Clinical ethics consultants represent a multidisciplinary group of scholars and practitioners with varied training backgrounds, who are integrated into a medical environment to assist in the provision of ethically supportable care. Little has been written about the degree to which such consultants are accountable for the patient care outcome of the advice given. We propose a model for examining degrees of internally motivated accountability that range from restricted to unbounded accountability, and support balanced accountability as a goal for practice. Finally, (...) we explore implications of this model for training of clinical ethics consultants from diverse academic backgrounds, including those disciplines that do not have a formal code of ethics relating to clinical practice. (shrink)

Clinical ethics consultants provide a range of services in hospital settings and in teaching environments. Training to achieve the skills needed to meet the expectations of employers comes in various forms, ranging from on-the-job training to formal fellowship training programs. We surveyed graduates of clinical ethics fellowships to evaluate their self-reported preparedness for their first job after fellowship training. The results indicated several areas of need, including greater exposure to program-building skills, quality improvement skills, and approaches to working with members (...) of higher administration. These data will be of use to educators as well as to fellows who advocate for elements of training in preparation for their first position. (shrink)

Clinical ethics consultants face a wide range of ethical dilemmas that require broad knowledge and skills. Although there is considerable overlap with the approach to adult consultation, ethics consultants must be aware of differences when they work with infant, pediatric, and adolescent cases. This article addresses unique considerations in the pediatric setting, reviews foundational theories on parental authority, suggests practical approaches to pediatric consultation, and outlines current available resources for clinical ethics consultants who wish to deepen their skills in this (...) area. (shrink)

Kimberly et al. (2005) have examined an important issue surrounding end-of-life decision-making, that of honoring do-not-resuscitate (DNR) orders in the non-medical setting of public schools. Their...

We congratulate Fox and her colleagues (2007) for contributing to the published empirical literature on ethics consultation in United States hospitals. Their study demonstrates the continued wide v...

Advocates for the professionalization of clinical bioethics argue that bioethics professionals play an important role in contemporary medicine and patient care, especially when addressing complex ethical questions that arise in the delivery of reproductive medicine. For bioethics consultants to serve effectively, they need adequate training in the medical and ethical issues that patients and clinicians will face, and they need skills to facilitate effective dialog among all parties. Because clinical ethics consultation is a “high‐stakes endeavor” that can acutely affect patient (...) care, efforts are under way to ensure that bioethics consultants have the competence to provide such guidance. Yet to date, no studies have examined whether the training of bioethics consultants meets the needs of health care professionals who are on the front lines of such issues. In fact, limited information is available on the reproductive health issues that bioethics training programs address or the degree to which these programs meet the needs of patients confronting reproductive health decisions and their clinicians. It is therefore important to answer this key question: What are the primary ethical issues encountered in reproductive medicine that currently affect patient care? Equally important, are bioethics training programs prepared to address those issues?To begin to answer these questions, we conducted parallel surveys of directors of graduate bioethics training programs and obstetrician‐gynecologists. The goal of this project is to lay the groundwork to establish a working partnership between bioethics educators and reproductive medicine practitioners to address the often troubling and frequently complex ethical issues in reproductive medicine. (shrink)

While consensus exists among many practitioners of ethics consultation about the need for and identification of core competencies and standards, there has been virtually no attempt to determine how these competencies and standards are best taught and assessed. We believe that clinical ethics consultation has reached a state of sufficient maturity that expert practitioners can evaluate those who are new to the field. We will outline several steps that can facilitate the creation of a certification process for clinical ethics consultants, (...) assuring the competency and quality of consultation for the patients, families, and healthcare professionals who utilize ECSs. (shrink)

Verbal protocol methodology is used to examine how fourth-grade students construct meaning as they read and respond to two informational social studies texts. Results indicate most students are active readers, often engaging in higher-level comprehension strategies and critical thinking as they read independently. However, critical thinking and comprehension processes are not often captured in their responses to end-of-reading questions (ERQ), which as a result have limited scope and utility for guiding social studies instruction. Results also indicate that when students change (...) their patterns of strategy use for reading and responding to text in response to a change in text, they are more successful on the ERQ than when their strategy use remains stagnant. (shrink)

In this article, I focus on two problematic aspects of British health-promotion campaigns regarding feeding children, particularly regarding breastfeeding and obesity. The first of these is that health-promotion campaigns around “lifestyle” issues dehumanize mothers with their imagery or text, stemming from the ongoing undervaluing and objectification of mothers and women. Public health-promotion instrumentalizes mothers as necessary components in achieving its aims, while at the same time undermining their agency as persons and interlocutors by tying “mother” to particular images. This has (...) a double effect: first, it excludes mothers who do not fit the campaign picture of a mother; second, it encloses those who do fit the picture into an objectified image of motherhood that is defined by and subject to the dominant white, heteropatriarchal gaze. The second problem is that campaigns place unjustified demands on mothers, which stem from a misinterpretation of the maternal duty to benefit. I argue that nutrition-related health concerns regarding children are improperly framed as individual failures of maternal duty, rather than as failures of a system to function correctly. These arguments ultimately support shifting the focus of responsibility for issues around childhood nutrition away from mothers and back toward policymakers. (shrink)

Military reproductive health policies affect large numbers of women. In 2006 servicewomen numbered nearly 350,000 and comprised 14.5% of active-duty forces and 17.4% of the reserve force. In addition, approximately 165,000 female dependents of active duty military personnel and 157,000 female dependents of reserve duty personnel are between the ages of 12 and 22 and are eligible for military health care services. Dependents of military personnel are eligible for military health care coverage until age 21, or up to the age (...) of 23 if considered a full-time student.About 10% of active duty female servicemembers become pregnant each year. Pregnant servicewomen are considered non-deployable and are usually not assigned to overseas commands. Pregnant women in the Army, the service branch with the greatest number of women on active duty, can choose to remain on active duty, request temporary leave from service, or request separation from service. Separation options include either discharge, honorable or uncharacterized depending on rank, or transfer to individual ready reserve. (shrink)

This article describes a qualitative content analysis of 37 elementary examples of social studies Inquiry Design Models (C3 Teachers, 2023a), conducted with the purpose of identifying the core student skills necessary to successfully engage in these inquiries. Prior research identifies core inquiry teaching skills for teachers across content areas and grade bands, but there has been little research on the demands placed on elementary students in social studies inquiry. In this study, we identify 33 broad skills, each of which are (...) observable and teachable. Four of these skills occurred in high frequency: generation of new ideas ( n = 152), writing process ( n = 110), linking evidence with claims ( n = 65), and discussion ( n = 63). These most frequently occurring skills all required higher-level and/or critical thinking. Implications for preservice and in-service teacher education are discussed. (shrink)

A commentary on “‘Aid in Dying’ in the Courts,” by Stephen R. Latham, in the May-June 2015 issue.

In The Medical Right, Remaking Medicine in Their Image (2007) (Medical Right Report or Report), the Religious Coalition for Reproductive Choice (RCRC) applies the term "Medical Right" to refer to religiously influenced medical, bioethics and health policy organizations of the Religious Right. This extremely important, well researched Report examines how the political agenda of the Religious Right, a political force comprised of fundamentalists primarily in the Protestant and Roman Catholic traditions, impacts reproductive health care. The growing influence of medical associations (...) that apply fundamentalist Christian "biblical values" to research and policy affecting reproductive health care is explored. The Report reveals that many consortiums, think tanks, institutes, and programs apply Religious Right ideology to medical concerns under the mantle of "bioethics" or "biomedical ethics." These groups work with conservative advocacy, outreach, and legal organizations, along with politicians, to advance the policy agendas of the Religious Right. The confluence of conservative politics, fundamentalist religion, and ideologically influenced medicine and science, poses a threat to reproductive health care services, as discussed in detail in the Report. While the Report is comprehensive in its discussion of the Religious Right's involvement in reproductive health issues, it addresses in only a cursory fashion how the Medical Right engages health law and policy governing end-of-life care. The purpose of this paper is to explore this area of concern more thoroughly. (shrink)

In addressing social issues, organizations have a responsibility to promote diverse participation, yet often struggle to harness the benefits of racial and gender diversity. Using a community-based participatory research design, with data collected over an 18 month field study, we examined how a social change organization, FoodLab, facilitated diverse collaboration. FoodLab aimed to grow a good food economy in Detroit, Michigan, through working with their members, local food entrepreneurs. We found that recurrent episodes of practicing dialogue catalyzed collaborative action around (...) multiple issues, including shared kitchens, licensing, and membership. Practicing dialogue included intentional convening, participatory devices, and collective language. While leaders set up the initial procedures and rules, leaders and members, together, enacted these structures. Through high quality interactions, participants developed additional resources, knowledge, motivation, and relationships. Across episodes of practicing dialogue, traces of high quality interactions supported sustained effort around social issues. Our findings demonstrate the dynamic aspects of organizational structure and individual action in working towards diverse collaborative action. (shrink)

This paper explores how the "environmental turn" for the last 25 years has been shaping remembrance of the destruction of Europe's Jewish populations. I argue that climate change is not just one more catastrophe to pass into the broad analogical field of the Holocaust. In fact, international Holocaust consciousness and understandings of what we now call the Anthropocene have long been intertwined and mutually constitutive. The paper starts in the 1990s with acclaimed writers Anne Michaels and W.G. Sebald, who sought (...) to recast the Holocaust's significance to modernity against a long backdrop of geologic time. Their memorial fiction, which grounds the history of the Holocaust in the eroding landscapes of Europe, reflects a growing and urgent global concern for the vulnerability of the environment and a sense of man's responsibility for preserving human and biological life. The paper then moves through more contemporary examples of the sublimation of Holocaust memory in discourse about global warming—evident in terms like "climate change denial" and calls to "bear witness" to mass extinction events. For better or worse, journalists and scholars who write about environmental activism frequently call on memory of World War II and genocide in order to redefine what constitutes "grievable life." Example authors include historian Timothy Snyder, who has predicted that climate change may lead to new genocidal wars over Lebensraum ; scientist James Lovelock, who has urged nation states to consider how to limit the coming influx of climate refugees; theorist Bruno Latour, who has argued, via Nazi philosopher Carl Schmitt, that we must "name our enemies" in the new climate wars; and essayist Ari Brostoff who has attempted to think climate catastrophe through Walter Benjamin's meditations on the angel of history. The implicit question in all of their work is this: What histories and philosophical traditions can help us redefine humanity's entangled relationship to nature in order to take political responsibility for saving life on Earth? In other words, the Anthropocene requires "a usable past"—but what will that usable past be? (shrink)

In the case discussion, ‘Equity in Public Health Ethics: The Case of Menu Labelling Policy at the Local Level’ , Mah and Timming state that menu labelling would ‘place requirements for information disclosure on private sector food businesses, which, as a policy instrument, is arguably less intrusive than related activities such as requiring changes to the food content’. In this commentary on Mah and Timming’s case study, I focus on discussing how menu-labelling policy permits governments to avoid addressing the heart (...) of the problem, which is high-calorie, high-sodium restaurant food. Menu labelling policy does not address food content in a way that is meaningful for change, instead relying on individuals to change their behaviour given new information. Besides having questionable efficacy, this raises concerns about moralizing food choices. (shrink)

Women's access to reproductive health care is an ongoing source of conflict in U.S. politics; however, women in the military are often overlooked in these debates. Reproductive health care, including family planning, is a fundamental component of health care for women. Unintended pregnancy carries substantial health risks and financial costs, particularly for servicewomen. Compared with their civilian counterparts, women in the military experience greater challenges in preventing unwanted pregnancy and have less access to contraceptive services and abortion. Current military policies, (...) federal laws, and health care practices are not always consistent with evidence-based research and patient-centered care. A multidisciplinary effort on the part of military personnel, lawmakers, and health care providers is needed to eliminate these disparities. We discuss recommendations in the following categories: improving contraceptive education and adherence, expanding research, broadening access to the full range of contraceptive options including emergency contraception, and ensuring access to safe abortion. (shrink)

This study examines the use of an explicit, reflective method for teaching the difference and relationship between scientific theories and laws to ninth-grade students. Students reflected individually and then as a whole class on theories and laws using a Venn diagram, both before and after reading short articles describing features of theories and laws that provided an explicit challenge to their naïve prior conceptions. In small groups, they chose a theory or law, researched it, constructed a poster, and did a (...) gallery walk. Examination of students’ Venn diagrams and answers to a single question from VNOS-C given as both a pre- and post-test showed that prior to the lesson, all students except for one held more naïve views of both the difference between theories and laws and the nature of scientific theories. After the lesson, more than a third of them had improved their conceptions to more informed, and nearly a quarter understood that there is not a hierarchical relationship between scientific theories and laws. (shrink)

Elizabeth A. McGibbon and Josephine B. Etowa, Anti-racist health care practice, Toronto: Canadian Scholars’ Press, 2009, reviewed by Kathryn L. Mackay.

Near the conclusion of the so-called marriage group in the Canterbury Tales sits Chaucer's Squire's Tale, a strange, hybrid narrative of love and betrayal located in the Mongol empire. Surprisingly, however, none of the many modern readers of the tale has made a study of how the Squire's Tale's setting in the East is connected to its view of the subject that dominates Fragments IV and V of the Canterbury Tales: love, power, and the negotiation of a settlement in the (...) prolonged war between the sexes. The omission is especially perplexing when the Squire's Tale is read in combination with its companion narrative, the Franklin's Tale. Indeed, the relation of Squire to Franklin is normally seen as old money to new, aristocrat to parvenu without reference either to the question of female power or to the geographical and cultural oppositions upon which the stories also insist. When the Squire is understood as making a contribution to the conversation initiated by the Wife of Bath and carried on at least through the Franklin's Tale, it is generally on the subject of true nobility, chivalry, or gentillesse—not on the “gentle sex.” Donald Baker even goes so far as to rechristen G. L. Kittredge's marriage group a “gentillesse group” in order to include the Squire in its discussion. (shrink)

New readings of Chaucer's dream visions, demonstrating his philosophical interests and learning.

The purpose of this study is to describe ways in which elementary students access information from various components of informational social studies texts in schools. Although the time devoted to elementary social studies has decreased considerably in recent years, a renewed focus on content-area literacy skills, driven by state standard initiatives, presents us with the opportunity to regain lost social studies instructional time by integrating social studies content during literacy instructional time. However, it is not entirely clear what this instructional (...) time should entail. This paper describes how third-, fourth-, and fifth-grade children navigate various aspects of the written and graphical elements of informational social studies reading materials. Results indicate that when students are unable to correctly answer questions about the content of the reading materials, they primarily attempt to do so in one of four ways: (1) responding without the use of a discernable strategy; (2) extracting random information from the passage; (3) relying on prior knowledge; or, (4) extracting information from the correct aspect of text that is not responsive to the question. Based on researcher-developed reading assessments as data sources, we explain the challenges children encounter and make recommendations for elementary social studies instruction. (shrink)

This paper draws on nearly two decades of research on health consumer and patients’ organizations in the United Kingdom. In particular, it addresses questions of representation and legitimacy in the health policy process. HCPOs claim to represent the collective interests of patients and others such as relatives and carers. At times they also make claims to represent the wider public interest. Employing Pitkin’s classic typology of formalistic, descriptive, symbolic, and substantive representation, the paper explores how and in what sense HCPOs (...) represent their constituencies. We found that policymakers themselves are less concerned with formal mechanisms adopted by groups and are more concerned with credibility, in particular whether HCPOs carry the confidence of their constituents. While some concerns about legitimacy remain, particularly in relation to funding from commercial interests, we argue that HCPOs bring a unique perspective to the policy process and to focus purely on formalistic representation provides only a partial understanding of their representative role and a constrained view of their collective moral claims. (shrink)

Although it is clear that i-frame approaches cannot stand alone, the impact of s-frame changes can plateau. Combinations of these approaches may best reflect what we know about behavior and how to support behavioral change. Interactions between i-frame and s-frame thinking are explored here using two examples: alcohol consumption and meat consumption.

Elizabeth A. McGibbon and Josephine B. Etowa’s co-authored book Anti-racist Health Care Practice exposes and addresses systemic racism in the Canadian health-care system. McGibbon and Etowa directly confront racism in health provision and Canadian society, and provide a discussion of racism and related issues (gender, class) that does not hold back criticisms. The system of racial oppression and its sustenance by white privilege is presented to the reader in a clear and straightforward way, making it impossible for the reader to (...) deny or misunderstand his or her role in the power structures of Canadian (or American) society. The book is directed primarily at medical practitioners, as well as educators and policy .. (shrink)

The precarious rights of senior citizens, especially those who are highly educated and who are expected to counsel and guide the younger generations, has stimulated the creation internationally of advocacy associations and opinion leader groups. The strength of these groups, however, varies from country to country. In some countries, they are supported and are the focus of intense interest; in others, they are practically ignored. For this is reason we believe that the creation of a network of all these associations (...) is essential. The proposed network would act as a support for the already-existing policies of the United Nations’ High Commission for Human Rights, of independent experts, and of the Global Alliance for the Rights of Older People. All three have long ago recommended the creation of a recognized instrument for uniting presently scattered efforts. The proposed network, therefore, will seek to promote the international exchange of relevant expertise, and it will reinforce the commitments and actions that single countries are currently taking to meet these objectives. For example, informative public events can be organised to promote particular support initiatives and to provide an opportunity for new members of the network to be presented. The network will promote health for senior citizens, disease prevention, senior mobility, safe free time for seniors, alimentary education, protection against new risks and dangers, as well as equity in the services necessary for seniors to adopt new information and communication technologies. In the case of retired academic members, the network will promote equality with respect to continuing use of digital technologies (particularly email), continuing access to research libraries, and the guaranteed ability for seniors to fund their own research programs and to deliver free seminars. (shrink)

Though we agree with their argument that language is shaped by domain-general learning processes, Christiansen & Chater (C&C) neglect to detail how the development of these processes shapes language change. We discuss a number of examples that show how developmental processes at multiple levels and timescales are critical to understanding the origin of domain-general mechanisms that shape language evolution.

In cognitive science, there is a tacit norm that phenomena such as cultural variation or synaesthesia are worthy examples of cognitive diversity that contribute to a better understanding of cognition, but that other forms of cognitive diversity (e.g., autism, attention deficit hyperactivity disorder/ADHD, and dyslexia) are primarily interesting only as examples of deficit, dysfunction, or impairment. This status quo is dehumanizing and holds back much-needed research. In contrast, the neurodiversity paradigm argues that such experiences are not necessarily deficits but rather (...) are natural reflections of biodiversity. Here, we propose that neurodiversity is an important topic for future research in cognitive science. We discuss why cognitive science has thus far failed to engage with neurodiversity, why this gap presents both ethical and scientific challenges for the field, and, crucially, why cognitive science will produce better theories of human cognition if the field engages with neurodiversity in the same way that it values other forms of cognitive diversity. Doing so will not only empower marginalized researchers but will also present an opportunity for cognitive science to benefit from the unique contributions of neurodivergent researchers and communities. (shrink)

One important problem in cognitive science is to understand the development of cognitive processes in children and to devise computer models to explore the mechanisms that underlie these changes. Our research addresses these general goals. In particular, we are concerned with developmental changes in cognitive strategies in typical children and in children with mild mental retardation.

Presents a plethora of approaches to developing human potential in areas not conventionally addressed. Organized in two parts, this international collection of essays provides viable educational alternatives to those currently holding sway in an era of high-stakes accountability.