Unconsented intimate exams on men and women are known to occur for training purposes and diagnostic reasons, mostly during gynecological surgeries but also during prostate examinations and abdominal surgeries. UIEs most often occur on anesthetized patients but have also been reported on conscious patients. Over the last 30 years, several parties—both within and external to medicine—have increasingly voiced opposition to these exams. Arguments from medical associations, legal scholars, ethicists, nurses, and some physicians have not compelled meaningful institutional change. Opposition is (...) escalating in the form of legislative bans and whistleblower reports. Aspiring to professional and scientific detachment, institutional consent policies make no distinction between intimate exams and exams on any other body part, but patients do not think of their intimate regions in a detached or neutral way and believe intimate exams call for special protections. UIEs are found to contribute to moral erosion and moral distress of medical students and compromise the sacred trust between the medical community and the general public. This paper refutes the main arguments in favor of the status quo, identifies a series of harms related to continuing the current practice, and proposes an explicit consent policy for intimate exams along with specific changes to medical school curriculum and institutional culture. Because patients are the rights-holders of their bodies, consent practices should reflect and uphold patient values which call for explicit consent for intimate exams. (shrink)

Hastings Center Report, Volume 52, Issue 2, Page 7-9, March‐April 2022.

Due to COVID-19’s strain on health systems across the globe, triage protocols determine how to allocate scarce medical resources with the worthy goal of maximising the number of lives saved. However, due to racial biases and long-standing health inequities, the common method of ranking patients based on impersonal numeric representations of their morbidity is associated with disproportionately pronounced racial disparities. In response, policymakers have issued statements of solidarity. However, translating support into responsive COVID-19 policy is rife with complexity. Triage does (...) not easily lend itself to race-based exceptions. Reordering triage queues based on an individual patient’s racial affiliation has been considered but may be divisive and difficult to implement. And while COVID-19 hospital policies may be presented as rigidly focused on saving the most lives, many make exceptions for those deemed worthy by policymakers such as front-line healthcare workers, older physicians, pregnant women and patients with disabilities. These exceptions demonstrate creativity and ingenuity—hallmarks of policymakers’ abilities to flexibly respond to urgent societal concerns—which should also be extended to patients of colour. This paper dismantles common arguments against the confrontation of racial inequity within COVID-19 triage protocols, highlights concerns related to existing proposals and proposes a new paradigm to increase equity when allocating scarce COVID-19 resources. (shrink)

We read with interest Lanphier and Anani’s manuscript on trauma-informed ethics consultation. Their model rightly integrates trauma-informed principles within the ethics c...

Legislative strategies for reducing infant abandonment and neonaticide developed in response to a series of sensational cases that occurred in Texas in 1999. The media coverage of these cases implied that the incidence of the crime was increasing, and Texas legislators responded with a law permitting parents to anonymously surrender their newborn at designated locations such as hospitals. This was the first “safe haven” law. Interest peaked nationwide, and by 2008 all states had a similar version of the law. These (...) laws can trigger rapid cessation of parental rights and a fast-tracked adoption to a preapproved family, reflecting the legislators’ assumption that it is better to permit struggling mothers to leave their children with well-intentioned strangers than to abandon the children or end their lives. These laws, however, suffer from several inadequacies. (shrink)

The use of participatory methods has become increasingly popular in agricultural research and development and natural resource management. A range of approaches are being used at the grassroots level in order to involve local citizens and groups in projects. Many of these activities remain peripheral and isolated from conventional development agencies and policies. However, recent efforts are evolving to link participatory approaches into wider planning and policy-making processes and to increase the influence of such methods in resource management initiatives. Main (...) lessons from these innovative participatory experiences in addressing policy issues for sustainable development are summarized. (shrink)

This issue considers the ethics of a healthcare provider intervening into a patient’s genitalia, whether by means of cutting or surgery or by ‘mere’ touching/examination. Authors argue that the permissibility of such actions in the absence of a relevant medical emergency does not primarily turn on third-party judgments of expected levels of physical harm versus benefit, or on related notions such as extensiveness or invasiveness; rather, it turns on the patient’s own consent. To bolster this argument, attention is drawn to (...) the status of the genitals as ‘intimate’ anatomy—a status that is not fully erased by being in a medical context. In this editorial, we draw on the work of Talia Mae Bettcher on ‘intimate agency’ to explore why unconsented interventions into the genitalia may constitute a distinctive sort of personal violation compared to unconsented contact with various other parts of the human body. In their feature article, Marit van der Pijl and colleagues1 argue it is unethical for healthcare providers to perform unconsented episiotomies on persons in labour. In particular, they suggest that, outside of certain rare emergencies in which, for example, the person giving birth is incapacitated1 and the procedure cannot be delayed until consent becomes possible without introducing a significant risk of serious harm (call these ‘medically necessary’2 procedures), ‘presumed consent’ is the incorrect standard to apply. Instead, they stress that, especially when a proposed intervention involves a person’s genital, sexual or reproductive organs, the need to obtain their explicit consent in advance of proceeding must be honoured. As the authors note, the broader social significance of our genitalia—widely regarded as ‘private’ anatomy—is not erased by being in a medical context (see also 2–4). Boundaries must still be observed. Ethically, this ‘leaves a very small margin for error because invasion of these body parts …. (shrink)

Fox’s update of her pivotal 2007 study on ethics consultations in U.S. hospitals found that the gap in ethics consultations is widening between large teaching hospitals and small community hospital...

The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the protocol, summarize the protocol, and discuss the major ethical challenges (...) encountered, along with our answers to the challenges. These challenges include (1) the role of age and chronic comorbidities; (2) evaluating children and pregnant patients; (3) racial, ethnic, and socioeconomic disparities in health; (4) prioritization of healthcare workers; and (5) balancing clinical judgment versus protocolized assessments.We conclude with a review of the limitations of our protocol and the lessons learned. We hope that a robust public discussion of such protocols and the ethical challenges they raise will result in the fairest possible processes, less need for triage, and more lives saved during future waves of the pandemic and similar public health emergencies. (shrink)

Philosophers writing on the subject of human action have found it tempting to introduce their subject by raising Wittgenstein's question, 'What is left over if you subtract the fact that my arm goes up from the fact that I raise my arm?' The presumption is that something of particular interest is involved in an action of raising an arm that is not present in a mere bodily movement, and the philosopher's task is to specify just what this is. Unfortunately, such (...) an approach does not take us very far, since a person could properly be said to raise his (or her) arm while asleep or hypnotized even though he (or she) would not be performing an action in the sense of 'action' with which philosophers are particularly concerned. To avoid this kind of difficulty I shall approach the subject of human action is a more academic way: I shall expound some important rival theories of human action, and introduce the relevant issues by commenting critically on those theories. One of the issues I eventually introduce is a metaphysical one. A theory of action makes sense, I contend, only on the assumption that there are such 'things' as actions (or events). After considering some key arguments bearing on the issue I conclude that, as matters currently stand in philosophy, a metaphysically noncommittal attitude toward actions and events seems justified. (shrink)

Since the introduction of mathematical population genetics, its machinery has shaped our fundamental understanding of natural selection. Selection is taken to occur when differential fitnesses produce differential rates of reproductive success, where fitnesses are understood as parameters in a population genetics model. To understand selection is to understand what these parameter values measure and how differences in them lead to frequency changes. I argue that this traditional view is mistaken. The descriptions of natural selection rendered by population genetics models are (...) in general neither predictive nor explanatory and introduce avoidable conceptual confusions. I conclude that a correct understanding of natural selection requires explicitly causal models of reproductive success. *Received May 2006; revised December 2006. †To contact the author, please write to: Department of Philosophy, Kansas State University, 201 Dickens Hall, Manhattan, KS 66506; e‐mail: [email protected] . (shrink)

Gathering thoughts -- Teachers who inspired me -- What am I? : Montessori? Steiner? eclectic? : Is it important? -- Which comes first? : a philosophical framework, theory and research evidence : what do teachers and other practitioners need to bring out their best work -- Working with principles which are interpreted and embedded in articulated practice -- The importance of parent partnership and the development of moral values and self-discipline -- Play : a very complex thing -- Finding how (...) to position myself in relation to play -- Inclusion : commonalities, differences"fragmentation or wholeness?"-- Cultivating creativity -- Remaining a generalist rather than becoming a specialist within one area of early childhood education -- Changing political climates -- How best to train teachers of young children -- Remaining a Froebelian but still exploring why and wondering "will I always be one?". (shrink)

In their target article, “Proposed Principles for International Bioethics Conferencing: Anti-Discriminatory, Global, and Inclusive,” Jecker et al. (2024) highlight the growing international scope o...

This chapter contains sections titled: Eudaimonia, Ergon, and Espresso The Golden Mean The Bean.

Based upon Ajit Maan's groundbreaking theory of Internarrative Identity, this collection focuses upon redefining self, slave narrative, the black Caribbean diaspora, and cyberspace to explore the interconnection between identity and life experience as expressed through personal narrative.

The book examines what advocates of the law of karma mean by the doctrine, various ways they interpret it, and how they see it operating. The study investigates and critically evaluates the law of karma's connections to significant philosophical concepts like causation, freedom, God, persons, the moral law, liberation, and immortality. For example, it explores in depth the implications of the doctrine for whether we are free or fatalistically determined, whether human suffering can be reconciled with cosmic justice, the nature (...) of the self, and the character of moral experience. (shrink)

Industry groups engage in venue shifting when they seek to overturn or alter restrictive regulations imposed by one political venue through another. A critical step in this process is resolving uncertainties surrounding the preference of the targeted venue and the nature of the relevant policy proposal. While existing studies emphasize a long-term trial-and-error process of policy learning, we focus on nascent industries and argue that ventures seek other information sources to resolve these uncertainties quickly. In particular, nascent industry groups are (...) likely to perceive that the targeted venue will support their policy proposal if the targeted venue is ideologically distant from the venue that has enacted the restrictive regulations, if the targeted venue has recently supported other nascent industry groups’ similar policy proposals, or if the industry groups themselves are more exposed to industry peers’ success in promoting the same policy proposal in other jurisdictions. Under these conditions, the industry groups invest more to influence the targeted venue in response to restrictive regulations enacted by other venues. We find support for our theory by examining how from 2013 to 2019 the small unmanned aircraft systems industry trade associations in the United States lobbied state governments to nullify local regulations. (shrink)

"In Entangled Empathy, scholar and activist Lori Gruen argues that rather than focusing on animal rights, we ought to work to make our relationships with animals right by empathetically responding to their needs, interests, desires, vulnerabilities, hopes, and unique perspectives. Pointing out that we are already entangled in complex and life-altering relationships with other animals, Gruen guides readers through a new way of thinking about and practicing animal ethics. Lori Gruen is Professor of Philosophy and Coordinator of Wesleyan (...) Animal Studies at Wesleyan University. She is the author of Ethics and Animals and co-editor, with Carol Adams, of Ecofeminism: Feminist Intersections with Animals and the Earth."--Back cover. (shrink)

<I>Cosmopolitanism and the Arab Spring: Foundations for the Decline of Terrorism analyzes the role of social media in the Arab Spring within a specific philosophical framework. Kantian cosmopolitanism, enhanced by social media and Internet communications technologies, offers a solid explanation of the political evolution of the Arab Spring. These technologies have given rise to a new cosmopolitanism that rejects alternating dichotomies in favor of an evolving consciousness of our status as citizens of a global commonwealth with a tiered set of (...) duties to everyone within our sphere of influence. Cosmopolitanism as extended through social media has the potential to break down barriers to aid those who suffer under unjust governmental systems and to yield real and sustainable progress toward the amelioration of both tyranny and terrorism. <I>Cosmopolitanism and the Arab Spring is recommended for political philosophy courses as well as interdisciplinary capstone courses exploring problems in the modern world. (shrink)

Over the course of his work, Graham Oppy developed numerous important criticisms of versions of the cosmological argument. Here I am not concerned with his specific criticisms of cosmological arguments but rather with his claim that cosmological arguments per se are not good arguments, for they provide no persuasive reason for believing the conclusion that God exists and are embedded in theories that already affirm the conclusion. I explore what he believes makes an argument good, contend that cosmological arguments can (...) have functions within worldviews other than persuasion, and consider his recent modifications of the discussion that address competing worldviews. (shrink)

The version uploaded to this site is a late draft. The paper arises both from William L. Rowe's classic 1979 discussion of the problem of evil, argues that there exist instances of intense suffering which an omnipotent, omniscient being could have prevented without thereby losing some greater good or permitting some evil equally bad or worse, and also from Steven Wykstra's response, in the course of which he argues for the following Condition of Reasonable Epistemic Access (CORNEA): "On the basis (...) of cognized situation s, human H is entitled to claim 'It appears that p' only if it is reasonable for H to believe that, given her cognitive faculties and the use she has made of them, if p were not the case, s would likely be different in some way discernible by her." My paper discusses CORNEA, and proposes a replacement principle. (shrink)

Locates in Schelling a new understanding of our relation to nature in philosophy.

Why are we here? What is the meaning of life? How can we feel happy and free? The answers to these and other life questions are gathered in Tiny Buddha, Simple Wisdom for Life's Hard Questions. Tiny Buddha began as a quote-a-day Twitter account, @tinybuddha, in 2008. Lori Deschene's daily wisdom posts about mindfulness, non-attachment, and happiness became so popular that she now has more than 200,000 twitter followers who share quotes and stories about inspiration in their daily lives.Deschene (...) asked her Twitter followers to contribute their thoughts and perspectives on the difficult questions that influence how we live our everyday lives: thoughts about the meaning of life, pain, happiness, fate, and more.Tiny Buddha, Simple Wisdom for Life's Hard Questions is a combination of the amazing responses that she received along with her own insightful essays, and insights from wise teachers around the world and throughout time. Deschene explores how these issues have played out in her own life and offers action-oriented suggestions to help people empower themselves, even in a world with so much uncertainty. The result is a guide that helps readers discover the endless possibilities for a life lived mindfully in the present, and connected to others. (shrink)

Why do states who are committed to the principle of civilian immunity and the protection of non-combatants end up killing and injuring large numbers of civilians during their military operations? Bugsplat explains this paradox through an in-depth examination of five conflicts fought by Western powers since 1989.

The practical guide provides advice on assessing whether existing ethics programmes are effective and culturally appropriate and developing and disseminating organisation-wide values and standards to take account of the many cultures in which a business operates, including training which is as culturally relevant to employees worldwide.

« Ce guide offre aux étudiants en formation initiale à l'enseignement, au personnel enseignant en poste, à leurs formateurs et aux directions d'établissement scolaire les ressources nécessaires pour se frayer un chemin à travers les cadres éthiques et légaux complexes qui réglementent le quotidien de la pratique enseignante. ».

This study examined differences between university students who were caught and sanctioned for cheating, students admitting to cheating but who were not caught, and students reporting that they had never cheated. Our findings showed that noncheaters are older, have better grade point averages, and have more sophisticated moral and epistemological reasoning skills. Qualitative analyses revealed that denial of responsibility and injury were the most common neutralization techniques and differed between the sanctioned and self-reported cheaters. We discuss the need to examine (...) the extent to which reasoning skills have a causal impact on cheating behaviors. (shrink)

BackgroundMedical aid in dying was introduced in Quebec in 2015. Quebec clinical guidelines recommend that MAiD be approached as a last resort when other care options are insufficient; however, the law sets no such requirement. To date, little is known about when and how requests for MAiD are situated in the broader context of decision-making in end-of-life care; the timing of MAiD raises potential ethical issues.MethodsA retrospective chart review of all MAiD requests between December 2015 and June 2017 at two (...) Quebec hospitals and one long-term care centre was conducted to explore the relationship between routine end-of-life care practices and the timing of MAiD requests.ResultsOf 80 patients requesting MAiD, 54% received the intervention. The median number of days between the request for MAiD and the patient’s death was 6 days. The majority of palliative care consults came less than 7 days prior to the MAiD request and in another 25% of cases occurred the day of or after MAiD was requested. 35% of patients had no level of intervention form, or it was documented as 1 or 2 at the time of the MAiD request and 19% were receiving life-prolonging interventions.InterpretationWe highlight ethical considerations relating to the timing of MAiD requests within the broader context of end-of-life care. Whether or not MAiD is conceptualised as morally distinct from other end-of-life options is likely to influence clinicians’ approach to requests for MAiD as well as the ethical importance of our findings. We suggest that in the wake of the 2015 legislation, requests for MAiD have not always appeared to come after an exploration of other options as professional practice guidelines recommend. (shrink)

One of America's foremost philosophers reflects on the discipline and its relation to everyday life.

Offers a compelling vision of how to achieve and conduct a liberal but democratic society through the ideal of Neutrality--between people and ideas of the good--and using the tool of Neutral dialogue.

Abstract:To date, our understanding of ethical decision making and behavior in organizations has been concentrated in the area of moral judgment, largely because of the hundreds of studies done involving cognitive moral development. This paper addresses the problem of our relative lack of understanding in other areas of human morality by applying a recently developed construct—moral approbation—to illuminate the link between moral judgment and moral action. This recent work is extended here by exploring the effect that organizations have on ethical (...) behavior in terms of the moral approbation construct. (shrink)

Corporate governance and finance are dynamic academic fields that offer myriad opportunities for business ethics analysis. Within the corporate governance triad in recent years, shareholders have increased their power over boards of directors and executives through both regulation and movements to change corporate by-laws. The impact of board characteristics on firm performance has proven elusive, leading to questions concerning board processes and individual director beliefs and behaviors. At the same time, CEOs have lost considerable power, leaving many struggling to regain (...) their control and maintain their compensation levels, while others adopt a stewardship approach to their posts. In the field of finance, the recent financial debacle has led to a reexamination of financial regulation and of the fundamental nature and purpose of the industry. All of these issues provide business ethicists fodder for investigation and analysis. (shrink)

Some bioethicists argue that conscientious objectors in health care should have to justify themselves, just as objectors in the military do. They should have to provide reasons that explain why they should be exempt from offering the services that they find offensive. There are two versions of this view in the literature, each giving different standards of justification. We show these views are each either too permissive (i.e. would result in problematic exemptions based on conscience) or too restrictive (i.e. would (...) produce problematic denials of exemption). We then develop a middle ground position that we believe better combines respect for the conscience of healthcare professionals with concern for the duties that they owe to patients. Our claim, in short, is that insofar as objectors should have to justify themselves, they should have to do it according to the standard that we defend rather than according to the standards that others have developed. (shrink)

Examines art and literature of the Americas through the lens of the questionnaire, a genre as central as the manifesto to the history of the avant-garde. Demonstrates how modernism and the avant-garde were debated at the very moment of their development and consolidation"--Provided by publisher.