Book reviewed in this article: Censuses, Surveys & Privacy. Edited by Martin Bulmer.

In lieu of an abstract, here is a brief excerpt of the content:Hume on Human Excellence Marie A. Martin Hume was, in important respects, still verymuch a part ofthe classical ethical tradition. This is something we tend to overlook because we come out of a distinctly modern moral tradition, and we normally approach Hume looking for answers to a set of questions that are distinct, and often far removed, from the central questions of the classical tradition. Yet, the (...) classical aspects of Hume's ethics are not irrelevant to contemporary moral debates. There is evidence in recent years of a growing discontent with all the permutations of the two dominant strands of contemporary moral thought, Kantianism and utilitarianism. The sort of radical critique found in the works of Maclntyre, the increasing popularity of communitarian theories, and the resurgence of interest in virtue ethics in general, and Aristotelianism in particular, are all indications of this discontent. What I wish to suggest is that Hume's moral thought might prove a rich source for those who are dissatisfied with the direction ofmodern moral theory, and especially for those who believe that there is something within the classical tradition of virtue ethics worth salvaging. For Hume is a virtue ethicist, albeit one in modern dress, who, poised between the ancients and moderns, self-consciously chose to align himself with the ancient tradition, asserting its superiority over the modern. The ancient moralists are, Hume claims, the "best models,"1 morals being the one science "inwhich theyare not surpassed by the moderns" (E 330). The aim of this paper is to take an initial step towards refocusing our view on the largely neglected classical aspects of Hume's moral thought. The relationship between Hume's moral thought and the classical tradition is both extensive and complex, and I do not pretend to do anything more in this paper than present the tip of the iceberg. But the tip I shall examine is central to all that lies below; it is Hume's conception ofhuman excellence. Virtue or Human Excellence Perhaps Hume's most complete description ofhuman excellence occurs in the conclusion ofAn Enquiry Concerning the Principles ofMorals. Hume presents us with the fictional character, Cleanthes, as one whom "a philosopher might select... as a model ofperfect virtue" (E 270). He is, Hume claims, "a man ofhonour andhumanity," one ofwhom "[e]very one, who has anyintercourse... is sure offair and kind treatment." His Volume XVIII Number 2 383 MARIE A. MARTIN "assiduous application... [and] quick penetration... prognosticate the greatest honours and advancement." His company is enjoyed by all because he has "so much wit with good manners; so much gallantry without affectation" and "so much ingenious knowledge." His "cheerfulness... runs through the whole tenor ofhislife, and preserves a perpetual serenity on his countenance, and tranquillity ofhis soul." Finally, "[h]e has met with severe trials, misfortunes as well as dangers; and by his greatness ofmind, was still superior to all ofthem" (E 269-70). In the Treatise, Hume offers a less specific, yet similar portrait of human excellence: when we enumerate the good qualities of any person, we always mention those parts ofhis character, which renderhim a safe companion, an easy friend, a gentle master, an agreeable husband, or an indulgent father. We consider him with all hisrelations in society; andlove orhate him, according as he affects those, who have any immediate intercourse with him. And 'tis a most certain rule, that if there be no relation oflife, in which I cou'd not wish to stand to aparticular person, his character must so far be allow'd to be perfect. If he be as little wanting to himselfas to others, his character is entirely perfect.2 Although there are numerous passages throughout Hume's works that paint the same general picture, I will offer only one more, his description of an ideally virtuous disposition from his essay, The Sceptic: that which leads to action and employment, renders us sensible to the social passions, steels the heart against the assaults offortune, reduces the affections to ajustmoderation, makes our own thoughts an entertainment to us, and inclines us rather to the pleasure of society and conversation, than to those ofthe senses.3 What is common to all these descriptions... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Utility and Morality: Adam Smith's Critique of Hume Marie A. Martin Reading Smith's Theory ofMoral Sentiments one cannot help but note that, in spite ofthe obvious similarities between Smith and Hume and the equally obvious borrowings and adaptions Smith makesofportions of Hume's theory, the two differ substantially on the role of utility in morality. The difference is, in fact, practically diametrical opposition. Hume believed that utility was (...) the "foundation of the chief part of morals." Smith, on the other hand, believed that, while utility may contribute an additional beauty to virtue, it is never the source oftheir virtue and rarely the source of moral approbation. Given their agreement in so many other respects, why the difference regarding utility? To answer this question I shall examine both Smith's specific criticisms ofHume regarding the role ofutility in morals and his more general objections to any theory that makes an appeal to utility a foundation ofmoral approval. I shall show that, while Smith does raise anumber ofgenuine difficulties for Hume's theory, he does not succeed in his most serious criticism, that is, that Hume's theory does not adequately capture the essentially social nature ofmorality. Hume's View ofthe Role ofUtility AccordingtoHume, the sentimentofmoral approbation arisesfrom the perception ofqualities ofcharacter or mind which are either useful or agreeable to ourselves or others. Examples of qualities agreeable to ourselves include cheerfulness, confidence, self-respect, and taste. Examples of qualities agreeable to others include manners, wit, eloquence, andmodesty. But themajorityofourmoral sentiments arise from the perception of the usefulness of qualities, that is, "from reflexions on their tendency to the happiness of mankind, and of particularpersons."2 Utility or usefulness is nothing but a tendency to a certain end. But, Hume claims, "itis acontradictioninterms, thatany thingpleases as means to an end, where the end itself no wise affects us" (E 219). Thus, ifwe approve ofthose qualities thathave a tendency to promote the happiness or well-being of either the possessor or others, it must be eitherbecause we value theirhappinessin itselforbecause we value it as a means to our own interests. Volume XVI Number 2 107 MARIE A. MARTIN Hume rejects the second alternative as contrary to experienced fact. The "selfish systems" which attempt to reduce all moral approbation to self-interest cannot account for our praise and admiration ofthe courage and fortitude ofour enemies even when their consequences thwart our own interests. Neither can such systems account for the fact that "[w]e frequently bestow praise on virtuous actions, performed in very distant ages and remote countries; where the utmost subtilty ofimagination would not discover any appearance ofself-interest" (E 215-16). If it is not self-interest that leads us to approve useful qualities, thenitis clear that"[w]e must adopt amore public affection, and allow, that the interests ofsocietyare not, even on their own account, entirely indifferent to us" (E 219). We approve of qualities that promote the well-being of others because we have a natural concern for their welfare. In general, it is certain, that, wherever we go, whatever we reflect on or converse about, every thing still presents us with the view of human happiness or misery, and excites in our breast a sympathetic movement of pleasure or uneasiness. (E 221) Thus, our approval of useful qualities rests on their tendency to promote the happiness of those who possess or are affected by them, and this, in turn, rests on sympathy, the communication of passions, whereby we "feel" for others—happiness for theirjoys, sorrow for their miseries. So, althoughtheutilityofqualitiesofcharacteris notthe solecause ofour approbation, it is the most extensive and important one. It appears tobe matter offact, that the circumstance oíutility, in all subjects, is a source ofpraise and approbation: That it is constantly appealed to in all moral decisions concerning the merit and demerit ofactions: That it is the sole source ofthat high regard paid to justice, fidelity, honour, allegiance, and chastity: That it is inseparable from all the other social virtues, humanity, generosity, charity, affability, lenity, mercy, and moderation: And, in a word, that it is the foundation ofthe chief part of morals, which has a reference to mankind and our fellow-creatures. (E... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Utility and Morality: Adam Smith's Critique of Hume Marie A. Martin Reading Smith's Theory ofMoral Sentiments one cannot help but note that, in spite ofthe obvious similarities between Smith and Hume and the equally obvious borrowings and adaptions Smith makesofportions of Hume's theory, the two differ substantially on the role of utility in morality. The difference is, in fact, practically diametrical opposition. Hume believed that utility was (...) the "foundation of the chief part of morals." Smith, on the other hand, believed that, while utility may contribute an additional beauty to virtue, it is never the source oftheir virtue and rarely the source of moral approbation. Given their agreement in so many other respects, why the difference regarding utility? To answer this question I shall examine both Smith's specific criticisms ofHume regarding the role ofutility in morals and his more general objections to any theory that makes an appeal to utility a foundation ofmoral approval. I shall show that, while Smith does raise anumber ofgenuine difficulties for Hume's theory, he does not succeed in his most serious criticism, that is, that Hume's theory does not adequately capture the essentially social nature ofmorality. Hume's View ofthe Role ofUtility AccordingtoHume, the sentimentofmoral approbation arisesfrom the perception ofqualities ofcharacter or mind which are either useful or agreeable to ourselves or others. Examples of qualities agreeable to ourselves include cheerfulness, confidence, self-respect, and taste. Examples of qualities agreeable to others include manners, wit, eloquence, andmodesty. But themajorityofourmoral sentiments arise from the perception of the usefulness of qualities, that is, "from reflexions on their tendency to the happiness of mankind, and of particularpersons."2 Utility or usefulness is nothing but a tendency to a certain end. But, Hume claims, "itis acontradictioninterms, thatany thingpleases as means to an end, where the end itself no wise affects us" (E 219). Thus, ifwe approve ofthose qualities thathave a tendency to promote the happiness or well-being of either the possessor or others, it must be eitherbecause we value theirhappinessin itselforbecause we value it as a means to our own interests. Volume XVI Number 2 107 MARIE A. MARTIN Hume rejects the second alternative as contrary to experienced fact. The "selfish systems" which attempt to reduce all moral approbation to self-interest cannot account for our praise and admiration ofthe courage and fortitude ofour enemies even when their consequences thwart our own interests. Neither can such systems account for the fact that "[w]e frequently bestow praise on virtuous actions, performed in very distant ages and remote countries; where the utmost subtilty ofimagination would not discover any appearance ofself-interest" (E 215-16). If it is not self-interest that leads us to approve useful qualities, thenitis clear that"[w]e must adopt amore public affection, and allow, that the interests ofsocietyare not, even on their own account, entirely indifferent to us" (E 219). We approve of qualities that promote the well-being of others because we have a natural concern for their welfare. In general, it is certain, that, wherever we go, whatever we reflect on or converse about, every thing still presents us with the view of human happiness or misery, and excites in our breast a sympathetic movement of pleasure or uneasiness. (E 221) Thus, our approval of useful qualities rests on their tendency to promote the happiness of those who possess or are affected by them, and this, in turn, rests on sympathy, the communication of passions, whereby we "feel" for others—happiness for theirjoys, sorrow for their miseries. So, althoughtheutilityofqualitiesofcharacteris notthe solecause ofour approbation, it is the most extensive and important one. It appears tobe matter offact, that the circumstance oíutility, in all subjects, is a source ofpraise and approbation: That it is constantly appealed to in all moral decisions concerning the merit and demerit ofactions: That it is the sole source ofthat high regard paid to justice, fidelity, honour, allegiance, and chastity: That it is inseparable from all the other social virtues, humanity, generosity, charity, affability, lenity, mercy, and moderation: And, in a word, that it is the foundation ofthe chief part of morals, which has a reference to mankind and our fellow-creatures. (E... (shrink)

Die in diesem Band versammelten Essays erörtern die Frage nach der Möglichkeit des Verstehens menschlichen Handelns ohne den Rückbezug auf moralische Werte und Normen. Obwohl die Autoren sich dieser Frage auf ganz unterschiedliche, manchmal divergierende, Weisen nähern, verbindet sie alle die Annahme, es sei nicht wünschenswert oder sogar inkohärent, das menschliche Handeln grundsätzlich unabhängig von moralischen Werten zu betrachten. Die Herausgeber haben sich um eine für Philosophen und Gesellschaftswissenschaftler gleichermaßen attraktive Beitragssammlung bemüht. Die Verknüpfung philosophischer und soziologischer Perspektiven könnte zur (...) Klärung gegenseitiger Missverständnisse beitragen, die aufgrund eines mangelhaften Dialogs zwischen der philosophischen und soziologischen Handlungstheorie erwachsen sind. In diesem Band enthalten sind Essays von Terry Pinkard, Sebastian Rödl, Dieter Schönecker, Ana Marta González, John Levi Martin, Alejandro N. García Martínez, Sophie Djigo, Teresa Enríquez und Evgenia Mylonaki. The essays in this volume address the question of whether we can understand human action without reference to moral norms or values. Although the authors approach this question in different and sometimes even incompatible ways, they are united in thinking that it is undesirable or even incoherent to treat human agency as if it were conceptually independent of value questions. The editors have attempted to invite contributions that would be interesting to both philosophers and social theorists. The conjunction of philosophic and sociological perspectives might help to overcome some of the mutual misunderstandings that have been fostered by a lack of dialogue between the philosophic and sociological action theory. The volume includes essays by Terry Pinkard, Sebastian Rödl, Dieter Schönecker, Ana Marta González, John Levi Martin, Alejandro N. García Martínez, Sophie Djigo, Teresa Enríquez, and Evgenia Mylonaki. (shrink)

Critical congenital heart disease screening is rapidly becoming the standard of care in the United States after being added to the Recommended Uniform Screening Panel in 2011. Newborn screens typically do not require affirmative parental consent. In fact, most states allow parents to exempt their baby from receiving the required screen on the basis of religious or personally held beliefs. There are many ethical considerations implicated with allowing parents to exempt their child from newborn screening for CCHD. Considerations include the (...) treatment of religious exemptions in our current legal system, as well as medical and ethical principles in relation to the rights of infants. Although there are significant benefits to screening newborns for CCHD, when a parent refuses for religious or personal beliefs, in the case of CCHD screening, the parental decision should stand. (shrink)

While valuable work has been done addressing clinical ethics within established healthcare systems, we anticipate that the projected growth in acquisitions of community hospitals and facilities by large tertiary hospitals will impact the field of clinical ethics and the day-to-day responsibilities of clinical ethicists in ways that have yet to be explored. Toward the goal of providing clinical ethicists guidance on a range of issues that they may encounter in the systematization process, we discuss key considerations and potential challenges in (...) implementing system-wide ethics consultation services. Specifically, we identify four models for organizing, developing, and enhancing ethics consultation activities within a system created through acquisitions: train-the-trainer, local capacity-building, circuit-riding, and consolidated accountability. We note each model’s benefits and challenges. To our knowledge, this is the first paper to consider the broader landscape of issues affected by consolidation. We anticipate that clinical ethicists, volunteer consultants, and hospital administrators will benefit from our recommendations. (shrink)

Despite the increasingly multinational nature of the workplace, there have been few studies of the convergence and divergence in beliefs about ethics-based leadership across cultures. This study examines the meaning of ethical and unethical leadership held by managers in six societies with the goal of identifying areas of convergence and divergence across cultures. More specifically, qualitative research methods were used to identify the attributes and behaviors that managers from the People’s Republic of China (the PRC), Hong Kong, the Republic of (...) China (Taiwan), the United States (the U.S.), Ireland, and Germany attribute to ethical and unethical leaders. Across societies, six ethical leadership themes and six unethical leadership themes emerged from a thematic analysis of the open-ended responses. Dominant themes for ethical and unethical leadership for each society are identified and examined within the context of the core cultural values and practices of that society. Implications for theory, research, and management practice are discussed. (shrink)

The article concentrates on problems, which emerge in the ongoing process of transforming a socialistic society to a western welfare society. This process does not only include economic aspects, as it might seem from several articles and books written about the subject. Often these societies, having established a stable financial and legal systems face much harder problems related to the prevailing values. They are not struggling anymore because of bad loans or lack of investment but because of outdated values and (...) inability to adapt themselves to a changing world. To understand these difficulties better, 2000 conflicts, occurred during last four years in local companies, have been investigated.Conflict as the research tool has been chosen because it is a very informative phenomenon for revealing an organisation's general status. It sheds light on different aspects of problems, which occur during rapid development. We could name several conflict reasons but generally all of them stem from three sources. (shrink)

The clinical ethicist met with Ms. H to clarify what information she wants and does not want to know. First, she wants to receive any treatment that could prolong her life, regardless of how the treatment affects her ability to engage in activities of daily living. Second, she wants to be included in the decision‐making process as much as possible, as long as clinicians use only “positive” language. Ms. H considers the words “dying,” “chemotherapy,” “radiation,” and “cancer” to be “bad (...) words.” For conversations in which these words cannot be avoided, she wants her clinicians to talk to her son. Her desired engagement includes hearing about risks, benefits, and alternatives to treatments if clinicians use only “positive” language. Finally, she says that she rarely sees doctors and that she is “very scared” of hospitals, despite exhibiting a comfortable demeanor.Should clinicians honor Ms. H's waiver of specified information and, if so, to what degree? (shrink)

This paper examines beliefs about four aspects of ethical leadership – Character/Integrity, Altruism, Collective Motivation and Encouragement – in Germany and the United States using data from Project GLOBE (Global Leadership and Organizational Behavior Effectiveness) and a supplemental analysis. Within the context of a push toward convergence driven by the demands of globalization and the pull toward divergence underpinned by different cultural values and philosophies in the two countries, we focus on two questions: Do middle managers from the United States (...) and Germany differ in their beliefs about ethical leadership? And, do individuals from these two countries attribute different characteristics to ethical leaders? Results provide evidence that while German and US middle managers, on average, differed in the degree of endorsement for each aspect, they each endorsed Character/Integrity, Collective Motivation and Encouragement as important for effective leadership and had a more neutral view of the importance of Altruism . The findings are reviewed within the social-cultural context of each country. (shrink)

This paper examines beliefs about four aspects of ethical leadership –Character/Integrity, Altruism, Collective Motivation and Encouragement– in Germany and the United States using data from Project GLOBE (Global Leadership and Organizational Behavior Effectiveness) and a supplemental analysis. Within the context of a push toward convergence driven by the demands of globalization and the pull toward divergence underpinned by different cultural values and philosophies in the two countries, we focus on two questions: Do middle managers from the United States and Germany (...) differ in their beliefs about ethical leadership? And, do individuals from these two countries attribute different characteristics to ethical leaders? Results provide evidence that while German and US middle managers, on average, differed in the degree of endorsement for each aspect, they each endorsed Character/Integrity, Collective Motivation and Encouragement as important for effective leadership and had a more neutral view of the importance of Altruism. The findings are reviewed within the social-cultural context of each country. (shrink)

This study examines the outcomes of a four-year faculty learning community (FLC) that aimed to transform departmental ethics curriculum by supporting Earth Sciences faculty members as they ethically inquired into their teaching of ethics and refined existing courses in alignment with an Integrated Community-Engaged Learning and Ethical Reflection (ICELER) framework. We present ethnographic case studies that unpack processes through which three faculty members transformed undergraduate courses. We assembled case studies by triangulating interview data, course artifacts, and faculty reflections. We examine (...) how faculty (1) built awareness around teaching ethics, (2) took responsibility for and made judgments about teaching ethics, (3) experimented by designing and implementing ICELER-inspired courses, and (4) interrogated the outcomes of their ethics teaching, utilizing findings to enhance awareness and revise courses. The paper closes by introducing a model detailing how instructors inquire into ethics teaching and how model components might inspire future educational practice and research. (shrink)

Family Medicine Groups (FMGs) are the most recently developed primary care organizations in Quebec (Canada). Nurses within FMGs play a central role for patients with chronic diseases (CD). However, this complex role and the nursing activities related to this role vary across FMGs. Inadequate knowledge of nursing activities limits the implementation of exemplary nursing practices. This study aimed to describe FMG nursing activities with patients with CD and to describe the facilitators and barriers to these activities. A multiple‐case study was (...) performed with ten nurses practicing among patients with CD in FMGs. Five data sources were used to provide an in‐depth description of nursing activities and the facilitators and barriers to the development of these activities. After qualitative data analysis, findings show that nursing activities are clustered into five domains: Global assessment of the patient, Care management, Health promotion, Nurse–physician collaboration, and Planning services for patients with CD. Activities vary depending on contextual factors identified in each case. This multiple‐case study provides a clear description of nursing activities with patients with CD. There is a need for improved nursing activities and expertise in domains of activities that are less present in FMGs, such as case management and interprofessional collaboration. (shrink)

Park rangers hold a unique set of knowledge—of science, of publics, of institutional structures, of place, and of self—that should be recognised as valuable. For too long, models of the knowledge of scientists and publics have set people like rangers in an inbetweener position, seeing them as good at communicating, translating or negotiating from one side to the other, but not as making knowledge that is powerful in its own right. In this paper we argue that focus groups with park (...) rangers across regional and conservation parks in Aotearoa/New Zealand reveal the complexity and multiplicity of rangers’ knowledge-making that shows the science-public model as incomplete. We argue further that the model is flawed for its focus on the making and holding of knowledge and not also on how it is enacted. Rangers, we argue, are responsible every day for making knowledgeable decisions for the health and well-being of parks and people. Making good decisions, though, requires not just knowledge but also care. An understanding of the many ways rangers know and enact their knowledge is important for biosecurity practice, especially in models of adaptive governance. (shrink)

Despite recommendations from the Cartwright Report ethical review by health ethics committees has continued in New Zealand without health practitioners ever having to acknowledge their dual roles as health practitioners researching their own patients. On the other hand, universities explicitly identify doctor/research-patient relations as potentially raising conflict of role issues. This stems from the acknowledgement within the university sector itself that lecturer/research-student relations are fraught with such conflicts. Although similar unequal relationships are seen to exist between health researchers and their (...) patients, the patient/subjects are not afforded the levels of protection that are afforded student/subjects. In this paper we argue that the difference between universities and health research is a result of the failure of the Operational Standard Code for Ethics Committees to explicitly acknowledge the vulnerability of the patient and conflict of interests in the dual roles of health practitioner/researcher. We end the paper recommending the Ministry of Health consider the rewriting of the Operational Standard Code for Ethics Committees, in particular in the rewriting of section 26 of the Operational Standard Code for Ethics Committees. We also identify the value of comparative ethical review and suggest the New Zealand's Health Research Council's trilateral relationship with Australia's NHMRC (National Health and Medical Research Council) and Canada's CIHR (Canadian Institute of Health Research) as a useful starting point for such a process. (shrink)

This edited text recaptures many of Joe L. Kincheloe's national and international influences. An advocate and a scholar in the social, historical, and philosophical foundations of education, he dedicated his professional life to his vision of critical pedagogy. The authors in this volume found mentorship, as well as kinship, in Joe and express the many ways in which he and his work made profound differences in their work and lives. Joe's research always pushed the limits of what critically reflective and (...) informed teaching entailed, never diluting the import of comprehending the complexity of sociopolitical, cultural, economic, and educational discourses and practices. Dedicated to a praxis of social and political activism rooted in students' development as citizens and workers, the labor of teachers as action researchers, cultural workers, and social mediators is always at the heart of all he achieved. We who were so influenced directly and indirectly by him knew his genius and relished the generosity with which he shared his ideas, advice, encouragement, and art. The world is better because of Joe L. Kincheloe scholarship-inextricably related to "critical" critical thinking and enactment of education that tenaciously interrupts complacency, mediocrity, always responding thoughtfully to particular educational contexts. (shrink)

Priority setting in health care is ubiquitous and health authorities are increasingly recognising the need for priority setting guidelines to ensure efficient, fair, and equitable resource allocation. While cost-effectiveness concerns seem to dominate many policies, the tension between utilitarian and deontological concerns is salient to many, and various severity criteria appear to fill this gap. Severity, then, must be subjected to rigorous ethical and philosophical analysis. Here we first give a brief history of the path to today’s severity criteria in (...) Norway and Sweden. The Scandinavian perspective on severity might be conducive to the international discussion, given its long-standing use as a priority setting criterion, despite having reached rather different conclusions so far. We then argue that severity can be viewed as a multidimensional concept, drawing on accounts of need, urgency, fairness, duty to save lives, and human dignity. Such concerns will often be relative to local mores, and the weighting placed on the various dimensions cannot be expected to be fixed. Thirdly, we present what we think are the most pertinent questions to answer about severity in order to facilitate decision making in the coming years of increased scarcity, and to further the understanding of underlying assumptions and values that go into these decisions. We conclude that severity is poorly understood, and that the topic needs substantial further inquiry; thus we hope this article may set a challenging and important research agenda. (shrink)

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step (...) on the pathway to an eventual certification process for clinical ethics consultants. (shrink)

When the COVID-19 surge hit New York City hospitals, the Division of Medical Ethics at Weill Cornell Medical College, and our affiliated ethics consultation services, faced waves of ethical issues sweeping forward with intensity and urgency. In this article, we describe our experience over an eight-week period (16 March through 10 May 2020), and describe three types of services: clinical ethics consultation (CEC); service practice communications/interventions (SPCI); and organizational ethics advisement (OEA). We tell this narrative through the prism of time, (...) describing the evolution of ethical issues and trends as the pandemic unfolded. We delineate three phases: anticipation and preparation, crisis management, and reflection and adjustment. The first phase focused predominantly on ways to address impending resource shortages and to plan for remote ethics consultation, and CECs focused on code status discussions with surrogates. The second phase was characterized by the dramatic convergence of a rapid increase in the number of critically ill patients, a growing scarcity of resources, and the reassignment/ redeployment of staff outside their specialty areas. The third phase was characterized by the recognition that while the worst of the crisis was waning, its medium- and long-term consequences continued to pose immense challenges. We note that there were times during the crisis that serving in the role of clinical ethics consultant created a sense of dis-ease as novel as the coronavirus itself. In retrospect we learned that our activities far exceeded the familiar terrain of clinical ethics consultation and extended into other spheres of organizational life in novel ways that were unanticipated before this pandemic. To that end, we defined and categorized a middle level of ethics consultation, which we have termed service practice communication intervention (SPCI). This is an underappreciated dimension of the work that ethics consult services are capable of in times of crisis. We believe that the pandemic has revealed the many enduring ways that ethics consultation services can more robustly contribute to the ethical life of their institutions moving forward. (shrink)

Throughout the biological and biomedical sciences there is a growing need for, prescriptive ‘minimum information’ (MI) checklists specifying the key information to include when reporting experimental results are beginning to find favor with experimentalists, analysts, publishers and funders alike. Such checklists aim to ensure that methods, data, analyses and results are described to a level sufficient to support the unambiguous interpretation, sophisticated search, reanalysis and experimental corroboration and reuse of data sets, facilitating the extraction of maximum value from data sets (...) them. However, such ‘minimum information’ MI checklists are usually developed independently by groups working within representatives of particular biologically- or technologically-delineated domains. Consequently, an overview of the full range of checklists can be difficult to establish without intensive searching, and even tracking thetheir individual evolution of single checklists may be a non-trivial exercise. Checklists are also inevitably partially redundant when measured one against another, and where they overlap is far from straightforward. Furthermore, conflicts in scope and arbitrary decisions on wording and sub-structuring make integration difficult. This presents inhibit their use in combination. Overall, these issues present significant difficulties for the users of checklists, especially those in areas such as systems biology, who routinely combine information from multiple biological domains and technology platforms. To address all of the above, we present MIBBI (Minimum Information for Biological and Biomedical Investigations); a web-based communal resource for such checklists, designed to act as a ‘one-stop shop’ for those exploring the range of extant checklist projects, and to foster collaborative, integrative development and ultimately promote gradual integration of checklists. (shrink)

What does it mean to ‘drop out’ of therapy? Many definitions of ‘dropout’ have been proposed, but the most widely accepted is the client ending treatment without agreement of their therapist. However, this is in some ways an external criterion that does not take into account the client’s experience of therapy, or reasons for ending it prematurely. This study aimed to identify whether there were more meaningful categories of dropout than the existing dropout definition, and to test whether this refined (...) categorisation of dropout was associated with clinical outcomes. This mixed-methods study used a subset of data from the IMPACT trial, which investigated psychological therapies for adolescent depression. Adolescents were randomly allocated to a treatment arm (Brief Psychosocial Intervention; Cognitive-Behavioural Therapy; Short-Term Psychoanalytic Psychotherapy). The sample for this study comprised 99 adolescents, aged 11-17 years. 32 were classified as having dropped out of treatment and participated in post-therapy qualitative interviews about their experiences of therapy. For 26 dropout cases, the therapist was also interviewed. 67 cases classified as having completed treatment were included to compare their outcomes to dropout cases. Interview data for dropout cases were analysed using ideal type analysis. Three types of dropout were constructed: ‘dissatisfied’ dropout, ‘got-what-they-needed’ dropout, and ‘troubled’ dropout. ‘Dissatisfied’ dropouts reported stopping therapy because they did not find it helpful. ‘Got-what-they-needed’ dropouts reported stopping therapy because they felt they had benefitted from therapy. ‘Troubled’ dropouts reported stopping therapy because of a lack of stability in their lives. The findings indicate the importance of including the perspective of clients in definitions of drop out, as otherwise there is a risk that the heterogeneity of 'dropout' cases may mask more meaningful distinctions. Clinicians should be aware of the range of issues experienced by adolescents in treatment that lead to disengagement. Our typology of dropout may provide a framework for clinical decision-making in managing different types of disengagement from treatment. (shrink)

It is generally accepted that appropriate documentation of activities and recommendations of ethics consultants in patients’ medical records is critical. Despite this acceptance, the bioethics literature is largely devoid of guidance on key elements of an ethics chart note, the degree of specificity that it should contain, and its stylistic tenor. We aim to provide guidance for a variety of persons engaged in clinical ethics consultation: new and seasoned ethics committee members who are new to ethics consultation, students and trainees (...) in clinical ethics, and those who have significant experience with ethics consultation so that they can reflect on their practice. Toward the goal of promoting quality charting practices in ethics consultations, we propose recommendations on a broad array of questions concerning clinical ethics consultation chart notes, including whether and when to write a chart note, and practical considerations for the tenor, purpose, and content of a chart note. Our broader aim is to promote discussion about good charting practices in clinical ethics, with the hope of contributing to clear standards of excellence in clinical ethics consultation. (shrink)

In a recent extended essay, philosopher Daniel Hausman goes a long way towards dismissing severity as a morally relevant attribute in the context of priority setting in healthcare. In this response, we argue that although Hausman certainly points to real problems with how severity is often interpreted and operationalised within the priority setting context, the conclusion that severity does not contain plausible ethical content is too hasty. Rather than abandonment, our proposal is to take severity seriously by carefully mapping the (...) possibly multiple underlying accounts to well-established ethical theories, in a way that is both morally defensible and aligned with the term’s colloquial uses. (shrink)

The multiplicity of definitions and conceptions of self-regulation that typifies contemporary research on self-regulation in psychology and educational psychology is examined. This examination is followed by critical analyses of theory and research in educational psychology that reveal not only conceptual confusions, but misunderstandings of conceptual versus empirical issues, individualistic biases to the detriment of an adequate consideration of social and cultural contexts, and a tendency to reify psychological states and processes as ontologically foundational to self-regulation. The essay concludes with a (...) consideration of educational research and intervention in the area of students’ self-regulated learning in terms of the scientific and professional interests of psychologists and educators, and the disguised manipulation of student self-surveillance in the service of the institutional mandates of schools. (shrink)

Introducing Philosophy: A Text with Integrated Readings, Tenth Edition, is an exciting, accessible, and thorough introduction to the core problems of philosophy and the many ways in which they are, and have been, answered. The authors combine substantial selections from significant works in the history of philosophy with excerpts from current philosophy, clarifying the readings and providing context with their own detailed commentary and explanation. Spanning 2,500 years, the selections range from the oldest known fragments to cutting-edge contemporary essays. Organized (...) topically, the chapters present alternative perspectives--including analytic, continental, feminist, and non-Western viewpoints--alongside the historical works of major Western philosophers.PEDAGOGICAL FEATURES:* Discussion questions, a summary, and a bibliography with suggestions for further reading at the end of each chapter* Questions at the end of each subsection* Marginal quotations from the featured readings* Key philosophical terms, boldfaced in the text and collected at the end of each chapter* A glossary at the end of the book. (shrink)

Corporations significantly influence the public and political spheres. In light of this corporate power in society, academics have criticized the lack of legitimization (i.e., the legitimacy gap) and highlighted a potential divergence between corporate resource allocation and the needs and preferences of the public (i.e., the social issues gap). To address these problems, democratizing organizations has been proposed as a potential solution. In line with this, the authors argue that an increase in corporate power outside the economic realm should be (...) counterbalanced by more democratic corporate governance (i.e., an internalization of democracy). While important groundwork exists, academic attention to these topics remains limited. The authors provide an overview of the literature linking corporate power and the claim for democratizing organizations, advocate for legitimization, identify research gaps, and develop a research agenda to inspire and guide future research efforts. The paper's findings suggest the importance of conceptual and empirical research on the micro-, meso-, and macro-levels and the cross-level effects, which is needed to advance this incipient research area. Future research must (1) clearly define corporate power and discuss how democratizing organizations can contribute to more legitimate organizational decisions, (2) unveil novel approaches for more democratic corporate governance, and (3) understand the organizational- and individual-level factors necessary for the successful realization of democratic organizations. (shrink)

Schizophrenia is a severe mental illness affecting sense of identity. Autobiographical memory deficits observed in schizophrenia could contribute to this altered sense of identity. The ability to give a meaning to personally significant events is also critical for identity construction and self-coherence. Twenty-four patients with schizophrenia and 24 control participants were asked to recall five self-defining memories. We assessed meaning making in participants’ narratives and afterwards asked them explicitly to give a meaning to their memories . We found that both (...) spontaneous and cued meaning making were impaired in patients with schizophrenia. This impairment was correlated with executive dysfunctions and level of negative symptoms. Our results suggest that patients’ difficulties in drawing lessons about past experiences could contribute to explain the lack of coherence observed in their life trajectories and their impaired social adjustment abilities. Implications for psychotherapy are also discussed. (shrink)

Introducing Philosophy: A Text with Integrated Readings, Eleventh Edition, is an exciting, accessible, and thorough introduction to the core questions of philosophy and the many ways in which they are, and have been, answered. The authors combine substantial selections from significant works in the history of philosophy with excerpts from current philosophy, clarifying the readings and providing context with their own detailed commentary and explanation. Spanning 2,500 years, the selections range from the oldest known fragments to cutting-edge contemporary essays. Organized (...) topically, the chapters present alternative perspectives--including analytic, continental, feminist, and non-Western viewpoints--alongside the historical works of major Western philosophers. (shrink)

The conflict between pregnant women freely using cocaine and the well-being of fetuses presents a difficult social problem. Since 1985, at least 200 women, in thirty states, have been criminally prosecuted for using illicit drugs or alcohol during pregnancy. Such policies enjoy considerable public and political support. Nonetheless, treatment programs that include referral to law enforcement officials raise serious ethical and legal issues for hospitals and health care providers. In this paper, we assess the development of one medical university's controversial (...) treatment program for pregnant women addicted to cocaine.In October 1989, the Medical University of South Carolina instituted a new program, called the Interagency Policy on Management of Substance Abuse During Pregnancy, designed “to ensure appropriate management of patients abusing illegal drugs during pregnancy.” This program required some pregnant women to seek drug counseling and prenatal care under the threat of criminal sanctions. (shrink)

The conflict between pregnant women freely using cocaine and the well-being of fetuses presents a difficult social problem. Since 1985, at least 200 women, in thirty states, have been criminally prosecuted for using illicit drugs or alcohol during pregnancy. Such policies enjoy considerable public and political support. Nonetheless, treatment programs that include referral to law enforcement officials raise serious ethical and legal issues for hospitals and health care providers. In this paper, we assess the development of one medical university's controversial (...) treatment program for pregnant women addicted to cocaine.In October 1989, the Medical University of South Carolina instituted a new program, called the Interagency Policy on Management of Substance Abuse During Pregnancy, designed “to ensure appropriate management of patients abusing illegal drugs during pregnancy.” This program required some pregnant women to seek drug counseling and prenatal care under the threat of criminal sanctions. (shrink)