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

Psychologists are ethically obligated to obtain informed consent to psychotherapy "as early as is feasible" (American Psychological Association, 2002, p. 1072). However, the range of topics to be addressed includes both information that may be immediately and uniformly applicable to most clients via policy or rule, as well as information that is not immediately presentable because it varies widely across clients or emerges over time. In this study, licensed psychologists were surveyed regarding the earliest feasible point at which they could (...) provide information regarding specific aspects of psychotherapy. Results indicate that, although psychologists believe that they are capable of presenting some information, such as payment and confidentiality policies, at the outset, they believe that a discussion of more substantive issues, such as psychotherapy duration, goals, orientation, and activities, can take place only after some therapy has transpired. Implications are discussed regarding the process and event models of informed consent. (shrink)

Are psychotherapy clients who pay via health insurance more likely to receive Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV], American Psychiatric Association, 1994) diagnoses than identical clients who pay out of pocket? Previous research (Kielbasa, Pomerantz, Krohn, & Sullivan, 2004) indicates that when psychologists consider a mildly depressed or anxious client, payment method significantly influences diagnostic decisions. This study extends the scope of the previous study to include clients whose symptoms are even less severe. Independent practitioners (...) responded to vignettes of clients whose profiles deliberately included subclinical impairment and a high level of functioning. Half of the participants were told that the clients would pay via managed care; the other half were told that the clients would pay out of pocket. As in the earlier study, payment method had a highly significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to be assigned DSM-IV diagnoses. In addition, a noteworthy percentage of participants assigned diagnoses regardless of payment method. Ethical implications are discussed. (shrink)

Modal responses to items from a recent survey of independent practitioners regarding the impact of managed care on their practices and ethics were presented to participants as the responses of a hypothetical independent practitioner. Participants were asked to consider seeing this hypothetical practitioner both before and after being informed of the practitioner's responses to the managed care survey. Results indicate that when participants were informed of the practitioner's views toward managed care, their own attitudes toward therapy changed significantly. Specifically, compared (...) to uninformed participants, informed participants were significantly more likely to believe that managed care would have a negative impact on treatment and significantly less likely to see an independent practitioner, use insurance benefits, expect to benefit from treatment, expect to form a strong working relationship, and trust that the practitioner would work in their best interest. Implications regarding ethics and informed consent are discussed. (shrink)

Previous research (Kielbasa, Pomerantz, Krohn, & Sullivan, 2004; Pomerantz & Segrist, 2006) indicates that when psychologists consider a client with symptoms of depression or anxiety, payment method significantly influences diagnostic decisions. This study extends the scope of the previous research to consider clients with symptoms of social phobia and attention deficit hyperactivity disorder (ADHD). Psychologists in independent practice responded to vignettes of clients whose descriptions deliberately included subclinical impairment. Half of the participants were told that the clients would (...) pay via managed care; the other half were told that the clients would pay out-of-pocket. Confirming previous studies, payment method had a highly significant impact on diagnosis such that compared to out-of-pocket clients, managed care clients were much more likely to be assigned Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnoses. Ethical implications relate to informed consent, accuracy and truthfulness in diagnosis, and psychologists' integrity. (shrink)

The present study examined nonprofessionals' perceptions of culturally based and noncultural ethical violations. One hundred seventy-four undergraduates students read 12 vignettes depicting situations in which a clinician committed either a culturally based violation (e.g., sexist or ageist behavior) or a noncultural violation (e.g., breeching confidentiality or multiple relationship). Results indicated that participants were more likely to have unfavorable views of clinicians who had committed culturally based violations. In addition, results suggested that participants would be more likely to report a clinician (...) who had committed a culturally based violation to a supervisor or ethics board. (shrink)

Research on multiple relationships by practicing psychologists has typically presumed the presence of a professional relationship and focused on the ethicality of subsequent, nonprofessional relationships. Instead, this study focused on the question of what, exactly, constitutes the professional relationship in the first place. Practicing psychologists and undergraduates responded to vignettes portraying various early stages of interaction between a therapist and a prospective client. Participants' responses indicated that determinations of professional relationship establishment, and the ethicality of subsequent nonprofessional relationships, depended upon (...) the degree of engagement. Some differences emerged between perceptions by professionals and nonprofessionals. Ethical and professional implications are discussed. (shrink)

To what extent does payment method (managed care vs. out of pocket) influence the likelihood that an independent practitioner will assign a Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) diagnosis to a client? When a practitioner does diagnose, how does payment method influence the specific choice of a diagnostic category? Independent practitioners responded to a vignette describing a fictitious client with symptoms of depression or anxiety. In half of the vignettes, the fictitious client intended to pay (...) via managed care; in the other half, the fictitious client intended to pay out of pocket. Payment method had a very significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to receive diagnoses and more likely to receive adjustment disorder diagnoses in particular. We discuss implications involving informed consent and other ethical issues. (shrink)

Although psychologist impairment has received attention from researchers, there is a paucity of empirical data aimed at determining the point at which such impairment necessitates action. The purpose of this study was to provide such empirical data. Members of Division 42 ( n = 285) responded to vignettes describing a psychologist whose symptoms of either depression or substance abuse varied across five levels of severity. Results identified specific levels of impairment at which psychologists were deemed too impaired to practice psychotherapy, (...) as well as significant differences between ratings of increasingly severe impairment. Practical and ethical implications of these results are discussed. (shrink)

This paper argues that the dominance of linear models has led many sociologists to construe the social world in terms of a "general linear reality." This reality assumes (1) that the social world consists of fixed entities with variable attributes, (2) that cause cannot flow from "small" to "large" attributes/events, (3) that causal attributes have only one causal pattern at once, (4) that the sequence of events does not influence their outcome, (5) that the "careers" of entities are largely independent, (...) and (6) that causal attributes are generally independent of each other. The paper discusses examples of these assumptions in empirical work, consider standard and new methods addressing them, and briefly explores alternative models for reality that employ demographic, sequential, and network perspectives. (shrink)

Our thinking is still the captive of the dichotomy “national/ international.” The reaction to nationalism takes the form of an abstract internationalism, and reaction to internationalism leads to the rebirth of nationalism. However, this dichotomy was only true (and that relatively) in 19th century Europe, or at the latest, at the beginning of the twentieth century, when subnational cultures seemed on the way to disappearing, and everything European was considered “universal” (two hypotheses that the facts prove to be untrue). As (...) H. Frey observes, “Today, the decline or decadence of the West is part of the contemporary view of the world, like the electron or the dinosaur.” The linear outline of progress, with Europe at the head, did not withstand the test of the First World War. The year 1918 marked the beginning of the end of Europeanism. Since then, we have begun to speak of “areas of civilization” (Splengler), “civilizations” (Toynbee), “cultural coalitions” (Lévi-Strauss). The existence of “areas of civilization” (regions) is commonly admitted today; it has entered journalistic language and even the structure of regional commissions and agencies of the United Nations (Europe, Near East, Southern Asia, South-east Asia, and the Far East). New communities have inserted themselves between nations and humanity. What do they represent? Are they something unique, or are they divided into a certain number of types in opposition to each other because of some characteristic? And in what way have they modified our view of universal history? (shrink)

The unique context of the rural setting provides special challenges to furnishing ethical healthcare to its approximately 62 million inhabitants. Although rural communities are widely diverse, most have the following common features: limited economic resources, shared values, reduced health status, limited availability of and accessibility to healthcare services, overlapping professional–patient relationships and care giver stress. These rural features shape common healthcare ethical issues, including threats to confidentiality, boundary issues, professional–patient relationship and allocation of resources. To date, there exists a limited (...) focus on rural healthcare ethics shown by the scarcity of rural healthcare ethics literature, rural ethics committees, rural focused ethics training and research on rural ethics issues. An interdisciplinary group of rural healthcare ethicists with backgrounds in medicine, nursing and philosophy was convened to explore the need for a rural healthcare ethics agenda. At the meeting, the Coalition for Rural Health Care Ethics agreed to a definition of rural healthcare ethics and a broad-ranging rural ethics agenda with the ultimate goal of enhancing the quality of patient care in rural America. The proposed agenda calls for increasing awareness and understanding of rural healthcare ethics through the development of evidence—informed, rural-attuned research, scholarship and education in collaboration with rural healthcare professionals, healthcare institutions and the diverse rural population. (shrink)

How do teenage girls articulate sexism in an era where gender injustice has been constructed as a thing of the past? Our article addresses this question by qualitatively exploring Canadian girls’ experiences of being caught between the postfeminist belief that gender equality has been achieved and the realities of their lives in school, which include incidents of sexism in their classrooms, their social worlds, and their projected futures. This analysis takes place in relation to two celebratory postfeminist narratives: Girl Power, (...) where girls are told they can do, be, and have anything they want, and Successful Girls, where girls are told they are surpassing boys in schools and workplaces. We argue that these postfeminist narratives have made naming sexism in schools difficult for girls because they are now seen to “have it all.” Utilizing Foucault’s law of the tactical polyvalence of discourse, this article analyzes girls’ contradictory engagement with postfeminism in order to both show its importance in girls’ lives, and its instability as a narrative that can adequately explain gender injustice. (shrink)

When physicians take readings of health indices such as temperature or blood pressure, the practices that physicians and patients employ in discussing the readings both reflect and propose a set of expectations regarding the level of technical medical information the patients should acquire and understand. In this article we demonstrate how physicians’ reporting practices reflect and propose the roles of paternalism or independent expertise and how patients’ responding practices either ratify or contest the roles cast by the physicians’ practices. In (...) contrast to the usual assumption that roles are relatively stable for individuals over the course of encounters, we treat role enactments as matters that are negotiated turn by turn in interaction. Physicians’ practices for reporting test results implicate various sets of expectations about the knowledge, interest, and responsibility state of each participant; patients employ responding practices that ratify or contest the expectations implicated by the physicians’ prior report. In each subsequent turn within the information exchange sequence, a speaker indicates whether the level and kind of information being exchanged is appropriate/inappropriate and sufficient/insufficient for the participants. (shrink)

This paper has described three uses of Extreme Case formulationsto assert the strongest case in anticipation of non-sympathetic hearingsto propose the cause of a phenomenonto speak for the rightness (wrongness) of a practice.The interactants in the illustrations were engaged in several types of activities, among which were complaining, accusing, justifying, and defending. As concluding remarks, a few comments will be made about why participants use Extreme Case formulations in these activities.Part of the business of complaining involves portraying a situation as (...) a legitimate complainable. This may take the form of protraying the offense committed and/or the suffering endured in a way such that it would not be dismissed as minor. So as to legitimize a complaint and portray the complainable situation as worthy of the complaint, a speaker may portray the offense and/or the suffering with Extreme Case formulations. In both accusing and defending, participants ofyen present their strongest cases, including specifying Extreme Cases of their claims.Part of justifying a course of actions may involve portraying the precipitating circumstance as necessitating the action. The precipitating circumstance may be a problem circumstance which is portrayed as unfair, immoral, embarrassing, uncomfortable, or in some other way undesirable and/or intolerable. There is a shared assumption that the worse the problem, the more necessary it is to do something about it. In justifying, speakers use Extreme Case formulations to portray the circumstances that precipitated their actions as demanding their actions.A problem that participants have when engaged in, or reflecting on, conflicts, complaints, criticism, compliments, praise, etc. is to attribute the cause of the phenomenon. Who or what is responsible for the conflictual, complainable, praise-worthy state of affairs? One method that is used to determine what or who is responsible, i.e. to make an attribution, involves comparing the case in question to other similar cases. Through this procedure, persons determine that they are (are not) responsible for the state of affairsin questions. Extreme Case proportional formulations (‘everyone,’ ‘all,’ ‘every time’) are used to indicate that any individual member of that category is not responsible for the state of affairs; that responsibility is to be attributed elsewhere.The social order essentially is a moral order (Garfinkel, 1967). One of the ways of knowing what is acceptable and right is by finding out how people behave. There often is a shared assumption operating (one that is called into question on occasion): how people behave tells us what is the right way to behave. Proportional measures reporting the frequency or prevalence of practices are used to propose and substantiate the rightness and wrongness of those practices. Extreme Case formulations (‘all the time,’ ‘everybody,’ ‘no one’) propose behaviors are acceptable and right or unacceptable and wrong. (shrink)

The analysis in this article considers how dispatchers in a 911 wireless call center direct callers’ orientations from one possible trajectory of action to keeping the caller engaged and prepared to speak with a second dispatcher. We describe how dispatchers deploy two distinct actions, a directing action and an informing action, timed at a precise moment to execute successful transfers. The analysis presents largely unexplored features of the call transfer environment, including dispatchers’ management of callers’ expectations and how the transfer (...) phase contributes to a reshaping of the overall structural organization of a 911 call. (shrink)

In this paper I shall examine how the pragmatists regarded the context of a single self in time (the problem of personal development over the life course) and the context of a single self in social space (the problem not only of surrounding individuals but also of surrounding and fundamentally different groups). After a quick glance at the ontologies of the earlier pragmatists, I discuss the problems of individual development and social difference as they emerged society-wide during and after the (...) first pragmatist generation. Having specified these problems, I can set the second pragmatist generation in the context they provide. The paper concludes with a discussion of the centrality of accounts of development and difference in a processualized social ontology. (shrink)

Buchanan highlighted the inconsistencies that arise when public services are financed by general taxation. Citizens increase their demand for services, even though citizens are reticent to increase taxation. Buchanan invited readers to explore the impact of different assumptions of politicians’ behaviour. In this chapter, attention focuses on the way that vote maximising governments are likely to respond to the divorce between receipt and payment for services. Buchanan illustrated his analysis with reference to the National Health Service in the UK. Predictions (...) are tested with reference to the pattern of excess demand in the National Health Service between 1970 and 2012. (shrink)

The first edition was awarded the '2005 Textbook Award of the Association of University Professors of Management (Verband der Hochschullehrer fur ...

In the medieval Islamic world, eloquent expression was an important skill for statesmen to acquire, such that many of the leading viziers were often prominent belletrists. Among the most well known of these literary figures was the Būyid vizier Ibn ʿAbbād. Drawing from a wide range of historical and literary sources, this article compiles and corroborates the many accounts relating to Ibn ʿAbbād’s political career, beginning with his family background and early education as a scribe, to his experiences in the (...) Būyid courts of Baghdad, Iṣfahān, and Rayy and his two decades as vizier to the Būyids Muʾayyid al-Dawla and Fakhr al-Dawla in western Iran. (shrink)

In response to an article by Waring, Creider, Tarpey and Black, the author argues that the nature of the analytic aims of a research project determines whether or not participants’ reported goals and motives are relevant and useful. Her position is that for traditional conversation analytic studies aimed at explicating culturally shared methods for producing conversational actions and for interpreting interactional behavior, participants’ reports of their goals and motives are irrelevant. She differentiates between explanations based on participants’ reports of their (...) goals and motives and conversation analytic explanations consisting of preferences or principles to which members of a culture orient while interacting. (shrink)

La Pensée d’Ibn al-Muqaffaʿ: Un «agent double» dans le monde persan et arabe. By István T. Kristó-Nagy. Studia Arabica, vol. 19. Paris: Éditions de Paris, 2013. Pp. 605. €34.

Building on the success of the bestselling first edition, the second edition of this textbook provides a comprehensive and accessible introduction to the major issues in Principles and Parameters syntactic theory, including phrase structure, the lexicon, case theory, movement, and locality conditions. Includes new and extended problem sets in every chapter, all of which have been annotated for level and skill type. Features three new chapters on advanced topics including vP shells, object shells, control, gapping and ellipsis and an additional (...) chapter on advanced topics in binding. Offers a brief survey of both Lexical-Functional Grammar and Head-Driven Phrase Structure Grammar. Succeeds in strengthening the reader's foundational knowledge, and prepares them for more advanced study. Supported by an instructor's manual and online resources for students and instructors, available at www.blackwellpublishing.com/carnie. (shrink)

This paper develops a theory of analog representation. We first argue that the mark of the analog is to be found in the nature of a representational system’s interpretation function, rather than in its vehicles or contents alone. We then develop the rulebound structure theory of analog representation, according to which analog systems are those that use interpretive rules to map syntactic structural features onto semantic structural features. The theory involves three degree-theoretic measures that capture three independent ways in which (...) a system can be more or less analog. We explain how our theory improves upon prior accounts of analog representation, provides plausible diagnoses for novel challenge cases, extends to hybrid systems that are partially analog and partially symbolic, and accounts for some of the advantages and disadvantages of representing analogically versus symbolically. (shrink)

Vagueness is the study of concepts that admit borderline cases. The epistemology of vagueness concerns attitudes we should have towards propositions we know to be borderline. On this basis Andrew Bacon develops a new theory of vagueness in which vagueness is fundamentally a property of propositions, explicated in terms of its role in thought.

Conscious experiences are characterized by mental qualities, such as those involved in seeing red, feeling pain, or smelling cinnamon. The standard framework for modeling mental qualities represents them via points in geometrical spaces, where distances between points inversely correspond to degrees of phenomenal similarity. This paper argues that the standard framework is structurally inadequate and develops a new framework that is more powerful and flexible. The core problem for the standard framework is that it cannot capture precision structure: for example, (...) consider the phenomenal contrast between seeing an object as crimson in foveal vision versus merely as red in peripheral vision. The solution I favor is to model mental qualities using regions, rather than points. I explain how this seemingly simple formal innovation not only provides a natural way of modeling precision, but also yields a variety of further theoretical fruits: it enables us to formulate novel hypotheses about the space and structures of mental qualities, formally differentiate two dimensions of phenomenal similarity, generate a quantitative model of the phenomenal sorites, and define a measure of discriminatory grain. A noteworthy consequence is that the structure of the mental qualities of conscious experiences is fundamentally different from the structure of the perceptible qualities of external objects. (shrink)

In a new study, Ben-Haim et al. use subliminal stimuli to separate conscious and unconscious perception in macaques. A programme of this type, using a range of cognitive tasks, is a promising way to look for conscious perception in more controversial cases.

This three-part chapter explores a higher-order logic we call ‘Classicism’, which extends a minimal classical higher-order logic with further axioms which guarantee that provable coextensiveness is sufficient for identity. The first part presents several different ways of axiomatizing this theory and makes the case for its naturalness. The second part discusses two kinds of extensions of Classicism: some which take the view in the direction of coarseness of grain (whose endpoint is the maximally coarse-grained view that coextensiveness is sufficient for (...) identity), and some which take the view in the direction of fineness of grain (whose endpoint is the maximally fine-grained theory containing all distinctness claims compatible with Classicism). The third part introduces some techniques for constructing models of Classicism, and uses them to prove the consistency of many of the extensions of Classicism introduced in the second part. (shrink)

In this wide-ranging interview Andrew Sayer discusses how he became a realist and then the development of his work over the subsequent decades. He comments on his postdisciplinary approach, his early work on economy and its influences, how he came to write Method in Social Science and the transition in Realism and Social Science to normative critical social science and moral economy. The interview concludes with discussion of his three most recent books and the themes that connect them, not (...) least the ongoing problem of a ‘diabolical double crisis’ of capitalism: extreme inequality and climate change. (shrink)

We consider the relationship between neural and behavioural evidence for animal consciousness. We critically examine two recent studies: one neural and one behavioural. The first, on crows, finds different neural activity depending on whether a stimulus is reported as seen or unseen. However, to implicate this neural activity in consciousness, we must assume that a specific conditioned behaviour is a report of conscious experience. The second study, on macaques, records behaviours strikingly similar to patterns of conscious and unconscious perception in (...) humans. However, confounds are only ruled out in human subjects, presupposing substantial neural similarity between humans and macaques. Taken together, the two studies reveal a sense in which neural and behavioural research rely on each other. Looking ahead, these two types of evidence could prove to be either mutually reinforcing or mutually undermining. The science of animal consciousness needs both neural and behavioural evidence, ideally obtained as part of a single coordinated programme. (shrink)

Some philosophers think that life is worth living not merely because of the goods and the bads within it, but also because life itself is good. I explain how this idea can be formalized by associating each version of such of a view with a function from length of life to the value generated by life itself. Then I argue that every version of the view that life itself is good faces some version of the following dilemma: either (1) good (...) human lives are worse than very long lives wholly devoid of pleasure, desire-satisfaction, knowledge, or any other goods, or (2) very short lives containing nothing but suffering are worth living. Since neither result is plausible, we ought to reject the view that life itself is good. On the view I favor, any given life may be worth living because of the goods that it contains, but life itself is neutral. (shrink)