Autumn Fiester identifies an important element in clinical ethics consultation (CEC) that she labels, from the Greek, aporia, “state of perplexity,” evidenced in CEC as ethical ambiguity. Fiester argues that the inherent difficulties of cases so characterized render them inappropriate for voting and more amenable to mediation and the search for consensus. This commentary supports Fiester’s analysis and adds additional reasons for rejecting voting as a process for resolving disputes in CEC including: it distorts the analysis by empowering individual (...) voters preferences and biases rather than focusing on the interests and wishes of the patient and family; it offers an insufficiently sensitive model for resolving the awesome, nuanced, conflicted, and ethically complex issues surrounding life and death; it marginalizes minority opinions that may have moral validity. (shrink)

We respond to Autumn Fiester’s critique that our proposed bioethical consensus project amounts to “ethical hegemony,” and evaluate her claim that ethicists should restrict themselves to “mere process” recommendations. We argue that content recommendations are an inescapable aspect of clinical ethics consultation, and our primary concern is that, without standardization of bioethical consensus, our field will vacillate among appeals to the disparate claims in the 22 “Core References,” unsustainable efforts to defend value-neutral process recommendations, or become a practice of (...) Lone Ranger clinical ethicists. We contend that a consensus document that captures the basic moral commitments of patients and careproviders is the next step in the professional evolution of our field. (shrink)

Responding to Max Weber’s modern diagnosis of nature, science, and medicine as disenchanted, this article aims to reenvision nature and medicine with a sense of enchantment drawing from the Christian themes of creation, Christology, suffering, and redemption. By reenvisioning nature as enchanted with these theological themes, the vocation of medicine might be revitalized in terms of suffering presence, healing care, and works of mercy toward the neighbor in need.

Volume 20, Issue 6, June 2020, Page 73-75.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Too Expensive to Treat? Finitude, Tragedy, and the Neonatal ICU by Charles C. CamosyAutumn Alcott RidenourReview of Too Expensive to Treat? Finitude, Tragedy, and the Neonatal ICU CHARLES C. CAMOSY Grand Rapids, MI: Eerdmans, 2010. 208 pp. $18.00In Too Expensive to Treat? Charles Camosy makes an important contribution to bioethics and Christian ethics by making the case for the need to consider social factors when treating imperiled newborns. (...) Arguing for both the full moral status of newborns and Roman Catholic social teaching’s emphasis on the just allocation of resources, Camosy calls the medical community, bioethicists, and [End Page 209] Christian ethicists to account for current practices that disproportionately favor exorbitant costs for imperiled infants over other even more basic medical needs within the US health care system. Written before the adoption of the Affordable Care Act under the Obama administration, Camosy’s argument has only increased in significance given the national need to prioritize resources in view of the government’s expansion of health care coverage.Born within twenty-two to twenty-four weeks of gestation and weighing between 500 and 850 grams, some imperiled infants absorb hundreds of thousands of dollars in short-term care that may extend into millions of dollars given long-term costs (146, 171–93). Recognizing the tragic reality in which “we have virtually unlimited health care needs” coupled with “limited health care resources,” Camosy contends that current Medicaid funds that privilege the NICU (neonatal intensive care unit) should be reevaluated (1–3). In an effort to temper the “autonomous,” patient-driven principle with “justice,” Camosy poses a challenging philosophical, theological, and practical proposal for what he identifies as the “gray area” of the NICU.Maintaining a twofold commitment to human dignity that values the moral worth of the infant, on the one hand, and the common good that privileges a preferential option for the poor, on the other, Camosy develops his argument in four major steps. First, he validates the moral status of newborn infants and rejects social quality of life models that dismiss their intrinsic status as “persons.” Second, he dismisses arguments that emphasize personal dignity at the expense of considering the social quality of life, pointing out that such arguments disregard Catholic social teaching’s emphasis on the link between relational anthropology and human personhood (100). Third, he contends that “weak” social quality of life models that privilege the patient or individual over social considerations do not take seriously either Catholic social teaching’s emphasis on the common good or the potentially overwhelming economic and practical burdens they might place on families and society as a whole. Finally, Camosy presents a constructive proposal for limiting NICU resources that seeks to counter a culture of overtreatment that idolizes technology and is at the mercy of an unrestrained free market (162). Emphasizing the need for a just allocation of resources, he supports withholding and withdrawing life-sustaining treatment in some cases, thus foreseeing the possible death of some infants. Although he does not accept the direct killing of these infants, he does maintain that Catholic social teaching would allow for the withdrawal of life-sustaining treatment based on certain criteria.Camosy raises a host of important considerations relevant to decisions about imperiled infants. Yet a few questions remain. First, from a Christian point of view, does he not fall into a kind of soft utilitarianism, even though he himself desires to avoid the pitfalls of utilitarianism? Second, how might Camosy envision Christian practices that care for “exposed” infants left without life-sustaining treatment? Finally, what about the difficult emotions that accompany [End Page 210] the death of an infant or child? Do certain kinds of grief complicate our rationing choices that appear to pit the old against the young? While perhaps unanswerable, these questions merit further discussion.Autumn Alcott RidenourMerrimack CollegeCopyright © 2015 Society of Christian Ethics... (shrink)

While Simone de Beauvoir's inaugural reflection in The Coming of Age depicting the aging experience as one of social marginalization and lament seemingly endures, a surprising source for offering hope to aging persons may be found in the theology of Karl Barth in congruence with W. H. Vanstone. This essay reconsiders the meaning of aging within a Christological interpretation that not only values the various life stages along with intergenerational relationships but also offers meaning for the embodiment of active and (...) passive agency during the aging stage of life. (shrink)

Much evidence suggests that semantic characteristics of a message (e.g., the extent to which the message evokes thoughts of spatial or motor properties) and social characteristics of a speaking situation (e.g., whether there is a listener who can see the speaker) both influence how much speakers gesture. However, the Gesture as Simulated Action (GSA) framework (Hostetter & Alibali, ) predicts that these effects should not be independent but should interact such that the effect of visibility is lessened when a message (...) evokes strong thoughts of action. This study tested this claim by comparing the gesture rates produced by speakers as they described 24 nouns that vary in how strongly they evoke thoughts of action. Further, half of the words were described with visibility between speaker and listener blocked. The results demonstrated a significant interaction as predicted by the GSA framework. (shrink)

Sentence comprehension involves maintaining and continuously integrating linguistic information and, thus, makes demands on working memory. Past research has demonstrated that semantic WM, but not phonological WM, is critical for integrating word meanings across some distance and resolving semantic interference in sentence comprehension. Here, we examined the relation between phonological and semantic WM and the comprehension of center-embedded relative clause sentences, often argued to make heavy demands on WM. Additionally, we examined the relation between phonological and semantic WM and the (...) comprehension of transitive and dative active and passive sentences, which may also draw on WM resources depending on the number of propositions that must be maintained and the difficulty of processing passive clauses. In a large sample of individuals with aphasia, we assessed whether comprehension performance on more complex vs. simpler active-passive or embedded relative clause sentences would be predicted by semantic but not phonological WM when controlling for single word comprehension. For performance on the active-passive comprehension task, we found that semantic WM, but not phonological WM, predicted comprehension of dative sentences when controlling for comprehension of transitive sentences. We also found that phonological WM, but not semantic WM, predicted mean comprehension for reversible active-passive sentences when controlling for trials with lexical distractors. On the relative clause comprehension task, consistent with prior results, we found that semantic WM, but not phonological WM, predicted comprehension of object relative clause sentences and relative clause sentences with a passive construction. However, both phonological WM and semantic WM predicted mean comprehension across all relative clause types for reversible trials when controlling for trials with lexical distractors. While we found evidence of semantic WM’s role in comprehension, we also observed unpredicted relations between phonological WM and comprehension in some conditions. Post-hoc analyses provided preliminary evidence that phonological WM maintains a backup phonological representation of the sentence that may be accessed when sentence comprehension processing is less efficient. Future work should investigate possible roles that phonological WM may play across sentence types. (shrink)

Speakers often use gesture to demonstrate how to perform actions—for example, they might show how to open the top of a jar by making a twisting motion above the jar. Yet it is unclear whether listeners learn as much from seeing such gestures as they learn from seeing actions that physically change the position of objects (i.e., actually opening the jar). Here, we examined participants' implicit and explicit understanding about a series of movements that demonstrated how to move a set (...) of objects. The movements were either shown with actions that physically relocated each object or with gestures that represented the relocation without touching the objects. Further, the end location that was indicated for each object covaried with whether the object was grasped with one or two hands. We found that memory for the end location of each object was better after seeing the physical relocation of the objects, that is, after seeing action, than after seeing gesture, regardless of whether speech was absent (Experiment 1) or present (Experiment 2). However, gesture and action built similar implicit understanding of how a particular handgrasp corresponded with a particular end location. Although gestures miss the benefit of showing the end state of objects that have been acted upon, the data show that gestures are as good as action in building knowledge of how to perform an action. (shrink)

In the current career landscape and labor market, career transitions have become a critical aspect of career development and are significant for Human Resource Development research and practice. Our research examines the type of support used during different career transitions and who can provide that support to women in career transition. We investigated four types of social support—emotional, appraisal, informational, and instrumental—and their roles in five types of career transitions: school-to-work transition, upward mobility transition, transition to a new profession, transition (...) to entrepreneurship, career re-entry transition, and transition to retirement. We analyzed 80 journal articles using directed content analysis, cross-tabulation, and nonparametric statistical tests. Instrumental support appears to be the most commonly documented type of social support in this career transition literature. Appraisal support was consistently documented least for each type of career transition. Our results may highlight the importance of personal connections and internal resources in successful career transitions for women. Based on our findings, we offer a model of women's social support network for career transitions and advocate for expanded networks of social support for women anticipating and during career transitions. The results of our study contain insights for how women can be supported in transitioning to the next career experience. We conclude with suggestions for future research. (shrink)

A Black feminist disability framework allows for methodological considerations of the intersectional nature of oppression. Our work in this article is twofold: to acknowledge the need to consider disability in Black Studies and race in Disability Studies, and to forward an intersectional framework that considers race, gender, and disability to address the gaps in both Black Studies and Disability Studies. By employing a Black feminist disability framework, scholars of African American and Black Studies, Women’s, Gender, and Sexuality Studies, and Disability (...) Studies have a flexible and useful methodology through which to consider the historical, social, cultural, political, and economic reverberations of disability. (shrink)

According to the SIMS model, mimicry and simulation contribute to perceivers' understanding of smiles. We argue that similar mechanisms are involved in comprehending the hand gestures that people produce when speaking. Viewing gestures may elicit overt mimicry, or may evoke corresponding simulations in the minds of addressees. These real or simulated actions contribute to addressees' comprehension of speakers' gestures.

In the past decade there has been a lot of attention to the quality of the evidence in experimental psychology and in other social and medical sciences. Some have described the current climate as a ‘crisis of confidence’. We focus on a specific question: how can we increase the quality of the data in psychology and cognitive neuroscience laboratories. Again, the challenges of the field are related to many different issues, but we believe that increasing the quality of the data (...) collection process and the quality of the data per se will be a significant step in the right direction. We suggest that the adoption of quality control systems which parallel the methods used in industrial laboratories might be a way to improve the quality of data. We recommend that administrators incentivize the use of quality systems in academic laboratories. (shrink)

Using a feminist hermeneutic, Autumn Reinhardt-Simpson attempts to set out in this article how a third- or fourth-wave intersectional reading of the stories of Hagar and Sarah and Leah, Rachel, and their maids can become a source of both truth and healing within feminist activist communities today, particularly those working for reproductive justice. Reinhardt-Simpson identifies several issues within the stories such as societal acceptance of women who seek power only within patriarchal constructs or to benefit the aims of patriarchy, (...) as well as issues that divide women both then and today such as class, race, and status and the way that women relate to each other within a patriarchal structure. Reinhardt-Simpson concludes that a liberatory reading of these stories can point us toward reconciliation with our sisters. (shrink)

This book brings together scholars from a variety of epistemological perspectives to explore the multiple ways in which sexuality does indeed matter in the arena of public education.

While there is significant consensus that undergraduate medical education should include bioethics training, there is widespread debate about how to teach bioethics to medical students. Educators disagree about course methods and approaches, the topics that should be covered, and the effectiveness and metrics for UME ethics training. One issue that has received scant attention is the timing of bioethics education during medical training. The existing literature suggests that most medical ethics education occurs in the pre-clinical years. Follow-up studies indicate that (...) medical students in their clinical rotations have little recall or ability to apply ethics concepts that were learned in their pre-clinical training. Trainees also report a desire for medical ethics to be taught in the context of practical application, which would suggest that the timing of pre-clinical ethics education is flawed. However, moving bioethics training to the clinical years should not be assumed to be the solution to the problems of recall and theory application. We argue that the effectiveness of timing bioethics education will depend on when medical students witness or experience particular categories of ethical dilemmas during their training. Our overarching hypothesis is that ethics education will be most effective when the bioethics training on a particular topic correlates to experiential exposure to that ethical issue. The purpose of our current study was to describe medical students exposure to particular categories of ethical conflicts, dilemmas, or issues. Our results may help bioethics educators better strategize about the most effective timing of medical ethics training in UME. (shrink)

BackgroundUpper limb impairment is common after stroke, and many will not regain full upper limb function. Different technologies based on surface electromyography (sEMG) have been used in stroke rehabilitation, but there is no collated evidence on the different sEMG-driven interventions and their effect on upper limb function in people with stroke.AimSynthesize existing evidence and perform a meta-analysis on the effect of different types of sEMG-driven interventions on upper limb function in people with stroke.MethodsPubMed, SCOPUS, and PEDro databases were systematically searched (...) for eligible randomized clinical trials that utilize sEMG-driven interventions to improve upper limb function assessed by Fugl-Meyer Assessment (FMA-UE) in stroke. The PEDro scale was used to evaluate the methodological quality and the risk of bias of the included studies. In addition, a meta-analysis utilizing a random effect model was performed for studies comparing sEMG interventions to non-sEMG interventions and for studies comparing different sEMG interventions protocols.ResultsTwenty-four studies comprising 808 participants were included in this review. The methodological quality was good to fair. The meta-analysis showed no differences in the total effect, assessed by total FMA-UE score, comparing sEMG interventions to non-sEMG interventions (14 studies, 509 participants, SMD 0.14, P 0.37, 95% CI –0.18 to 0.46, I255%). Similarly, no difference in the overall effect was found for the meta-analysis comparing different types of sEMG interventions (7 studies, 213 participants, SMD 0.42, P 0.23, 95% CI –0.34 to 1.18, I273%). Twenty out of the twenty-four studies, including participants with varying impairment levels at all stages of stroke recovery, reported statistically significant improvements in upper limb function at post-sEMG intervention compared to baseline.ConclusionThis review and meta-analysis could not discern the effect of sEMG in comparison to a non-sEMG intervention or the most effective type of sEMG intervention for improving upper limb function in stroke populations. Current evidence suggests that sEMG is a promising tool to further improve functional recovery, but randomized clinical trials with larger sample sizes are needed to verify whether the effect on upper extremity function of a specific sEMG intervention is superior compared to other non-sEMG or other type of sEMG interventions. (shrink)

Faced with declining fertility rates, media in Britain are reacting with anxiety about cultural annihilation. To look at how nationalism inflects concerns over biological and cultural reproduction, the authors analyze coverage of falling fertility and rising immigration in Great Britain in major newspapers in 2000-2. They find pronatalist appeals to be commonand especially directed at women but varying in how women’s duty to the nation is framed. Appeals characterized as begging, lecturing, threatening, and bribing express different relationships between individual interest (...) and the national good and offer positive and negative views of women. The political leanings of specific newspapers affect how they connect biological reproduction to the cultural threat seen in immigration. Even positive views of women as making rational reproductive choices are tainted by alarmist views of immigration as a threat to national survival. (shrink)

This study explored Christians’ view that living a healthy lifestyle by eating right and exercising was essential to what being a Christian meant to them, theoretically representing internalization of these health behaviors into one’s religious values and identity. Using a secondary data analysis of Pew Research Center survey data, we found that a minority of Christians (16%) internalized a healthy lifestyle; who also tended to be more religious, as expressed by believing in God, reading scripture, praying, and volunteering at church. (...) The results provide preliminary support for the theorized disconnect in religious internalization of certain health behaviors, but not others. However, further exploratory analysis suggests that individuals who are a part of denominations that more recognizably express the importance of a healthy lifestyle as a part of their religious beliefs, and internalize this belief, might subsequently participate in and self-report healthier behavior. (shrink)

Autumn Fiester's “Neglected Ends: Clinical Ethics Consultation and the Prospects for Closure” (2015) demonstrates how a focus on recommendations in clinical ethics consultations (CECs) can fail to...

Autumn Fiester (2015) argues that when an ethics consult simply issues a recommendation it may leave a vacuum then filled by moral distress or moral emotion. “Assisted conversation”—a dialogue-focu...

According to Autumn Fiester, the Presumption of Restraint—the thesis that an application of biotechnology to an animal is unethical unless backed by morally compelling reasons—is justified by five ethical claims. In this commentary, I explore the relevance of what Derek Parfit has dubbed the Non-Identity Problem for the implications of one of these claims, the Animal Welfare Claim. I conclude that while the Animal Welfare Claim condemns the alteration of founder animals in ways that are bad for them when (...) there is no important human or animal health benefit in the offing, it fails to condemn the alteration of animals in the context of important research projects, even if the alteration causes some animal suffering, and, given the Non-Identity Problem, it fails to condemn the subsequent creation of animals bred from the founders, so long as the subsequent animals have a life worth living. (shrink)

An ethics consultant’s scope of practice is best understood as equipping stakeholders to achieve closure over time following after the ethics consultation. This is in contrast to Autumn Fiester’s position in the article, “Neglected Ends: Clinical Ethics Consultation and the Prospects for Closure,” where she claims that moral closure is a necessary condition for the proper completion of an ethics consultation case.

Our goal in producing this special issue is to encourage our colleagues to incorporate topics related to LGBT populations into bioethics curricula and scholarship. Bioethics has only rarely examined the ways in which law and medicine have defined, regulated, and often oppressed sexual minorities. This is an error on the part of bioethics. Medicine and law have served in the past as society's enforcement arm toward sexual minorities, in ways that robbed many people of their dignity. We feel that bioethics (...) has an obligation to discuss that history and to help us as a society take responsibility for it.We can address only a small number of topics in this special issue of the Hastings Center Report, and we selected topics we believe will stimulate discourse. Andrew Solomon offers an elegant overview of the challenges that bioethics faces in articulating a solid basis for LGBT rights. Timothy F. Murphy asks whether bioethics still faces issues related to lesbian, gay, and bisexual people, given the deletion of homosexuality as a disease and the progress toward same‐sex marriage. Jamie Lindemann Nelson's essay addresses the search for identity for transgender persons and the role of science in that search. Two articles, those by Brendan S. Abel and by Jack Drescher and Jack Pula, take up the complex issue of medical treatment for children who reject their assigned birth gender. Celia B. Fisher and Brian Mustanski address the special challenges of engaging LGBT youth in research, balancing the need for better information about this vulnerable group against the existing restrictions on research involving children. Tia Powell and Edward Stein consider the merits of legal bans on psychotherapies intended to change sexual orientation, particularly in the light of current research on orientation. Mary Beth Foglia and Karen I. Fredricksen‐Goldsen highlight health disparities and resilience among LGBT older adults and then discuss the role of nonconscious bias in perpetuating disparities. Stephan Davis and Nancy Berlinger assess the challenges of access to care and health policy for transgender persons. Edward J. Callahan et al. tackle the ways in which diverse aspects of medicine should change to better incorporate the needs of LGBT patients, including through use of the electronic medical record, education of health professionals, and recruitment efforts for LGBT health professionals. Virginia Ashby Sharpe and Uchenna S. Uchendu describe multifaceted efforts within Veterans Administration facilities to create change for LGBT veterans across the largest integrated health care network in the United States. Lance Wahlert and Autumn Fiester find a mixed record in the use of case studies in teaching about LGBT issues. (shrink)

In their article, “Ethical Issues in Using Behavior Contracts to Manage the “Difficult’ Patient and Family,” Autumn Fiester and Chase Yuan (2023) identify six ethical concerns regarding the specifi...

In their paper, “Ethical Issues in Using Behavior Contracts to Manage the “Difficult” Patient and Family,” Autumn Fiester and Chase Yuan raise numerous important ethical concerns regarding behavior...

Posthumous Fragments: Spring–Autumn 1881 [Excerpts].

For some contemporary historical theorists, the postmodernist movement in history and its nearly unilateral orientation towards language or discourse recently became subject to ‘the law of diminishing returns’ due to shifts in interests of philosophers and theorists of history at this time. Nevertheless, the contributions left by postmodernism in Western historical thought are too noticeable to be denied, even by those who have criticized it in the past. Frank Ankersmit is one of the few theorists that has been on both (...) sides; firstly, he swiftly tied his case to postmodernism, and secondly, he joined those who, then and now, think that postmodernism was nothing more than an irresponsible and irretrievable trend. Hence, the aim of this paper is to explore some of the particularities of Ankersmit’s affair with postmodernism, taking his metaphor of ‘the autumn of historiography’ as an example of the limits of this relationship and its eventual end. (shrink)

The Spring and Autumn Annals of Master Yan. Translated and annotated by Olivia Milburn. Sinica Leidensia, vol. 128. Leiden: Brill, 2016. Pp. xxx + 485. €161, $193.

Spring and Autumn Historiography: Form and Hierarchy in Ancient Chinese Annals. By Newell ann Van Auken. New York: Columbia UniversitY Press, 2023. Pp. xx + 328. $65.

A major resource expanding the study of early Chinese philosophy, religion, literature, and politics, this book features the first complete English-language translation of the_ Luxuriant Gems of the "Spring and Autumn"_ (_Chunqiu fanlu_),_ _one of the key texts of early Confucianism. The work is often ascribed to the Han scholar and court official Dong Zhongshu, but, as this study reveals, the text is in fact a compendium of writings by a variety of authors working within an interpretive tradition that (...) spanned several generations, depicting a utopian vision of a flourishing humanity that they believed to be Confucius's legacy to the world. The Spring and Autumn (_Chunqiu_) is a chronicle kept by the dukes of the state of Lu from 722 to 481 B.C.E. _The Luxuriant Gems_ follows the interpretations of the _Gongyang Commentary_, whose transmitters belonged to a tradition that sought to explicate the special language of the _Spring and Autumn_. The Gongyang masters believed that the_ Spring and Autumn_ had been written by Confucius himself, employing subtle and esoteric phrasing to indicate approval or disapproval of important events and personages. The _Luxuriant Gems_ augments Confucian ethical and philosophical teachings with chapters on cosmology, statecraft, and other topics drawn from contemporary non-Confucian traditions, reflecting the brilliance of intellectual life in the Han dynasty during the formative decades of the Chinese imperial state. To elucidate the text, Sarah A. Queen and John S. Major divide their translation into eight thematic sections with extensive introductions that address dating, authorship, authenticity, and the relationship between the original text and the evolving _Gongyang_ approach. (shrink)