by a distinct form of trust pressure—consumers who are particularly cynical about small scale farmers, food safety and the organic credentials of producers—this paper highlights how the dynamics of trust are in constant flux between producers and consumers. I suggest that it is the careful construction of the aesthetic and multi-sensory qualities of food, which is often celebrated via social media, that human centred relations in Chinese AFNs are mediated. This leads to two key conclusions: first, that the key variable for establishing trust is satisfying the consumer's desire for safe (i.e. "fresh") food; and second, the materiality of the food and the perception of foods materiality (especially through social media), must both be actively constructed by the farmer to fit the consumer's ideal of freshness. (shrink)

To make a business case for corporate sustainability, firms must be able to sell their sustainable products. The influence that firm engagement with non-governmental organizations (NGOs) may have on consumer adoption of sustainable products has been neglected in previous research. We address this by embedding corporate sustainability in a cosmopolitan framework that connects firms, consumers, and civil society organizations based on the understanding of responsibility for global humanity that underlies both the sustainability and cosmopolitanism concepts. We hypothesize that firms’ sustainability (...) engagement and their NGO engagement influence consumer adoption of sustainable products. Empirically, we investigate the adoption of sustainable Eco-circle products made from recycled fibers marketed by Li Ning, a China-based global sportswear brand. We apply a stepwise regression approach to test our hypotheses with paper-and-pencil survey data from 217 Chinese consumers. We find adoption to be positively associated with consumers’ sustainability attitude but not with firms’ sustainability engagement. For firm–NGO engagement, these relationships are reversed: Adoption is positively associated with firm–NGO engagement, but not with consumers’ related attitude. Our results present a picture of the Chinese context in which there is a business case for corporate sustainability if firms’ words about sustainable product strategies are supported by signals from civil society about firm deeds. The results imply that in a Chinese context, firms need to be particularly aware of the role of NGOs when hoping to be rewarded for sustainability. (shrink)

The widespread receptivity of Jewish communities around the world to Meir Kahane demands that we reconsider our narrative of modern Jewish history and religious thought. His racism, calls for violence, and protofascism are startling, given the standard presentation that liberalism and assimilation mark the modern Jewish era. Even more startling is that Kahane's name almost never appears in the major surveys of American Judaism, the history of Zionism, and modern Jewish thought. Yet, Kahane's influence is growing rapidly and already outweighs (...) the influence of most other modern Jewish thinkers and shows no sign of abating, especially with the rise of authoritarian regimes around the world. (shrink)

_Decolonizing Educational Research_ examines the ways through which coloniality manifests in contexts of knowledge and meaning making, specifically within educational research and formal schooling. Purposefully situated beyond popular deconstructionist theory and anthropocentric perspectives, the book investigates the longstanding traditions of oppression, racism, and white supremacy that are systemically reseated and reinforced by learning and social interaction. Through these meaningful explorations into the unfixed and often interrupted narratives of culture, history, place, and identity, a bold, timely, and hopeful vision emerges to (...) conceive of how research in secondary and higher education institutions might break free of colonial genealogies and their widespread complicities. (shrink)

In this paper I offer a reading of one of Plato's later works, the Sophist, that reveals it to be informed by principles comparable on the face of it with those that have emerged recently in the field of critical thinking. As a development of the famous Socratic method of his teacher, I argue, Plato deployed his own pedagogical method, a ‘mid‐wifely’ or ‘maieutic’ method, in the Sophist. In contrast to the Socratic method, the sole aim of this method is (...) not to disabuse the reader or learner of her false opinions. Rather, its purpose is to supply her with the skills and dispositions as well as the claims and counter‐claims she needs to critically evaluate a view, and so facilitate knowledge acquisition, for herself. But the text does not merely teach critical thinking in this indirect manner. One of the strategies its author employed was to encourage the reader/learner to consider under what conditions a claim or idea would be false. To the extent that it achieves this, the Sophist provides both a model and an application of that particular kind of critical thinking in the learning environment that Jonathan Baron has described as ‘active open‐mindedness’. (shrink)

This book provides the first intellectual history of cosmopolitan ideas in the early modern age. The roots of modern cosmopolitanism can be traced back to as early as the 1500s when a meta-narrative and awareness of the cosmopolitan idea came into existence. Unearthing occurrences of cosmopolitan language in popular media and analysing the writings of leading thinkers, Leigh T.I. Penman illustrates how cosmopolitanism was not, as previously thought, purely secular and inclusive but could be sacred and exclusive too. And, (...) significantly, this book reveals the extent to which these contesting ideas of cosmopolitanism influenced the modern concept of the cosmopolitan. (shrink)

Am I pretty? A simple question that epitomises both beauty and vulgarity in its monstrous representation of feminine embodiment. In this work, I look at the 2007 Japanese Horror film Carved: The Slit Mouth Woman directed by Koji Shiraishi and its relation to the way in which it the monster Kuchisake-Onna presents the idealised role of motherhood in Japan today. Through this critical examination of the film, we see how communities establish social order and gender scripts of the feminine within (...) the media, perpetuating hegemonic normalised roles through the monstrous feminine. This work looks at the Japanese urban legend of Kuchisake-Onna and compares it with the movie monster Carved as it projects forms of femininity and motherhood. By cross-referencing the telling of the legend with popular cinema we can see how media influence takes on a broader context towards the gendering of woman. In both the legend and the film, we see how women seek the approval of self and sovereignty, which is demonised, by revealing herself through sexual autonomy. (shrink)

We introduce a path-based cyclic proof system for first-order $\mu $-calculus, the extension of first-order logic by second-order quantifiers for least and greatest fixed points of definable monotone functions. We prove soundness of the system and demonstrate it to be as expressive as the known trace-based cyclic systems of Dam and Sprenger. Furthermore, we establish cut-free completeness of our system for the fragment corresponding to the modal $\mu $-calculus.

Why is racism so tenacious? Drawing from recent methodological innovations in the study of racism, this essay explores the appeal of racism and the erotics of race within the imagination. The slippery nature of racism, and its ability to alter its manifestations with ease and hide behind various disavowals, facilitates the racialization of both religious thought and social institutions.

In this paper I offer a reading of one of Plato’s later works, the Sophist, that reveals it to be informed by principles comparable on the face of it with those that have emerged recently in the field of critical thinking. As a development of the famous Socratic method of his teacher, I argue, Plato deployed his own pedagogical method, a ‘mid-wifely’ or ‘maieutic’ method, in the Sophist. In contrast to the Socratic method, the sole aim of this method is (...) not to disabuse the reader or learner of her false opinions. Rather, its purpose is to supply her with the skills and dispositions as well as the claims and counter-claims she needs to critically evaluate a view, and so facilitate knowledge acquisition, for herself. But the text does not merely teach critical thinking in this indirect manner. One of the strategies its author employed was to encourage the reader/learner to consider under what conditions a claim or idea would be false. To the extent that it achieves this, the Sophist provides both a model and an application of that particular kind of critical thinking in the learning environment that Jonathan Baron has described as ‘active open-mindedness’. (shrink)

These essays survey the histories, the theories and the fault lines that compose the field of memory research. Drawing on the advances in the sciences and in the humanities, they address the question of how memory works, highlighting transactions between the interiority of subjective memory and the larger fields of public or collective memory.

Theological Determinism Theological determinism is the view that God determines every event that occurs in the history of the world. While there is much debate about which prominent historical figures were theological determinists, St. Augustine, Thomas Aquinas, John Calvin, and Gottfried Leibniz all seemed to espouse the view at least at certain points in their … Continue reading Theological Determinism →.

Even though disquotationalism is not correct as it is usually formulated, a deep insight lies behind it. Specifically, it can be argued that, modulo implicit commitment to reflection principles, all there is to the notion of truth is given by a simple, natural collection of truth-biconditionals.

Three eminent scientists analyze the scientific, social, and political roots of biological determinism.

Peer review is an important component of scholarly research. Long a “black box” whose practical mechanisms were unknown to researchers and readers, peer review is increasingly facing demands for accountability and improvement. Numerous studies address empirical aspects of the peer review process. Much less consideration is typically given to normative dimensions of peer review. This paper considers what authors, editors, reviewers, and readers ought to expect from the peer review process. Integrity in the review process is vital if various parties (...) are to have trust, or faith, in the credibility of peer review mechanisms. Trust in the quality of peer review can increase or diminish in response to numerous factors. Five core elements of peer review are identified. Constitutive elements of scholarly peer review include: fairness in critical analysis of manuscripts; the selection of appropriate reviewers with relevant expertise; identifiable, publicly accountable reviewers; timely reviews, and helpful critical commentary. The F.A.I.T.H. model provides a basis for linking conceptual analysis of the core norms of peer review with empirical research into the adequacy and effectiveness of various processes of peer review. The model is intended to describe core elements of high-quality peer review and suggest what factors can foster or hinder trust in the integrity of peer review. (shrink)

Gender transition may be figured as part of a broader creaturely process of being partners in our own becoming. Gender transition is explored through the lenses of transformation (including comparisons with theosis and with religious conversion) and neurodiversity. Humans are transformative creatures; trans and gender-variant people, like others, have the power to curate their own identities and are on a journey toward perfection. Our nature as humans, including our sexed and gendered nature, is not over-and-done-with. In this sense, our active (...) building and shaping of our identities and body-stories is not a rejection of a divine blueprint for human existence, nor an exercise of illegitimate human hubris, but rather a licit creaturely form of generativity. (shrink)

Animals today and tomorrow -- What makes an argument? -- Should animals be used in rodeo sports? -- Should animals be kept as pets? -- Should zoos and safari parks be banned?

In this paper I argue for the superiority of a critical realist understanding of interdisciplinarity over a mainstream understanding of it. I begin by exploring the reasons for the failure of mainstream researchers to achieve interdisciplinarity. My main argument is that mainstream interdisciplinary researchers tend to hypostatize facts, fetishize constant conjunctions of events and apply to open systems an epistemology designed for closed systems. I also explain how mainstream interdisciplinarity supports oppression and gross inequality. I argue that mainstream interdisciplinarity is (...) not true interdisciplinarity and refer to it accordingly as ‘condisciplinarity’. By way of example, I examine the condisciplinarity of the World Health Organization’s ecological model applied to the issue of men’s violence against women. Specifically, I argue that critical realist interdisciplinarity is preferable because it acknowledges inter alia the empirical, actual and real layers of reality, which allows it to develop depth-explanations of phenomena. In practice, this means that critical realist interdisciplinarity can potentially provide explanations that, compared to condisciplinarity, are broader (include more of the human and non-human context) and deeper (include for example individuals’ conscious and unconscious psychological motivations). In the World Health Organization’s example of the causes of men’s violence against women, condisciplinarity resulted in the absence of historical, global and unconscious aspects of the problem. It is also restricted the analysis to reductive, constant-conjunction based theories of the causes of the problem, specifically ‘risk factors’, thereby providing a relatively shallow explanation for the problem. (shrink)

W. H. Auden and Hannah Arendt belonged to a generation that experienced the catastrophic events of the mid-twentieth century, and they both sought to respond to the enormity of the novel phenomena they witnessed.