This paper challenges the traditional assumption that descriptive and prescriptive sciences are essentially distinct by presenting a study on the implicit normativity of the production and presentation of biomedical scientific facts within evidence-based medicine. This interdisciplinary study serves as an illustration of the potential worth of the concept of implicit normativity for bioethics in general and for integrated empirical ethics research in particular. It demonstrates how both the production and presentation of scientific information in an evidence-based decision-support contain implicit presuppositions (...) and values, which pre-structure the moral environment of the clinical process of decision-making. As a consequence, the evidence-based decision support did not only support the clinical decision-making process; it also transformed it in a morally significant way. This phenomenon undermines the assumption within much of the literature on patient autonomy that information disclosure is a conditional requirement before patient autonomy even starts; patient autonomy is already influenced during the production and presentation of information. These results imply an increased responsibility of those who produce and present evidence-based facts(i.e. scientists in general and physicians in particular). The insights of this study not only involve a different focus on both theory and practice of patient autonomy and informed consent, but they also call for a broader scope of morality than does traditional empirical research in bioethics. The concept of implicit normativity within integrated empirical ethics research calls for a strong cooperation between bioethicists and descriptive scientists, i.e., a cooperation that goes beyond the discipline-specific epistemic values and that takes place during all phases of the research process. (shrink)

In pluralist societies, stakeholders in healthcare may have different experiences of and moral perspectives on health, well-being, and good care. Increasing cultural, religious, sexual, and gender diversity among both patients and healthcare professionals requires healthcare organizations to address these differences. Addressing diversity, however, comes with inherent moral challenges; for example, regarding how to deal with healthcare disparities between minoritized and majoritized patients or how to accommodate different healthcare needs and values. Diversity statements are an important strategy for healthcare organizations to (...) define their normative ideas with respect to diversity and to establish a point of departure for concrete diversity approaches. We argue that healthcare organizations ought to develop diversity statements in a participatory and inclusive way in order to promote social justice. Furthermore, we maintain that clinical ethicists can support healthcare organizations in developing diversity statements in a more participatory way by fostering reflective dialogues through clinical ethics support. We will use a case example from our own practice to explore what such a developmental process may look like. We will critically reflect on the procedural strengths and challenges as well as on the role of the clinical ethicist in this example. (shrink)

Deliberative ways of dealing with ethical issues in health care are expanding. Moral case deliberation is an example, providing group-wise, structured reflection on dilemmas from practice. Although moral case deliberation is well described in literature, aims and results of moral case deliberation sessions are unknown. This research shows (a) why managers introduce moral case deliberation and (b) what moral case deliberation participants experience as moral case deliberation results. A responsive evaluation was conducted, explicating moral case deliberation experiences by analysing aims (...) (N = 78) and harvest (N = 255). A naturalistic data collection included interviews with managers and evaluation questionnaires of moral case deliberation participants (nurses). From the analysis, moral case deliberation appeals for cooperation, team bonding, critical attitude towards routines and nurses’ empowerment. Differences are that managers aim to foster identity of the nursing profession, whereas nurses emphasize learning processes and understanding perspectives. We conclude that moral case deliberation influences team cooperation that cannot be controlled with traditional management tools, but requires time and dialogue. Exchanging aims and harvest between manager and team could result in co-creating (moral) practice in which improvements for daily cooperation result from bringing together perspectives of managers and team members. (shrink)

For much of the past two millennia philosophers have embraced a priori knowledge and have thought that the a priori plays an important role in philosophy itself. Philosophers from Plato to Descartes, Kant to Kripke, all endorse the a priori and engage in a priori reasoning in their philosophical discussions. Recent work in epistemology and experimental philosophy, however, has raised questions about both the existence of a priori knowledge and the centrality of the a priori for philosophy. This collection of (...) essays aims to advance the discussion of the a priori and its role in philosophy. The contributors include a mix of young and established philosophers, including some of the most prominent voices in philosophy today. (shrink)

To support healthcare professionals in dealing with ethically difficult situations, Clinical Ethics Support (CES) services like Moral Case Deliberation (MCD) are increasingly implemented. To assess the impact of CES, it is important to evaluate outcomes. Despite general claims about outcomes from MCD experts and some qualitative research, there exists no conceptual analysis of outcomes yet. Therefore, the aim of this study was to systematically define and categorize MCD outcomes. An additional aim was to compare these outcomes with the outcomes in (...) the Euro-MCD Instrument from 2014, to further validate this Instrument. The concept mapping method was used and involves qualitative and quantitative steps including brainstorming, individual structuring, computation of concept maps (by principal component analysis and cluster analysis), group interpretation and utilization. In total, 12 experienced MCD participants from a variety of professional backgrounds participated in two sessions. The focus group brainstorm resulted in a list of 85 possible MCD outcomes, of which a point map and concept maps were constructed. After a thorough discussion of each cluster, final consensus was reached on the names and position of 8 clusters of MCD outcomes: 1) Organisation and Policy; 2) Team development; 3) Personal development focused on the Other Person; 4) Personal development as Professional, focused on Skills; 5) Personal development as Professional, focused on Knowledge; 6) Personal development as an Individual; 7) Perception and Connection; and 8) Concrete action. This study explored and categorized MCD outcomes in a concept mapping focus group. When comparing the results with the Euro-MCD Instrument, our study confirms that outcomes of MCD can be categorized in clusters referring to the organisational level, team development, personal development (both as an individual and a professional) and the concrete case-level. In developing CES evaluation tools, it is important to be explicit if an outcome refers to the individual or the team, to knowledge or skills, to the organisation or the specific case. The findings will be used in the further validation of the Euro-MCD Instrument. The current study further contributes to the field of evaluating CES in general and defining outcomes of MCD in particular. (shrink)

Ethics support services like Moral Case Deliberation intend to support healthcare professionals in ethically difficult situations. To assess outcomes of MCD, the Euro-MCD Instrument has been developed. Field studies to test this instrument are needed and have been conducted, examining important outcomes before MCD participation and experienced outcomes. The current study aimed to describe how participants’ perceive the importance of MCD outcomes after MCD; compare these perceptions with those before MCD participation; and test the factor structure of these outcomes. Swedish, (...) Norwegian and Dutch healthcare professionals rated the importance of outcomes in the Euro-MCD Instrument after four and eight MCDs. Ratings were compared with those before MCD participation using paired and independent samples t-tests. The factor structure was tested using exploratory factor analyses. After 4 and 8 MCDs, 443 respectively 247 respondents completed the instrument. More than 69% rated all MCD outcomes as ‘quite’ or ‘very’ important, especially outcomes from Enhanced Collaboration, Improved Moral Reflexivity and Improved Moral Attitude. Significant differences for 16 outcomes regarding ratings before and after MCD participation were not considered meaningful. Factor analyses suggested three categories, which seemingly resemble the domains Improved Moral Reflexivity, Enhanced Collaboration and a combination of Improved Moral Attitude and Enhanced Emotional Support. After participation in MCDs, respondents confirmed the importance of outcomes in the Euro-MCD Instrument. The question on perceived importance and the categorization of outcomes need reconsideration. The revised instrument will be presented elsewhere, based on all field studies and theoretical reflections. (shrink)

Hermann Grassmann's Ausdehnungslehre of 1844 and his Lehrbuch der Arithmetik of 1861 are landmark works in mathematics; the former not only developed new mathematical fields but also both contributed to the setting of modern standards of rigor. Their very modernity, however, may obscure features of Grassmann's view of the foundations of mathematics that were not adopted since. Grassmann gave a key role to the learning of mathematics that affected his method of presentation, including his emphasis on making initial assumptions explicit. (...) In order to better understand this less well-known aspect of his work it will help to examine why some commentators have overlooked his theme of unifying logic, pedagogy and foundations, while others have recognised it. (shrink)

Hermann Grassmann's ideas on the nature and foundations of mathematics were published as an integral part of his mathematical treatise, the Ausdehnungslehre, in 1844. In spite of its notoriously obscure style we can better understand the work if we view it as an expression of the dialectical philosophy of his mentor, the theologian F. Schleiermacher. The relation to Schleiermacher is presented here through an analysis of the principal ideas of the Ausdehnungslehre.

Pierce challenges the argument that economic sanctions are always morally preferable to the use of military force. He argues that such sanctions inflict suffering and physical harm on noncombatants and that small-scale military operations are sometimes preferable.

The United Nations' designation of 1979 as the International Year of the Child marked the first global effort undertaken to heighten awareness of the special needs of children. Activities initiated during this special year were designed to promote purposive and collaborative actions for the benefit of children throughout the world. Michigan State University's celebration of the International Year of the Child was held from Septem ber 1979 through June 1980. A variety of activities focused attention on the multiplicity of factors (...) affecting the welfare of today's children as well as the children of the future. Many people involved with the university were concerned that benefits to children continue beyond the official time allocated to the celebration. The series Child Nurturance is one response to this concern. The first five volumes of Child Nurturance reflect directly the activities held on the Michigan State University campus and consist of original contributions from guest speakers and invited contributors. Subsequent biennial volumes will present original contributions from individuals representing such fields as anthropology, biology, education, human ecology, psychology, philosophy, sociology, and medicine. We hope the material presented in these volumes will promote greater understanding of children and encourage interdisciplinary inquiry into the individual, family, societal and cultural variables which influence their welfare and development. We would. like to express both our thanks and our admiration for who not only typed the camera-ready copy for each of Margaret Burritt the volumes, but also served as general manager of the entire project. (shrink)

Leslie, E. A. Albert Cornelius Knudson, the man.--McConnell, F. J. Bowne and personalism.--Brightman, E. S. Personality as a metaphysical principle.--Hildebrand, C. D. Personalism and nature.--Ramsdell, E. T. The cultural integration of science and religion.--Ensley, F. G. The personality of God.--Harkness, G. Divine sovereignity and human freedom.--Pfeiffer, R. H. Personalistic elements in the Old Testament.--Flewelling, R. T. Personalism and the trend of history.--Muelder, W. G. Personality and Christian ethics.--King, W. J. Personalism and race.--Marlatt, E. B. Personalism and religious education.

Major codes adopted by newspapers in recent years show marked similarities to the statements of purpose found in the first (and only) issue of Benjamin Harris? Public Occurrences Both Forreign and Domestick, published in Boston in 1690. This essay compares the front page statement by Harris with seven other statements about the role or responsibility of the press: The Associated Press Managing Editors Association ?Code of Ethics for Newspapers and their Staffs''; the 1947 report of the Commission on Freedom of (...) the Press; the American Society of Newspaper Editors 1923 Canons of Journalism and 1975 Statement of Principles; the Society of Professional Journalists, Sigma Delta Chi Code of Ethics; a memorandum to the staff of The New York Times by A.M. Rosenthal when he became managing editor in 1969; and an article by former Knight?Ridder executive Don Carter. Recurring themes include an emphasis on gathering and reporting news with accuracy, objectivity, truthfulness, and completeness. In addition, Harris led the way with his promises to correct errors when they occur and to allay false rumors and replace them with substantive information. Harris? stated goals, according to this essay, would sit quite comfortably on many American newspaper editorial pages today. (shrink)

This treatise deals with Philo's allegory of Genesis 9:20 (And Noah began to be a husbandman). The first part of the treatise deals with Noah as a someone who "cultivates" the soul, and the second part with Noah as one who has set out on the path towards spiritual and ethical perfection.

In forming the canon, the church acknowledged and established the Bible as the measure or standard of inspiration in the church, not as the totality of it. What concurs with canon is of like inspiration ; what does not is not of God.

Milton's influence upon poets and poetry has been broadly and specifically studied often in collections of essays. The present volume of original essays, by emphasizing and classifying Milton's influence on the arts other than poetry, is a significant addition to interdisciplinary scholarship. The editors choose to interpret John Good's words literally—Milton's influence "was powerfully felt upon all the multiplied forms and phases of eighteenth century life"—and to examine the implications of that assertion even into twentieth-century life. No other volume considers (...) the certainty or possibility of Milton's influence on arts as diverse as oratorio, opera, drama, dance, book illustration, sculpture, and landscape architecture. Beyond Milton's well-documented influence on poets and poetry, the contributors focus their attention on the other arts and other creative artists whose imaginations were nevertheless affected by the poet Milton, at times profoundly so. Their chief aim is to be representative, not fully comprehensive, in defining, describing, and demonstrating the manifold influence of Milton on the other arts. A related aim is to motivate others to do likewise. Divided into three parts—Milton and book illustrations, Milton and the performing arts, and Milton and the philosophy of form—this book makes a central and significant point about the impact of Milton's work on the imaginations of artists in various disciplines throughout the following centuries. Indeed, for many of the works of art analyzed in the present volume, Milton must be considered their "onlie begetter.". (shrink)

In moral case deliberation (MCD), healthcare professionals meet to reflect upon their moral questions supported by a structured conversation method and non-directive conversation facilitator. An increasing number of Dutch healthcare institutions work with MCD to (1) deal with moral questions, (2) improve reflection skills, interdisciplinary cooperation and decision-making, and (3) develop policy. Despite positive evaluations of MCD, organization and implementation of MCD appears difficult, depending on individuals or external experts. Studies on MCD implementation processes have not yet been published. The (...) aim of this study is to describe MCD implementation processes from the perspective of nurses who co-organize MCD meetings, so called ‘ local coordinators ’. Various qualitative methods were used within the framework of a responsive evaluation research design. The results demonstrate that local coordinators work hard on the pragmatic implementation of MCD. They do not emphasize the ethical and normative underpinnings of MCD, but create organizational conditions to foster a learning process, engagement and continuity. Local coordinators indicate MCD needs firm back-up from management regulations. These pragmatic action-oriented implementation strategies are as important as ideological reasons for MCD implementation. Advocates of clinical ethics support should pro-actively facilitate these strategies for both practical and ethical reasons. (shrink)