Relatively few articles discuss the ethical issues that accompany healthcare in rural areas. This article presents and discusses the key findings obtained from multi-method research studies conducted over a 9-year period of time in a multi-state rural area. It challenges the efficacy of current models for bioethics, shows what kinds of ethical issues develop in rural communities, and offers a framework for envisioning resources and approaches that may be more appropriate.

The Canadian Truth and Reconciliation Commission has been mandated to collect testimonies from survivors of the Indian Residential Schools system. The TRC demands survivors of the residential school system to share their personal narratives under the assumption that the sharing of narratives will inform the Canadian public of the residential school legacy and will motivate a transformation of settler identity. I contend, however, that the TRC provides a concrete example of how a politics of recognition fails to transform relationships between (...) Native and settler Canadians not only because it enacts an internalization of colonial recognition, but because it fails to account for what I call “settler ignorance.” Work in epistemologies of ignorance and epistemic oppression gives language to explain sustained denial and provide tools to further understand how settler denial is sustained, and how it can be made visible, and so challenged. For this task, Mills’s articulation of white ignorance should be expanded to a consideration of white settler ignorance. Over and above an account of white ignorance, such an account will have to consider the underlying logics of settler colonialism. This characterization of settler ignorance will show that the denial of past and ongoing violence against Indigenous peoples, through the reconstruction of the past to assert the primacy of settlers, is not explainable in terms of a lack of recognition but is rather structural ignorance. (shrink)

Firms face mounting pressure to appoint ethical leaders who will avoid unnecessary risk, scandal and crisis. Alongside mounting evidence that narcissistic leaders place organizations at risk, there is a growing consensus that women are more ethical, transparent and risk-averse than men. We seek to interrogate these claims by analyzing whether narcissism is as prevalent among women CEOs as it is among men CEOs. We further analyze whether narcissistic women CEOs take the same types of risk as narcissistic men CEOs. Drawing (...) on social role and token theories, we test hypotheses related to gender differences in the prevalence and impact of CEO narcissism on firm-level practices. Using a unique dataset that includes a large sample of CEOs of S&P 1500 companies from 1992 through 2014, we create a narcissism composite score for each CEO based on their photograph size in the annual report, and their cash earnings and non-cash earnings relative to the next highest paid executive. We find that women CEOs are less likely to exhibit narcissistic personality traits compared to men CEOs. Furthermore, we find that gender moderates the relationship between narcissistic CEOs and our outcome variables of risk-taking and questionable behaviors. (shrink)

A few weeks ago, a rural hospital administrator phoned with a question posed by his management team. “If you were going to give us some ethics resources,” he queried, “just exactly what would they...

Clinical research is increasingly conducted in settings that include private physicians’ offices, clinics, community hospitals, local institutes, and independent research centers. The migration of such research into this new, non–academic environment has brought new cadres of researchers into the clinical research enterprise and also broadened the pool of potential research participants. Regulatory approaches for protecting human subjects who participate in research have also evolved. Some institutions retain their own Institutional Review Boards (IRBs), but Independent IRBs, community hospital IRBs and community–based (...) IRBs also fulfill oversight responsibilities. This article sheds light on this evolving world by discussing the findings gleaned from two studies: a study of the decision making processes used by members who serve on different kinds of IRBs and a study of the decision making processes employed by research participants. The article then discusses how the key findings may inform proposed revisions to the Common Rule. (shrink)

Hospital ethics committees have evolved as a response to complicated legal, ethical, and social dilemmas that accompany modern medicine. In the United States, their growth has been augmented by Joint Commission for the Accreditation of Healthcare Organizations standards and the Patient Self-Determination Act. There appears to be an implicit presumption that all clinical ethics consultation practices are relatively similar. Finally, there is heightened awareness of the needs for quality standards and assessment of the outcomes of ethics consultations.

In lieu of an abstract, here is a brief excerpt of the content:Graffiti and Colonial Unknowing:A Comment on Mishuana Goeman's "Caring for Landscapes of Justice in Perilous Settler Environments"Anna Cookin "caring for landscapes of justice in Perilous Settler Environments," Dr. Goeman shows how the NDN Collective's initiatives, Chemehuevi photographer Cara Romero's Tongvaland project, and the works of Gabrieliño Tongva artist Mercedes Dorame "exemplify communities of care" that work toward "the unmapping of settler terrains" ("Caring for Landscapes" 51). Her address highlights (...) how these cartographic art productions are processes of (re)mapping that challenge colonial spatialities. Drawing on Michi Saagig Nishnaabeg scholar Leanne Betasamosake Simpson's poem "i am graffiti," Goeman frames these art works as Indigenous graffiti, insofar as they are everyday acts of resurgence1 that resist erasure and enact rematriation.My comments aim to articulate how Romero's and Dorame's works both reveal and disrupt a colonial unknowing by showing the cracks of settler colonial spatiality. I take Goeman's address to illustrate that the changing of minds and unsettling of settler identity will not occur through argumentation, facts, and figures alone, but rather through aesthetic and cartographic practices that "provide a way of seeing Indigenous futurities and relationalities" ("Caring for Landscapes" 52).Maps as Tools of Settler ColonialismIn order to highlight how these art practices enact a kind of (re)mapping that breaks through the veneer of colonial permanence, we first need to consider the way mapping transforms land into property in the service of Indigenous erasure and land dispossession. In her address, Goeman offers a short history of what is now called Los Angeles through the lens of dispossession that occurs through "international claiming of property and burgeoning US property law" ("Caring for Landscapes" 53). Tovaangar was divided into Spanish (and [End Page 64] then Mexican) land grants that, after 1846, were "registered under the US as property" (Goeman, "Caring for Landscapes" 53; emphasis added). The Land Act of 1851 "established the domestication of the California landscape under US governance" by legitimating existing Mexican land rights and mapping out territory yet "unclaimed" ("Caring for Landscapes" 54). The mapping of this so-called "unclaimed" territory propelled a violent erasure of California Indians by "establishing new and ongoing commerce centers" ("Caring for Landscapes" 53). Land was transferred into property—as a thing owned—without "the consent of those who … lived on the land since time immemorial, following the settler structure of passing land between Christian nations" ("Caring for Landscapes" 53). By showing how property rights legitimate conquest and violence, Goeman illustrates how mapping has been (and continues to be) an "essential settler-colonial tool to domesticate land in Southern California and propel development" ("Caring for Landscapes" 54). While she demonstrates how the mapping of Tovaangar using 493 hand-drawn Diseños maps served to sever Indigenous communities (and their relationships with land, such as the Gabrieliño Tongva with the San Gabriel Mountains), she emphasizes that this is an ongoing process that has not been left in a distant past. Newer maps that may seem more objective and scientific with "better models of scale or a more realist representation" remain, at their core, maps of dispossession ("Caring for Landscapes" 54).The very desire to objectively determine location by assigning latitude and longitude reveals a colonial spatiality, which "territorialize[s] the physical landscape by manufacturing categories and separating land from people" and conceives of space in terms of property logics (Goeman, "[Re]Mapping Indigenous Presence" 296). In addition to Indigenous land dispossession, this colonial spatiality rejects relationality by creating dualist boundaries between human and non-human, in which land is the raw material for human development and the creation of culture. Cherokee philosopher Brian Burkhart speaks of relationality in terms of locality, which he defines as "being-fromthe-land, knowing-from-the-land, and meaning-from-the-land" (Indigenizing Philosophy xvii). The severing of locality can be understood in terms of the transformation of land as relative to inert matter to be acted upon. Mapping serves as a tool of settler colonial erasure insofar as it delocalizes "land as the relational ground of kinship" into "land as a mere object that only has meaning or value in relation to people" ("Indigenizing Philosophy... (shrink)

Summary Theatre offers an opportunity for communities to think with and through fiction. We come together to hear and tell stories because it is moving, both in the literal and the figurative sense: it changes us. Theories from cognitive science of embodied cognition make clear that making sense of theatre is a full-bodied affair. In this essay, I argue that we can see moments when theatre invited its audience to think in new ways by shifting theatrical conventions. I explore how (...) a contemporary production of Hamlet, Pan Pan’s production of “The Rehearsal: Playing the Dane”, brings its audience to question the stability of the self and text by altering the conventions around casting and representation. This is theatre that I may not understand in a traditional way, but this gives me a way to understand a new way of thinking about the world around me. It is theatre I can use. (shrink)

Currently, all 50 states and the District of Columbia have youth concussion laws based on the core principals of the 2009 Lystedt Law of Washington State. On April 23, 2013, the state of Georgia signed into law House Bill 284, “The Return to Play Act of 2013” and became one of the last states to pass youth concussion legislation. This Act became effective on January 1, 2014. The purpose of this report is to highlight the legislative process of enacting Georgia (...) House Bill 284 and compare it to the legislation of other states. (shrink)

Concussion is a form of mild traumatic brain injury that can occur as a result of contact to the head or other parts of the body that causes a rapid acceleration-deceleration force to the brain that may cause a functional disturbance in an individual’s ability to concentrate or learn new information. Contrary to popular belief, it is not a bruise to the brain, and there is usually nothing detectable on standard imaging such as a computed tomography or magnetic resonance imaging. (...) Symptoms and signs are therefore important to detect and include decreased levels of consciousness, headache, nausea, difficulty concentrating, memory loss, and poor coordination. These signs and symptoms usually occur within minutes after the injury but may also appear several hours or even days later. (shrink)

In a global era of apology and reconciliation, Canadians, like their counterparts in other settler nations, face a moral and ethical dilemma that stems from an unsavoury colonial past. Canadians grew up believing that the history of their country is a story of the cooperative venture between people who came from elsewhere to make a better life and those who were already here, who welcomed and embraced them, aside from a few bad white men.on 11 June 2008, the Prime Minister (...) of Canada Stephen Harper made a Statement of Apology on behalf of the Canadian government for the Indian Residential Schools system : “The government now recognizes that the consequences of the Indian Residential... (shrink)

In 1766 Jean-Jacques Rousseau, in exile from France and Switzerland, came to England, where he made the acquaintance of Margaret Cavendish Harley Bentinck, Duchess of Portland. The two began to botanise together and to exchange letters about botany. These letters contain salient statements about Rousseau's views on natural theology, gardens, botanical texts and exotic botany. This exchange entailed not only discussions about plant identifications and other botanical matters, but most important, reciprocal gifts of books and specimens in the manner of (...) gentlemanly scientific correspondence of the period. Rousseau volunteered his services as the Duchess's ‘herborist’ or plant collector, and collected specimens and seeds in her behalf; these were destined for her own extensive herbaria and other natural history collections. Rousseau, who elsewhere denied female talent for science, admired the Duchess's knowledge of natural history, acknowledging his own as inferior. Their correspondence ended when the Duchess sent him the Herbarium amboinense of Georg Rumpf (Rumphius), an important work of exotic botany. Rousseau considered exotic botany to be the antithesis of the domination-free nature from which he derived solace and inspiration. (shrink)

Over the past 20 years, clinical research has migrated from academic medical centers to community-based settings, including rural settings. This evolving research environment may present some moral hazards or challenges that could undermine traditionally accepted standards for the protection of human subjects. The study described in this article was designed to explore the influence of motives driving the decisions to conduct clinical trial research in rural community settings. The researchers conducted semi-structured interviews with 80 participants who conducted clinical trials with (...) rural subjects. The interviews provided a way to examine the influence of budgetary factors when deciding to conduct a clinical study, how information about the budget and the purpose of the study is conveyed to research participants, and the potential willingness of clinicians and coordinators to enroll in the kinds of studies they offer. The findings suggest that clinical trial research in rural communities may challenge clinicians’ abilities to balance the needs of the patient with the needs of the research enterprise. Few respondents seemed to recognize the traditionally recognized hazards of a dual relationship, specifically the moral risks of trying to attend to the interests of both patient and industry. It seems important to re-examine how we protect human subjects and what such protection should look like as research becomes part of the way medical care is provided, even in very rural areas. (shrink)

The French Revolution had a complex relationship with historical thought. In a significant sense, the politics of 1789 was built upon a rejection of the authority of the past. As old institutions and practices were swept away, many champions of the Revolution attacked conventional historical modes for legitimating authority, seeking to replace them with a politics anchored in notions of reason, natural law and natural rights. Yet history was not so easily purged from politics. In practice, symbols and images borrowed (...) from the past saturated Revolutionary culture. The factional disputes of the 1790s, too, invoked history in a range of ways. The politics of nature itself often relied on a range of historical propositions and, as the Revolution developed, a new battle between “ancients” and ‘moderns’ gradually emerged amongst those seeking to direct the future of France. This article explores these issues by focusing on a series of lectures delivered at the École Normale in the Year III (1795), in the wake of Thermidor and the fall of Robespierre. The lectures, commissioned by the Ministry of Education, were designed to lay out a program for historical pedagogy in the French Republic. Their author, Constantin-Francois Volney (1757–1820), was one of a group of figures who sought, during these years, to stabilise French politics by tying it to the development of a new form of social science—a science that would eventually be labelled “idéologie.” With this in mind, Volney sought to promote historical study as an antidote to the political appropriation of the past, with particular reference to its recent uses in France. In doing so, he also sought to appropriate the past for political purposes. These lectures illustrate a series of tensions in the wider Revolutionary relationship with history, particularly during the Thermidorian moment. They also, however, reflect ongoing ambiguities in the social role of the discipline and the self-understanding of its practitioners. (shrink)

in canada, after the publication of the Truth and Reconciliation Commission’s final report on the Indian Residential Schools, universities and town halls have been flooded with questions about how they are going to implement its ninety-four calls to action and how they are going to promote reconciliation on stolen lands.1 Many universities have taken heed of the call to “Indigenize” their curricula.2 The worry remains, however, that the language of reconciliation is empty rhetoric that “metaphorizes” decolonization, rather than responding to (...) the demands of Indigenous communities for self-determination and land back. For example, we might be wary of the Canadian government’s language of... (shrink)

Cover -- Title -- Copyright -- Dedication -- Contents -- Acknowledgements -- Part 1 -- Introduction -- 1 A holy kind of healing -- 2 Some striking similarities: personal and philosophical -- 3 Introducing Kierkegaard -- 4 Presenting Jung -- 5 The wounds of the father: a shared inheritance -- Part 2 -- 6 An unconventional Christianity -- 7 Jung and religion -- 8 The therapeutic value of faith -- 9 Grounding ethics in spirit: the medium of our self-realisation -- (...) 10 Suffering and the pain of personal growth: perrissem, nisi perissem -- 11 Authenticity: the creation of one's genuine self -- Part 3 -- 12 'That Religious Neurotic': Kierkegaard on the couch -- 13 Keeping mum: a powerful silence -- 14 Søren's spiritual castration: a father's influence -- 15 To marry or to martyr -- 16 The final years of Søren Kierkegaard: a story of archetypal compensation -- Part 4 -- 17 The nature of a Kierkegaardian neurosis: Jung's reception of Kierkegaard -- 18 Kierkegaard and Nietzsche: polar opposites in the mind of Jung -- 19 Summary of discussion -- 20 Conclusion -- Epilogue: Jung and Kierkegaard: a legacy considered -- Bibliography -- Index. (shrink)

It has been alleged that Carolus Linnaeus practised Eurocentrism, sexism and racism in naming plant genera after famous botanists, and excluding ‘barbarous names’. He has therefore been said to practise ‘linguistic imperialism’. This paper examines whether Linnaeus applied ‘linguistic imperialism’ to the naming of Chinese plants. On the basis of examples such as Thea (¼Camellia), Urena, Basella, Annona, Sapindus (¼Koelreuteria), and Panax, I conclude that Linnaeus used generic names of diverse origins. However, he misidentified Chinese plants’ habitats, and acted on (...) these misapprehensions. (shrink)

Relatively few articles discuss the ethical issues that accompany healthcare in rural areas. This article presents and discusses the key findings obtained from multi-method research studies conducted over a 9-year period of time in a multi-state rural area. It challenges the efficacy of current models for bioethics, shows what kinds of ethical issues develop in rural communities, and offers a framework for envisioning resources and approaches that may be more appropriate.

The Enlightenment era saw European thinkers increasingly concerned with what it meant to be human. This was due at least in part to the increasing awareness of human diversity brought by exploration and travel to new domains. This collection of essays traces the concept of 'humanity' through revolutionary politics, feminist biography, portraiture, explorer narratives, libertine and Orientalist fiction, the philosophy of conversation and musicology. Its contributors argue that across these fields, the central philosophical conundrums of the era were reflected, and (...) sometimes transformed, in surprising ways. Publisher's note. (shrink)

This paper examines methodological issues associated with the theory of planned behaviour and explains that an alternative account of data used to support this theory can be provided by positioning theory. A case is presented that shows tests of the theory of planned behaviour fail to eliminate the possibility of alternative explanations for co-variation in its data. An agency or person-centered alternative shows how a causal interpretation can be reinterpreted as evidence of the actions of a person. Unlike the conceptualisation (...) of the individual as behaving in keeping with postulated underlying cognitive laws or rules we assume that the person has, through socialisation, acquired the skills necessary to initiate and manage their own actions. Unlike the interest in TPB data as a causal explanation of action we draw attention to the interpretation of patterns in these data as an aggregate of each person using a common mode of explanation to justify and explain their intentions. (shrink)

Steven Pinker’s recent Enlightenment Now aside, Enlightenment values have been in for a rough ride of late. Following Max Horkheimer and Theodor Adorno’s critique of Enlightenment as the source of fascism, recent studies, amplified by Black Lives Matter, have laid bare the ugly economic underbelly of Enlightenment. The prosperity that enabled intellectuals to scrutinize speculative truths in eighteenth-century Paris salons relied on the slave trade and surplus value extracted from slave labor on sugar plantations and in other areas Europeans controlled. (...) Indeed, deprived of its ugly economic underbelly, Enlightenment was barely conceivable; furthermore, its reliance on surplus value extraction from oppressed labor was accompanied by a racism that, with the exception of the thought of Jean-Jacques Rousseau and a few other thinkers, was arguably inherent to Enlightenment. However, I am not proposing yet another revelation of Enlightenment’s complicity in exploitation of, or disregard for, the Other. Rather, I want to highlight the damage being done today by an insidious strategy of labelling as “pseudo-science” entire domains of non-Western knowledge such as Chinese medicine and Ayurveda, thereby rendering them no-go zones for serious minds. Even though the term pseudo-science had yet to be coined, the beginnings of this tendency are already evident in Enlightenment-era works such as Jean-Baptiste Du Halde’s Description … de la Chine. The perpetuation of this dismissive treatment of non-Western natural knowledge creates a significant obstacle to superseding a “scientific revolution” whose confines have long been burst: it is increasingly recognized that traditional/indigenous knowledge affords a vast reservoir of materials, skills and insights of which the world has desperate need, no more urgently than in response to the covid-19 pandemic. (shrink)