This project evaluates the impact of the National Science Foundation's policy to promote education in the responsible conduct of research. To determine whether this policy resulted in meaningful RCR educational experiences, our study examined the instructional plans developed by individual universities in response to the mandate. Using a sample of 108 U.S. institutions classified as Carnegie “very high research activity”, we analyzed all publicly available NSF RCR training plans in light of the consensus best practices in RCR education that were (...) known at the time the policy was implemented. We found that fewer than half of universities developed plans that incorporated at least some of the best practices. More specifically, only 31% of universities had content and requirements that differed by career stage, only 1% of universities had content and requirements that differed by discipline; and only 18% of universities required some face-to-face engagement from all classes of trainees. Indeed, some schools simply provided hand-outs to their undergraduate students. Most universities had plans that could be satisfied with online programs such as the Collaborative Institutional Training Initiative's RCR modules. The NSF policy requires universities to develop RCR training plans, but provides no guidelines or requirements for the format, scope, content, duration, or frequency of the training, and does not hold universities accountable for their training plans. Our study shows that this vaguely worded policy, and lack of accountability, has not produced meaningful educational experiences for most of the undergraduate students, graduate students, and post-doctoral trainees funded by the NSF. (shrink)

Explores the metaphysical, epistemological, and hermeneutical theories of Schelling’s final system concerning the nature and meaning of religious mythology.

Is evidential pluralism possible when we move to the social sciences, and if so, to what degree? What are the analytical benefits? The answer put forward in this article is that there is a tradeoff between how serious social science methodologies take the study of mechanisms and the analytical benefits that flow from evidential pluralism. In the social sciences, there are a range of different approaches to studying mechanisms, differentiated by the degree to which the ‘process’ is unpacked theoretically, and (...) whether the approach takes seriously the particular nature of social phenomena and the epistemological consequences that flow from this, as in realist approaches to the study of mechanisms, or whether more neopositivist-based foundational assumptions are adopted. Depending on which approach to study mechanisms is used, evidential pluralism is either: easy but superficial, very productive but challenging, or almost impossible because of the fundamental differences between the types of claims being made and the forms of evidence used. (shrink)

Background Respect is essential to providing high quality healthcare, particularly for groups that are historically marginalized and stigmatized. While ethical principles taught to health professionals focus on patient autonomy as the object of respect for persons, limited studies explore patients’ views of respect. The purpose of this study was to explore the perspectives of a multiculturally diverse group of low-income women living with HIV (WLH) regarding their experience of respect from their medical physicians. Methods We analyzed 57 semi-structured interviews conducted (...) at HIV case management sites in South Florida as part of a larger qualitative study that explored practices facilitating retention and adherence in care. Women were eligible to participate if they identified as African American (n = 28), Hispanic/Latina (n = 22), or Haitian (n = 7). They were asked to describe instances when they were treated with respect by their medical physicians. Interviews were conducted by a fluent research interviewer in either English, Spanish, or Haitian Creole, depending on participant’s language preference. Transcripts were translated, back-translated and reviewed in entirety for any statements or comments about “respect.” After independent coding by 3 investigators, we used a consensual thematic analysis approach to determine themes. Results Results from this study grouped into two overarching classifications: respect manifested in physicians’ orientation towards the patient (i.e., interpersonal behaviors in interactions) and respect in medical professionalism (i.e., clinic procedures and practices). Four main themes emerged regarding respect in provider’s orientation towards the patient: being treated as a person, treated as an equal, treated without blame or prejudice, and treated with concern/emotional support. Two main themes emerged regarding respect as evidenced in medical professionalism: physician availability and considerations of privacy. Conclusions Findings suggest a more robust conception of what ‘respect for persons’ entails in medical ethics for a diverse group of low-income women living with HIV. Findings have implications for broadening areas of focus of future bioethics education, training, and research to include components of interpersonal relationship development, communication, and clinic procedures. We suggest these areas of training may increase respectful medical care experiences and potentially serve to influence persistent and known social and structural determinants of health through provider interactions and health care delivery. (shrink)

The neural representation of a repeated stimulus is the standard against which a deviant stimulus is measured in the brain, giving rise to the well-known mismatch response. It has been suggested that individuals with dyslexia have poor implicit memory for recently repeated stimuli, such as the train of standards in an oddball paradigm. Here, we examined how the neural representation of a standard emerges over repetitions, asking whether there is less sensitivity to repetition and/or less accrual of “standardness” over successive (...) repetitions in dyslexia. We recorded magnetoencephalography as adults with and without dyslexia were passively exposed to speech syllables in a roving-oddball design. We performed time-resolved multivariate decoding of the MEG sensor data to identify the neural signature of standard vs. deviant trials, independent of stimulus differences. This “multivariate mismatch” was equally robust and had a similar time course in the two groups. In both groups, standards generated by as few as two repetitions were distinct from deviants, indicating normal sensitivity to repetition in dyslexia. However, only in the control group did standards become increasingly different from deviants with repetition. These results suggest that many of the mechanisms that give rise to neural adaptation as well as mismatch responses are intact in dyslexia, with the possible exception of a putatively predictive mechanism that successively integrates recent sensory information into feedforward processing. (shrink)

Although the concept of dignity is commonly invoked in clinical care, there is not widespread agreement—in either the academic literature or in everyday clinical conversations—about what dignity means. Without a framework for understanding dignity, it is difficult to determine what threatens patients’ dignity and, conversely, how to honor commitments to protect and promote it. This article aims to change that by offering the first conceptual model of dignity for patients in the intensive care unit. The conceptual model we present is (...) based on the notion that there are three sources of patients’ dignity—their shared humanity, personal narratives, and autonomy—each of which independently warrants respect. The article describes each source of dignity and draws on examples to illustrate how clinician attitudes, actions, and behaviors can either contribute to, or detract from, expressions of respect for patient dignity. (shrink)

Despite wide recognition of the importance of treating patients with respect and dignity, little is known about what constitutes treatment in this regard. The intensive care unit (ICU) is a unique setting that can pose specific threats to treatment with respect and dignity owing to the critical state of patients, stress and anxiety amongst patients and their family members, and the highly technical nature of the environment. In attempt to understand various stakeholders’ perspectives of treatment with respect and dignity, patients (...) and family members were interviewed, a wide range of health care professionals participated in focus groups, and third party observers took field notes of interactions in the ICU. This paper compares and contrasts the data that were generated using these different methods. Triangulating the data in this way contributes to a more complete and nuanced understanding of treatment with respect and dignity in the ICU. (shrink)

Respect and dignity are central to moral life, and have a particular importance in health care settings such as the intensive care unit (ICU). We conducted 15 semistructured interviews with 21 participants during an ICU admission to explore the definition of, and specific behaviors that demonstrate, respect and dignity during treatment in the ICU. We transcribed interviews and conducted thematic qualitative analysis. Seven themes emerged that focused on what it means to be treated with respect and/or dignity: treated as a (...) person; Golden Rule; acknowledgement; treated as family/friend; treated as an individual; treated as important/valuable; and treated as equal. Participants described particular behaviors or actions that were considered related to demonstrating treatment with respect and dignity: listening; honesty/giving information; attention to body/modesty/appearance; caring/bedside manner; patient and family as an information source; attention to pain; and responsiveness. These behaviors provide a framework for improving experiences with care in the ICU. (shrink)

Business bluffing as a subject has been mentioned in various journals for at least the past 16 years. Its treatment has become one of apparent serious intent to identify it as a subject matter unto itself. Definitionally and theoretically, its essence has been specified but seemingly without due regard to its true nature. Business bluffing is an act of puffing at best and misrepresentation or fraud at worst. In either case, its legality and morality are already well defined and discussions (...) of the subject should be directed along these established pathes. A businessman is admonished to judge things as they are, to speak of them, when properly called thereto, according to such judgment, neither adding or diminishing, neither depreciating a commodity, nor putting false color upon it. (Plain and Serious Hints and Advice for the Tradesman's Prudent and Pious Conduct, Dr. Isaac Watts, 1747.). (shrink)

A limiting factor in ethics education in medical training has been difficulty in assessing competence in ethics. This study was conducted to test the concept that content analysis of pediatric residents’ personal reflections about ethics experiences can identify changes in ethical sensitivity and reasoning over time. Analysis of written narratives focused on two of our ethics curriculum’s goals: 1) To raise sensitivity to ethical issues in everyday clinical practice and 2) to enhance critical reflection on personal and professional values as (...) they affect patient care. Content analysis of written reflections was guided by a tool developed to identify and assess the level of ethical reasoning in eight domains determined to be important aspects of ethical competence. Based on the assessment of narratives written at two times (12 to 16 months/apart) during their training, residents showed significant progress in two specific domains: use of professional values, and use of personal values. Residents did not show decline in ethical reasoning in any domain. This study demonstrates that content analysis of personal narratives may provide a useful method for assessment of developing ethical sensitivity and reasoning. (shrink)

_Explores the metaphysical, epistemological, and hermeneutical theories of Schelling’s final system concerning the nature and meaning of religious mythology._.

Little is known about health care professionals’ perceptions regarding what it means to treat patients and families with respect and dignity in the intensive care unit (ICU) setting. To address this gap, we conducted nine focus groups with different types of health care professionals (attending physicians, residents/fellows, nurses, social workers, pastoral care, etc.) working in either a medical or surgical ICU within the same academic health system. We identified three major thematic domains, namely, intrapersonal (attitudes and beliefs), interpersonal (behaviors), and (...) system (contextual) factors that influence treatment with respect and dignity. Participants suggested strategies for improving treatment of patients and families in the ICU with respect and dignity, as well as the related need for enhancing respect among the multidisciplinary team of clinicians. Implementing these strategies will require innovative educational interventions and leadership. Future research should focus on the design and evaluation of such interventions on the quality of care. (shrink)

Kant's noncognitive argument based on practical reason claims that moral considerations alone suffice to justify the idea of personal immortality as a postulate. Some recent objections are considered here that have charged him with overstepping his own distinction between phenomenon and noumenon. After examining the arguments, Kant is exonerated of having violated his own principles. More troubling, however, is the peculiarity involved in postulating an infinite progression toward a goal whose attainment, by hypothesis, would undermine the very foundations of morality (...) (which for Kant always requires the agonistic condition of struggling to improve one's lower nature). It is argued that this paradox necessitates a reexamination of some tacit cultural presuppositions underlying Kant's conception of the soul. Finally, an examination is made of the thought of Kitarō Nishida, whose Zen Buddhist–inspired dialectic of the basho (logical "place") provides an alternative perspective from which to reconsider the postulate of immortality. Nishida, like Kant, rigorously maintains the phenomenonnoumenon distinction, yet his examination of ethics leads him to postulate an eventual sublation of the "soul" principle. It is concluded that Kant's postulate of immortality, while plausible enough on its own terms, is limited by a Western cultural bias and therefore fails in the end to be compelling. (shrink)

In this study, we tested the feasibility of conducting quantitative assessments of patients’ experiences with care in the intensive care unit (ICU), in regard to treatment with respect and dignity. Patients completed the Patient Dignity Inventory, Collaborate, and selected domains from the Hospital Consumer Assessment of Health Providers and Systems Survey. Family members were additionally surveyed using the Family Satisfaction in ICU Care questionnaire. Overall, patients reported high levels of satisfaction in terms of nurses and doctors treating them with courtesy (...) and respect; however, physical aspects of care were reported to be more problematic. While this pilot study suggests some target areas for improving treatment with respect and dignity, the findings are limited since many patients were unable to participate in the survey. Future work should be directed at developing new measures that are easier to administer in this setting. (shrink)

Treating patients and their family members with respect and dignity is a broadly accepted goal of health care. The work presented in this article is part of a larger project aimed at better understanding what constitutes treatment with respect and dignity in the ICU to improve the care that patients and family members receive in this regard. Direct observation was selected as one of the methods to facilitate this understanding because it provides the opportunity to see and document what actually (...) occurs during encounters among patients, their families, and clinicians. This article reports seven major thematic domains and many subthemes that together create a detailed account of the interpersonal and environmental components of treatment with respect and dignity. Attention to these components might enhance the experience and treatment of patients and family members. (shrink)

Conviction Narrative Theory bears a close resemblance to the Theory of Narrative Thought, although the two were designed to address different questions. In this commentary, we detail some of the more pronounced similarities and differences and suggest that resolving the latter could produce a third theory of narrative cognition that is superior to either of these two.

This essay explores Hegel’s treatment of Carl Friedrich Gauss’s mathematical discoveries as examples of “Analytic Cognition.” Unfortunately, Hegel’s main point has been virtually lost due to an editorial blunder tracing back almost a century, an error that has been perpetuated in many subsequent editions and translations.The paper accordingly has three sections. In the first, I expose the mistake and trace its pervasive influence in multiple languages and editions of the Wissenschaft der Logik. In the second section, I undertake to explain (...) the mathematical significance of Gauss’s discoveries. In the third section, I take a look at the deeper implications of Hegel’s treatment of Gauss’s work as a window onto the nature and limitations of analytic cognition. In conclusion, I seek to explain how the linear method embodied in deductive reason leads by its own inner principle, according to Hegel, to its dialectical Aufhebung (sublation). The result is a kind of deliberately circular reasoning that he describes as “the Absolute Idea.”. (shrink)

Providers and patients bring different understandings of health and disease to their encounters in the hospital setting. The literature to date only infrequently addresses patient and provider concordance on the reported reason for hospitalization, that is, whether they express this reason in similar ways. An agreement or common ground between such understandings can serve as a basis for future communication regarding an illness and its treatment. We interviewed a convenience sample of patients on the medical wards of an urban academic (...) medical center. We asked subjects to state the reason why their doctors admitted them to the hospital, and then compared their statement with the reason in the medical record. We defined concordance on reported reason for hospitalization as agreement between the patient’s report and the reason abstracted from the chart. We interviewed and abstracted chart data from a total of 46 subjects. Concordance on reported reason for hospitalization was present in 24 (52%) and discordance in 17 (37%); 5 patients (11%) could not give any reason for their hospitalization. Among the 17 patients whose report was discordant with their chart, 12 (71%) reported a different organ system than was recorded in the chart. A significant proportion of medical inpatients could not state their physicians’ reason for admission. In addition, patients who identify a different reason for hospitalization than the chart often give a different organ system altogether. Providers should explore patient understanding of the reason for their hospitalization to facilitate communication and shared decision making. (shrink)

Schelling is best known in the Anglo-American philosophical community for work he did in his twenties, between 1797 and 1803. During this time, he appropriated Fichte’s standpoint of transcendental idealism and developed some of its implications for the philosophies of nature, history, and art. Schelling did not claim at this stage to be formulating an original standpoint of his own, but simply to be extending the Fichtean principles in new directions. In this endeavor he was quite successful, and for a (...) brief period he was lionized as philosophy’s youngest and brightest hope. He has been recognized since then as an important pioneer in the post-Kantian German idealist movement. (shrink)

Dieter Henrich has presented persuasive evidence that Hegel’s logic does not, in practice, provide a linear deduction of logical categories, but rather borrows thought-forms proper to subsequent stages in order to effect its dialectical transitions. In reply, I argue that the presented order of the categories is already implicitly sublated by a deep structure of circularity that determines the development. Thus, Hegel’s dialectic is deliberately nonlinear in terms of both its content and its method. One can therefore acknowledge the astuteness (...) of Henrich’s many insights without regarding them as telling criticisms of the system as Hegel intended it. (shrink)

As an important corollary of this interpretation of absolute knowledge, the dissertation concludes with the suggestion that Hegelian philosophy need not be regarded merely as an interesting curiosity in the history of ideas, but rather that it can serve as a vital and potentially rewarding source of fresh theoretical insights. ;Instead, the concrete completeness of speculative philosophy can only consist in the activity of a dynamical, ceaselessly self-examining and self-regulating intellectual community. In one sense, of course, no finite system can (...) ever be complete, insofar as it will inevitably be guilty of errors and misconceptions. Yet at the same time, the infinite System is perfect and complete, insofar as it contains within itself the means whereby its own unavoidable flaws will be discovered, corrected, and "forgiven"--i.e. aufgehoben into vanishing moments of a universal totality. ;In opposition to most traditional interpretations of Hegel, the position is maintained that Hegel himself deliberately faced this problem, and that a true understanding of his proposed solution requires a radical Aufhebung of the concept of cognition as such. Relying primarily on the penultimate chapters of the Phenomenology of Spirit, the dissertation argues that absolute knowledge can neither be a finalized system of fully explicit content, nor an endless movement toward such an ideal state. ;This dissertation undertakes a critical examination of one central problem in Hegelian philosophy: viz., whether the final realization of "absolute knowledge" is logically consistent with significant epistemic progress in the system's continuing development. Serious consideration of the concept of systematic completeness, as interpreted on Hegel's terms, uncovers the existence of a profound paradox. On the one hand, if the Truth is the Whole, then the truth of any finite part or aspect of that Whole depends upon its place within the system as a totality. In order to grasp the part and comprehend it correctly, one must already have a systematically ordered knowledge of the universe in its entirety. Yet the methodological open-endedness of dialectical thinking precludes the acceptance of any particular theoretical formulation as final or complete in itself. Hegel interprets the history of philosophy as a progression of successive formulations of the Truth, each of which improves on its predecessors by reconciling their internal contradictions, but no one of which is adequate in itself. Hence, no theoretical world view, including Hegel's own, can rest content within its limits, for the inevitable advance of thought must in the end throw it down. (shrink)

In the journey of faith almost everyone experiences times of spiritual desolation when our sense of God's presence is stripped away and our certainty about his faithfulness is deeply eroded. Times like this are intensely disorienting as they leave us grasping for answers, but even more importantly searching for a way forward. The literature of the Bible provides us with both experiential companionship and language to guide our journey through the desolate places of spiritual experience. The prayer language of exile (...) offers us a paradigm for engaging with God in the midst of our experience of his absence. In particular the biblical book of Lamentations and a number of Psalms provide language that helped Israel express the depths of their suffering in the face of their exilic experience. The prayer language of exile is the language of God's absence. Through the language of exilic prayer we encounter the bold movements of lament, remembrance, reorientation, and hope. These acts of prayerful speech form the core of a spirituality of exile that sustained the ancient community and can offer nourishment to contemporary journeys of desolation as well. (shrink)

This article addresses the issue of love in war from the position of an officer actively engaged in the training of officers in the British army over many years. It describes the ethos which informs this training and proposes that a better analogy is with the Golden Rule.

In his paper, “Why Every Theory of Luck is Wrong,” Steven D. Hales presents a range of purported counterexamples to every account of luck that has a control condition or a chance condition. He gathers these counterexamples under the headings of lucky necessities, skillful luck, and diachronic luck. He concludes that no account of luck does or even can be developed which adequately handles these cases. In response, a novel account of luck— contrastive luck —is briefly developed in this paper. (...) Contrastive luck, complete with control and modal conditions, meets the challenges posed by Hales’ strongest representative counterexamples. Only space limitations prevent speaking to all. The takeaway is that at least one account of luck evades his charge of defect. Not every theory of luck is wrong. (shrink)