The study explored the motivations behind Australian wool producers’ intentions regarding mulesing; a surgical procedure that will be voluntarily phased out after 2010, following retailer boycotts led by People for the Ethical Treatment of Animals. Telephone interviews were conducted with 22 West Australian wool producers and consultants to elicit their behavioral, normative and control beliefs about mulesing and alternative methods of breech strike prevention. Results indicate that approximately half the interviewees intend to continue mulesing, despite attitudes toward the act of (...) mulesing being quite negative. This indicates that attitudes alone are unlikely to be good predictors of this goal directed behavior. Most respondents believed mulesing was more effective and involved less cost, time, and effort than the currently available alternatives to prevent breech strike. Further, they felt relatively little social pressure, as they believed few consumers were concerned about mulesing. However, they noted that if consumer sentiment changed they would likely change their practices. Thus, attitudes are likely to be only one of several factors influencing intentions to change farm practices to address societal concerns about animal welfare. Further, mulesing appears to be goal - directed behavior , suggesting that other factors depicted by the Model of Goal-directed Behavior (MGB; Perugini and Bagozzi In: Br J Soc Psychol, 40: 79–98, 2001 ) may be worth exploring in this context. Finally, these results provide insight into how policy makers may influence farmers to change practices in response to societal pressure for improving farm animal welfare. (shrink)

As scientific and engineering efforts become increasingly global in nature, the need to understand differences in perceptions of research ethics issues across countries and cultures is imperative. However, investigations into the connection between nationality and ethical decision-making in the sciences have largely generated mixed results. In Study 1 of this paper, a measure of biases and compensatory strategies that could influence ethical decisions was administered. Results from this study indicated that graduate students from the United States and international graduate students (...) studying in the US are prone to different biases. Based on these findings, recommendations are made for developing ethics education interventions to target these decision-making biases. In Study 2, we employed an ethics training intervention based on ethical sensemaking and used a well-established measure of ethical decision-making that more fully captures the content of ethical judgment. Similar to Study 1, the results obtained in this study suggest differences do exist between graduate students from the US and international graduate students in ethical decision-making prior to taking the research ethics training. However, similar effects were observed for both groups following the completion of the ethics training intervention. (shrink)

As scientific and engineering efforts become increasingly global in nature, the need to understand differences in perceptions of research ethics issues across countries and cultures is imperative. However, investigations into the connection between nationality and ethical decision-making in the sciences have largely generated mixed results. In Study 1 of this paper, a measure of biases and compensatory strategies that could influence ethical decisions was administered. Results from this study indicated that graduate students from the United States and international graduate students (...) studying in the US are prone to different biases. Based on these findings, recommendations are made for developing ethics education interventions to target these decision-making biases. In Study 2, we employed an ethics training intervention based on ethical sensemaking and used a well-established measure of ethical decision-making that more fully captures the content of ethical judgment. Similar to Study 1, the results obtained in this study suggest differences do exist between graduate students from the US and international graduate students in ethical decision-making prior to taking the research ethics training. However, similar effects were observed for both groups following the completion of the ethics training intervention. (shrink)

The relationship between mental models and ethical decision making, along with the mechanisms through which mental models affect EDM, are not well understood. Using the sensemaking approach to EDM, we empirically tested the relationship of mental models to EDM. Participants were asked to depict their mental models in response to an ethics case to reveal their understanding of the ethical dilemma, and then provide a response, along with a rationale, to a different ethical problem. Findings indicated that complexity of respondents’ (...) mental models was related to EDM, and that this relationship was mediated by sensemaking processes. The implications of these findings for improving integrity training in organizations, as well as ultimately understanding the role of mental models in EDM, are discussed. (shrink)

Character strengths profiles in the specific setting of medical professionals are widely unchartered territory. This paper focused on an overview of character strengths profiles of medical professionals (medical students and physicians) based on literature research and available empirical data illustrating their impact on well-being and work engagement. A literature research was conducted and the majority of peer-reviewed considered articles dealt with theoretical or conceptually driven ‘virtues’ associated with medical specialties or questions of ethics in patient care (e.g., professionalism, or what (...) makes a good physician). The virtues of compassion, courage, altruism, and benevolence were described most often. Only a limited number of papers addressed character strengths of medical students or physicians according to the VIA-classification. Those articles showed that the VIA-character strengthsfairness, honesty,kindness, andteamworkwere considered most often by respondents to be particularly important for the medical profession. Available cross-sectional (time span: six years) and longitudinal (time span: three years) data regarding VIA-character strengths profiles of medical professionals were analyzed (N= 584 medical students, 274 physicians). These profiles were quite homogenous among both groups. The character strengthsfairness,honesty,judgment,kindness, andlovehad the highest means in both samples. Noteworthy differences appeared when comparing medical specialties, in particular concerning general surgeons and psychiatrists, with the former reporting clearly higher levels of e.g.,honesty(d= 1.02) orprudence(d= 1.19). Long-term results revealed significant positive effects of character strengths on well-being and work engagement (e.g.,perseveranceon physicians’ work engagement) but also significant negative effects (e.g.,appreciation of beauty and excellenceon students’ well-being). Further,hopewas significantly associated both positively with physicians’ well-being and negatively with students’ work engagement, possibly indicating specific issues concerning medical education or hospital working conditions. According to the modern-day physician’s pledge, medical professionals should pay attention to their own well-being and health. Therefore, promoting self-awareness and character building among medical professionals could be a beneficial strategy. (shrink)

Case-based reasoning has long been used to facilitate instructional effectiveness. Although much remains to be known concerning the most beneficial way to present case material, recent literature suggests that simplifying case material is favorable. Accordingly, the current study manipulated two instructional techniques, incremental case presentation and forecasting outcomes, in a training environment in an attempt to better understand the utility of simplified versus complicated case presentation for learning. Findings suggest that pairing these two cognitively demanding techniques reduces satisfaction and detracts (...) from the effectiveness of the learning approach. Implications regarding the use of instructional techniques in training programs are discussed. (shrink)

La Philosophie de la Révélation propose une véritable philosophie de la fonction diabolique. Le diable est le principe des religions païennes en même temps que celui du mal . Cette double fonction donne la mesure de l’Erhabenheit du diable, sa « majesté », qui traduit l’idée du mot grec kyriotès, de souveraineté. Cette analyse s’oppose aux représentations qui manquent le principe de la majesté diabolique. Négativement, le diable n’est ni une créature ni un principe éternellement mauvais. Positivement, Schelling repense en (...) termes philosophiques, par sa théorie des Potenzen divines, les interprétations traditionnelles non spéculatives : le diable ne diffère pas de la première puissance réactivée par l’homme alors même qu’elle devait se reposer en lui ; c’est conformément à l’essence de cette puissance, qui est ce qui ne doit pas mais peut être manifeste, qu’il ravage l’homme. Pour jouir d’une existence usurpée, le diable ne peut qu’user du soupçon, du mensonge et de la jalousie, vouloir tenter et perdre l’homme. Cette nécessité en fait l’outil paradoxal de la révélation.In Philosophy of Revelation, Schelling suggests a true philosophy of the diabolical function. The devil is the principle of pagan religions as well as of evil . Such a twofold function gives measure of the devil’s Erhabenheit, i.e. the devil’s majesty which indeed well translates the idea intrinsic of the term kyriotès, i.e. the idea of sovereignty. Shelling’s analysis is critical against representations which seem quite apart from the diabolical principle and its majesty. Negatively, the devil is no more a creature than an eternally evil principle. Positively, Schelling recaptures through philosophical terms according to his theory of divine Potenzen non speculative tradition : the devil is in no way different from the first power reactivated by man when in fact it were to rest in him ; thus does he play havoc with man in a manner identical to the essence of this latter power which is what should not but may be manifest. In order to enjoy a so-called usurped existence, the devil can but use suspicion, lies and jealousy, the only stake is to tempt and mislay man. It is such a necessity which turns him into the paradoxical tool of revelation. (shrink)

This study examined how structuring case-based ethics training, either through (a) case presentation or (b) prompt questions, influences training outcomes. Results revealed an interaction between case presentation and prompt questions such that some form of structure improved effectiveness. Specifically, comparing cases led to greater sensemaking strategy use and decision-ethicality when trainees considered unstructured rather than structured prompts. When cases were presented sequentially, structuring prompts improved training effectiveness. Too much structure, however, decreased future ethical decision making, suggesting that there can be (...) too much of a good thing when structuring case-based ethics education. Implications for designing ethics training programs are discussed. (shrink)

The effectiveness of case-based learning in ethics education varies widely regarding how cases are presented. Case process instruction may impact case-based ethics education to promote sensemaking processes, ethical sensemaking strategy use, and ethical decision making (EDM) quality. This study examined two teaching techniques, notes and review, and participants completed note-taking and review activities examining a case-based scenario during an ethics education course. Results suggest that providing case notes in outline form improves sensemaking processes, strategy use, and EDM quality. In addition, (...) combining processes of provided notes and passive review results in incremental, additive performance via certain ethical sensemaking strategies and EDM quality. (shrink)

Traditional whistleblowing theories have purported that whistleblowers engage in a rational process in determining whether or not to blow the whistle on misconduct. However, stressors inherent to whistleblowing often impede rational thinking and act as a barrier to effective whistleblowing. The negative impact of these stressors on whistleblowing may be made worse depending on who engages in the misconduct: a peer or advisor. In the present study, participants are presented with an ethical scenario where either a peer or advisor engages (...) in misconduct, and positive and the negative consequences of whistleblowing are either directed to the wrongdoer, department, or university. Participant responses to case questions were evaluated for whistleblowing intentions, moral intensity, metacognitive reasoning strategies, and positive and negative, active and passive emotions. Findings indicate that participants were less likely to report the observed misconduct of an advisor compared to a peer. Furthermore, the findings also suggest that when an advisor is the source of misconduct, greater negative affect results. Post-hoc analyses were also conducted examining the differences between those who did and did not intend to blow the whistle under the circumstances of either having to report an advisor or peer. The implications of these findings for understanding the complexities involved in whistleblowing are discussed. (shrink)

Case-based instruction has been regarded by many as a viable alternative to traditional lecture-based education and training. However, little is known about how case-based training techniques impact training effectiveness. This study examined the effects of two such techniques: (a) presentation of alternative outcome scenarios to a case, and (b) conducting a structured outcome evaluation. Consistent with the hypotheses, results indicate that presentation of alternative outcome scenarios reduced knowledge acquisition, reduced sensemaking and ethical decision-making strategy use, and reduced decision ethicality. Conducting (...) a structured outcome evaluation had no impact on these outcomes. Results indicate that those who use case-based instruction should take care to use clear, less complex cases with only a singular outcome if they are seeking these types of outcomes. (shrink)

Some people have found my distinction between meaning and significance useful. In the following revision of that distinction, I hope to improve its accuracy and perhaps, therefore, its utility as well. My impulse for making the revision has been my realization, very gradually achieved, that meaning is not simply an affair of consciousness and unconsciousness. In 1967, in Validity in Interpretation, I roundly asserted that “there is no magic land of meanings outside human consciousness.” 1 That assertion would be true (...) if, godlike, we could oversee the whole of human consciousness, past, present, and future. But we language users, being limited creatures, intend our verbal meanings to go beyond what we can pay attention to at any moment. We intend our meanings to transcend our momentary limitations of attention and knowledge. Hence there is a land of meanings beyond past and present human consciousness—the land of the future. What I should have said originally is that there is no magic lance of meanings beyond the whole extent of human consciousness, past, present, and future. This correction of my original statements leads to a deepening of the concept of meaning.In 1960 I first proposed the analytical distinction between two aspects of textual interpretation. One of them, meaning, was fixed and immutable; the other, significance, was open to change.2 I acknowledged that significance, changeable or not, is the more valuable object of interpretation, because it typically embraces the present use of texts, and present use is present value. But I argued that, in academic criticism, the significance and use of a text ought to be rooted in its fixed meaning, since otherwise criticism would lack a stable object of inquiry and would merely float on tides of preference. The claim that one reader’s opinion is as valid as another’s would then be right, despite any indignant protest to the contrary. I did not wish to dissuade people from floating on the tides of preference if that was what they wished to do. I intended to provide a firm justification for those who wished to pursue historical scholarship. 3 I also assumed that even those who did not pursue historical scholarship might sometimes wish to exploit the possibility of historically fixed meaning. In my experience, even antiauthorial theorists sometimes with to regard their own texts as having a historically fixed meaning and will complain if someone misunderstands that meaning. 1. E. D. Hirsch, Jr., Validity in Interpretation, p. 4.2. See my “Objective Interpretation,” PMLA 75 : 463-79.3. See, for instance, W. K. Wimsatt, Jr., and Monroe C. Beardsley, “The Intentional Fallacy,” in Wimsatt, The Verbal Icon: Studies in the Meaning of Poetry, which ends:We submit that this is the true and objective way of criticism, as contrasted to what the very uncertainty of exegesis might tempt a second kind of critic to undertake: the way of biographical or genetic inquiry …. Our point is that such an answer to such an inquiry would have nothing to do with the poem “Prufrock”; it would not be a critical inquiry. Critical inquiries, unlike bets, are not settled in this way. Critical inquiries are not settled by consulting the oracle. [P. 18] E. D. Hirsch, Jr., professor of English at the University of Virginia, is the author of numerous works, including Validity in Interpretation and The Aims of Interpretation. His previous contributions to Critical Inquiry are “Against Interpretation?”, “The Politics of Theories of Interpretation, and “Stylistics and Synonymity”. (shrink)

Among philosophers as well as linguists the battle is still joined between those who view the correlation between meaning and linguistic form as strictly determined by convention and those who argue for the essential indeterminacy of the relationship between meaning and form.1 Plato's Cratylus aside, the philosphical dialogue that forms the locus classicus of this debate is the following: "You're holding it upside down!" Alice interrupted. "To be sure I was!" Humpty Dumpty said gaily, as she turned it round for (...) him. "I thought it looked a little queer. As I was saying. that seems to be done right - though I haven't time to look it over thoroughly just now - and that shows that there are three hundred and sixty-four days when you might get un-birthday presents -" "Certainly," said Alice. "And only one for birthday presents, you know. There's glory for you!" "I don't know what you mean by 'glory,'" Alice said. Humpty Dumpty smiled contemptuously. "Of course you don't - till I tell you. I meant 'there's a nice knock-down argument for you!'" "But 'glory' doesn't mean 'a nice knock-down argument,'" Alice objected. "When I use a word," Humpty Dumpty said in rather a scornful tone, "it means just what I choose it to mean - neither more nor less."2 · 1. This should not be taken as an argument for the indeterminacy of linguistic meaning itself. Quite the contrary; it is because meaning can be stable and determinate despite variations in mental acts and linguistic forms that the relation between form and meaning must be indeterminate on the basis merely of rules and conventions.· 2. Lewis Carroll, Through the Looking Glass, chap. 6. E. D. Hirsch, Jr. is Kenan Professor of English at the University of Virginia. He is the author of Validity in Interpretation and Wordsworth and Schelling: A Typological Study of Romanticism. A second edition of his book on Blake, Innocence and Experience, will appear next year, as will a new book on critical theory. (shrink)

Medical-legal partnerships connect legal advocates to healthcare providers and settings. Maintaining effectiveness of medical-legal partnerships and consistently identifying opportunities for innovation and adaptation takes intentionality and effort. In this paper, we discuss ways in which our use of data and quality improvement methods have facilitated advocacy at both patient (client) and population levels as we collectively pursue better, more equitable outcomes.

This paper presents two formation tracking control strategies for a combined set of single and double integrator agents with an arbitrary undirected communication topology. The first approach is based on the design of distance-based potential functions with interagent collision avoidance using local information about the distance and orientation between agents and the desired trajectory. The second approach adds signed area constraints to the desired formation specification and a control strategy that uses distance as well as area terms is designed to (...) achieve tracking convergence. Numerical simulations show the performance from both control laws. (shrink)

More and more these days it is asked whether aesthetics is still possible. A question that, given the context and phrasing, seems to direct us towards its answer. Conferences and meetings, books and journal specials examine the issue of aesthetics, talk about rediscovery or return of aesthetics. Well known philosophers and aestheticians underscore the need to reconsider the foundations of aesthetics and set new directions for aesthetics today (Berleant, 2004) or attempt to expand aesthetics beyond aesthetics–like Welsch, for example who (...) tries to extend aesthetics beyond art to society and the life-world (Welsch, 1997). Others underline the need to revisit the aesthetic experience (Shusterman, 1999; Iseminger, 2002, Fenner, 1996) and examine the relevance or irrelevance of the aesthetic with art (Carroll, 2001). It seems that it is strongly recommended to turn to aesthetics on the condition however to carefully re-approach the meaning and import of the term in the present situation. The aesthetic that Passmore condemned as “dreary”(Passmore, 1954), the one Sparshott considered a formless conception, vague and loose in application (Sparshott, 1982), the same that Danto emphatically argues that has nothing to do with the definition of art or arts in general (Danto, 1981) returns to claim its rightful place in the fields of philosophy and critical theory (Levine, 1994, Michaud, 1999), as well as artistic creation. And one cannot but wonder: what does this return mean? What was the degree of aesthetics decline that we need to discuss about recovery or for new implementations of aesthetics? (shrink)

Practices such as mindfulness, introspection, and self-reflection are known to have positive short and long-term effects on health and well-being. However, in today’s modern, fast-paced, technological world tempted by distractions these practices are often hard to access and relate to a broader audience. Consequently, technologies have emerged that mediate personal experiences, which is reflected in the high number of available applications designed to elicit positive changes. These technologies elicit positive changes by bringing users’ attention to the self – from technologies (...) that show representation of quantified personal data, to technologies that provide experiences that guide the user closer in understanding the self. However, while many designs available today are either built to support or are informed by these aforementioned practices, the question remains: how can we most effectively employ different design elements and interaction strategies to support positive change? Moreover, what types of input and output modalities contribute to eliciting positive states? To address these questions, we present here a state of the art scoping review of immersive interactive technologies that serve in a role of a mediator for positive change in users. We performed a literature search using ACM Digital Library, Web of Science, IEEE Xplore, and Design and Applied Arts Index (beginning of literature – January 1, 2018). We retrieved English-language articles for review, and we searched for published and unpublished studies. Risk of bias was assessed with Downs and Black 26-item QAT scale. We included 34 articles as relevant to the literature, and the analysis of the articles resulted in 38 instances of 33 immersive, interactive experiences relating to positive human functioning. Our contribution is threefold: First we provide a scoping review of immersive interactive technologies for positive change; Second, we propose both a framework for future designs of positive interactive technologies and design consideration informed by the comparative analysis of the designs; Third, we provide design considerations for immersive, interactive technologies to elicit positive states and support positive change. (shrink)

Traditional whistleblowing theories have purported that whistleblowers engage in a rational process in determining whether or not to blow the whistle on misconduct. However, stressors inherent to whistleblowing often impede rational thinking and act as a barrier to effective whistleblowing. The negative impact of these stressors on whistleblowing may be made worse depending on who engages in the misconduct: a peer or advisor. In the present study, participants are presented with an ethical scenario where either a peer or advisor engages (...) in misconduct, and positive and the negative consequences of whistleblowing are either directed to the wrongdoer, department, or university. Participant responses to case questions were evaluated for whistleblowing intentions, moral intensity, metacognitive reasoning strategies, and positive and negative, active and passive emotions. Findings indicate that participants were less likely to report the observed misconduct of an advisor compared to a peer. Furthermore, the findings also suggest that when an advisor is the source of misconduct, greater negative affect results. Post-hoc analyses were also conducted examining the differences between those who did and did not intend to blow the whistle under the circumstances of either having to report an advisor or peer. The implications of these findings for understanding the complexities involved in whistleblowing are discussed. (shrink)

In this article, we analyze the intractability of the low-level radioactive waste debate in California through the construction and examination of policy frames and their associated policy narratives. Relying primarily on reports, formal comments, and written correspondence, we reconstruct three policy frames and explore their interaction in the public debate through the policy stories told by the actors. We analyze how policy actors using these policy frames appropriate available information, value scientific input, and respond to uncertainty in technical and regulatory (...) information to create policy stories. These policy frames and their associated policy narratives demonstrate how policy actors differ in their drivers for action, bases for trusting claims, and response to uncertainty. These differences lead to divergent characterizations of the risk of low-level radio-active waste disposal. This analysis provides insight into the dynamics of intractable policy controversies. (shrink)

Featuring nine new articles chosen by coeditor, Steven M. Cahn, the third edition of E. D. Klemke's The Meaning of Life offers twenty-two insightful selections that explore this fascinating topic. The essays are primarily by philosophers but also include materials from literary figures and religious thinkers. As in previous editions, the readings are organized around three themes. In Part I the articles defend the view that without faith in God, life has no meaning or purpose. In Part II the selections (...) oppose this claim, defending instead a nontheistic, humanistic alternative--that life can have meaning even in the absence of theistic commitment. In Part III the contributors ask whether the question of the meaning of life is itself meaningful. The third edition adds substantial essays by Moritz Schlick, Joel Feinberg, and John Kekes as well as selections from the writings of Louis P. Pojman, Emil L. Fackenheim, Robert Nozick, Susan Wolf, and Steven M. Cahn. The only anthology of its kind, The Meaning of Life: A Reader, Third Edition, is ideal for courses in introduction to philosophy, human nature, and the meaning of life. It also offers general readers an accessible and stimulating introduction to the subject. (shrink)

Plant-based milk alternatives–or mylks–have surged in popularity over the past ten years. We consider the politics and consumer subjectivities fostered by mylks as part of the broader trend towards ‘plant-based’ food. We demonstrate how mylk companies inherit and strategically deploy positive framings of milk as wholesome and convenient, as well as negative framings of dairy as environmentally damaging and cruel, to position plant-based as the ‘better’ alternative. By navigating this affective landscape, brands attempt to make mylk as simultaneously palatable and (...) disruptive to the status quo. We examine the politics of mylks through the concept of palatable disruption, where people are encouraged to care about the environment, health, and animal welfare enough to adopt mylks but to ultimately remain consumers of a commodity food. By encouraging consumers to reach for “plant-based” as a way to cope with environmental catastrophe and a life out of balance, mylks promote a neoliberal ethic: they individualize systemic problems and further entrench market mechanisms as solutions, thereby reinforcing the political economy of industrial agriculture. In conclusion, we reflect on the limits of the current plant-based trend for transitioning to more just and sustainable food production and consumption. (shrink)

Increasingly, voices in the growing neurodiversity movement are alleging that individuals who are neurologically divergent, such as those with conditions related to bipolar disorder, autism, schizophrenia, and depression, must struggle for their civil rights. This movement therefore raises questions of interest to scholars in the humanities and social sciences, as well as to concerned members of the general public. These questions have to do with such matters as the accessibility of knowledge about mental health; autonomy and community within the realm (...) of the mentally ill; and accommodation in civil society and its institutions. The contributors to Ethics and Neurodiversity explore these questions, and the traditional philosophical questions related to them. The authors pay special attention to the need to examine the policies and practices of institutions, such as higher education, social support, and healthcare. (shrink)

Primary headaches are highly prevalent and represent a major cause of disability in young adults. Neurofeedback is increasingly used in the treatment of chronic pain; however, there are few studies investigating its efficacy in patients with headaches. We report the results of a cross-over sham-controlled study on the efficacy of neurofeedback in the prophylactic treatment of tension-type headache. Participants received ten sessions of infra-low frequency electroencephalographic neurofeedback and ten sessions of sham-neurofeedback, with the order of treatments being randomized. The study (...) also included a basic psychotherapeutic intervention — a psychoeducational session performed before the main study phases and emotional support provided throughout the study period. The headache probability was modeled as a function of the neurofeedback and sham-neurofeedback sessions performed to date. As a result, we revealed a strong beneficial effect of neurofeedback and no influence of the sham sessions. The study supports the prophylactic use of infra-low frequency neurofeedback in patients with TTH. From a methodological point of view, we advocate for the explicit inclusion of psychotherapeutic components in neurofeedback study protocols. (shrink)

The right to refuse medical intervention is well established, but it remains unclear how best to respect and exercise this right in life support. Contemporary ethical guidelines for critical care give ambiguous advice, largely because they focus on the moral equivalence of withdrawing and withholding care without confronting the very real differences regarding who is aware and informed of intervention options and how patient values are communicated and enacted. In withholding care, doctors typically withhold information about interventions judged too futile (...) to offer. They thus retain greater decision-making burden and face weaker obligations to secure consent from patients or proxies. In withdrawing care, there is a clearer imperative for the doctor to include patients in decisions, share information and secure consent, even when continued life support is deemed futile. How decisions to withhold and withdraw life support differ ethically in their implications for positive versus negative interpretations of patient autonomy, imperatives for consent, definitions of futility and the subjective evaluation of benefits and burdens of life support in critical care settings are explored. Professional reflection is required to respond to trends favouring a more positive interpretation of patient autonomy in the context of life support decisions in critical care. Both the bioethics and critical care communities should investigate the possibilities and limits of growing pressure for doctors to disclose their reasoning or seek patient consent when decisions to withhold life support are made. (shrink)

The path of those who would approach the study of Bentham's writings on Evidence has been considerably smoothed by the recent publication of William Twining's work on the evidence theories of Bentham and Wigmore. The material on evidence is now being tackled by the Bentham Project. It presents no easy task. The central core, The Rationale of Judicial Evidence, edited and published by John Stuart Mill in 1827, exists only in the printed version, the MSS from which Mill worked having (...) disappeared. But a substantial body of related material which survives has yet to be thoroughly investigated, though William Twining has made a gallant start. A new edition of the work hitherto known as ‘An Introductory View of the Rationale of Evidence’, first printed in full in the Bowring edition of the Works of Jeremy Bentham is in preparation. The first fruits of this endeavour is that the title of that work as it should appear in due course in the new Collected Works will be Introduction to the Rationale of Evidence: An Introductory View for the Use of Lawyers as well as Non-lawyers, the title in fact given to the work by Bentham. It is intended that what follows should similarly be of use to non-lawyers as well as lawyers. (shrink)

Culminada la Guerra Fría, la sociedad global consideró superadas la colisión ideológica y la polarización de teorías. Sin embargo, al finalizar el siglo xx y descollando el siglo xxi surgieron indicios que apuntaban en dirección contraria. Los primeros con el resurgimiento del marxismo que a partir de la tesis humanista de la filosofía de la praxis revive desde Latinoamérica el legado de Mariátegui, el Che Guevara y Camilo Torres R. El artículo se pregunta si el paradigma del marxismo humanista arroga (...) los fundamentos del buen vivir o vivir bien para enfrentar al capitalismo neoliberal y su proyecto desarrollista. La aproximación al tema se hace de manera cualitativa y descriptiva. A través del método de análisis del discurso político expuesto en la teoría crítica al desarrollismo se aborda la caracterización del capitalismo neoliberal y el modelo de desarrollo, continuando con las tesis que desde el marxismo humanista y la estrategia de revolución cultural se estructura para la emancipación en Latinoamérica. Finalmente, se exponen los planteamientos del buen vivir a partir de la apropiación que hacen los neomarxistas para dar la batalla contra el capitalismo neoliberal. (shrink)

Background: Demand for organisational ethics capacity is growing in health organisations, particularly among managers. The role of clinical ethicists in, and perspective on, organisational ethics has not been well described or documented in the literature. Objective: To describe clinical ethicists’ perspectives on organisational ethics issues in their hospitals, their institutional role in relation to organisational ethics, and their perceived effectiveness in helping to address organisational ethics issues. Design and Setting: Qualitative case study involving semi-structured interviews with 18 clinical ethicists across (...) 13 health organisations in Toronto, Canada. Results: From the clinical ethicists’ perspective, the most pressing organisational ethics issues in their organisations are: resource allocation, staff moral distress linked to the organisation’s moral climate, conflicts of interest, and clinical issues with a significant organisational dimension. Clinical ethicists were consulted in particular on issues related to staff moral distress and clinical issues with an organisational dimension. Some ethicists described being increasingly consulted on resource allocation, conflicts of interest, and other corporate decisions. Many clinical ethicists felt they lacked sufficient knowledge and understanding of organisational decision-making processes, training in organisational ethics, and access to organisational ethics tools to deal effectively with the increasing demand for organisational ethics support. Conclusion: Growing demand for organisational ethics expertise in healthcare institutions is reshaping the role of clinical ethicists. Effectiveness in organisational ethics entails a re-evaluation of clinical ethics training to include capacity building in organisational ethics and organisational decision-making processes as a complement to traditional clinical ethics education. (shrink)

The hypothesis of group selection fell victim to a seemingly devastating critique in 1960s evolutionary biology. In Unto Others, we argue to the contrary, that group selection is a conceptually coherent and empirically well documented cause of evolution. We suggest, in addition, that it has been especially important in human evolution. In the second part of Unto Others, we consider the issue of psychological egoism and altruism -- do human beings have ultimate motives concerning the well-being of others? We argue (...) that previous psychological and philosophical work on this question has been inconclusive. We propose an evolutionary argument for the claim that human beings have altruistic ultimate motives. (shrink)

There is a common view in medical ethics that the patient's right to be informed entails, as well, a correlative right not to be informed, i.e., to waive one's right to information. This paper argues, from a consideration of the concept of autonomy as the foundation for rights, that there can be no such ‘right’ to refuse relevant information, and that the claims for such a right are inconsistent with both deontological and utilitarian ethics. Further, the right to be informed (...) is shown to be a mandatory right (though not a welfare right); persons are thus seen to have both a right and a duty to be informed. Finally, the consequences of this view are addressed: since the way in which we conceptualize our problems tends to determine the actions we take to resolve them, it is important properly to conceptualize patients' requests not to be informed. There may be many reasons for acting in accord with such a request, but it is a mistake to conceptualize one's act as ‘respecting a right possessed by persons’. Keywords: medical ethics, informed consent, autonomy, information-waivers, rights, obligations CiteULike Connotea Del.icio.us What's this? (shrink)

Continuous recordings of brain electrical activity were obtained from a group of 176 patients throughout surgical procedures using general anesthesia. Artifact-free data from the 19 electrodes of the International 10/20 System were subjected to quantitative analysis of the electroencephalogram (QEEG). Induction was variously accomplished with etomidate, propofol or thiopental. Anesthesia was maintained throughout the procedures by isoflurane, desflurane or sevoflurane (N = 68), total intravenous anesthesia using propofol (N = 49), or nitrous oxide plus narcotics (N = 59). A set (...) of QEEG measures were found which reversibly displayed high heterogeneity of variance between four states as follows: (1) during induction; (2) just after loss of consciousness (LOC); (3) just before return of consciousness (ROC); (4) just after ROC. Homogeneity of variance across all agents within states was found. Topographic statistical probability images were compared between states. At LOC, power increased in all frequency bands in the power spectrum with the exception of a decrease in gamma activity, and there was a marked anteriorization of power. Additionally, a significant change occurred in hemispheric relationships, with prefrontal and frontal regions of each hemisphere becoming more closely coupled, and anterior and posterior regions on each hemisphere, as well as homologous regions between the two hemispheres, uncoupling. All of these changes reversed upon ROC. Variable resolution electromagnetic tomography (VARETA) was performed to localize salient features of power anteriorization in three dimensions. A common set of neuroanatomical regions appeared to be the locus of the most probable generators of the observed EEG changes. (shrink)

OBJECTIVE: To examine the long-term effects of an innovative curriculum on medical house officers' (HOs') knowledge, confidence, and attitudes regarding medical ethics. DESIGN: Long term cohort study. The two-year curriculum, implemented by a single physician ethicist with assistance from other faculty, was fully integrated into the programme. It consisted of monthly sessions: ethics morning report alternating with didactic conferences. The content included topics such as ethics vocabulary and principles, withdrawing life support, informed consent, and justice. Identical content was offered simultaneously (...) at the largest affiliated community hospital. SETTING: A multi-hospital university training programme from July, 1992 to June, 1994. PARTICIPANTS: Thirty-nine HOs responded in 92. Thirty HOs from the same cohort responded in 94 (response rates = 83% v 71%; P = 0.19). RESULTS: The curriculum was well received, with 96% of HOs finding the sessions stimulating. Previously validated scales of knowledge and confidence were administered at baseline and at follow-up. The average knowledge score improved 14% (P < 0.001). Confidence also improved, rising from 3.3 to 3.8 on a 5-point Likert scale (P < 0.001). These findings were independent of age, gender, religion, and prior education. The only attitudinal change was an increase in the proportion of residents who thought that ethics should be a required part of residency training (57% v 80%, P = 0.05). CONCLUSION: This curriculum appears practical, popular, and effective. It should be readily transferable to other institutions. (shrink)

Editors and commentators ancient and modern have not responded very well to the challenge of the two riddles which round off the contest between Damoetas and Menalcas at the end of Eclogue 3 . The first is generally regarded as impossibly difficult; the second as impossibly easy. Critics take refuge in quoting Servius' despairing statement: sciendum aenigmata haec sicuti pleraque carere aperta solutione. Yet it is most unlikely that Virgil would introduce insoluble or meaningless riddles into the Bucolica. If there (...) is no solution the lines become pointless, even tasteless; and these are not epithets to be applied lightly to Virgil's poetry. (shrink)

Our sense of self includes awareness of our thoughts and movements, and our control over them. This feeling can be altered or lost in neuropsychiatric disorders as well as in phenomena such as “automatic writing” whereby writing is attributed to an external source. Here, we employed suggestion in highly hypnotically suggestible participants to model various experiences of automatic writing during a sentence completion task. Results showed that the induction of hypnosis, without additional suggestion, was associated with a small but significant (...) reduction of control, ownership, and awareness for writing. Targeted suggestions produced a double dissociation between thought and movement components of writing, for both feelings of control and ownership, and additionally, reduced awareness of writing. Overall, suggestion produced selective alterations in the control, ownership, and awareness of thought and motor components of writing, thus enabling key aspects of automatic writing, observed across different clinical and cultural settings, to be modelled. (shrink)

OBJECTIVES: This study was designed to identify and compare the attitudes of patients and health care professionals towards advance directives. Advance directives promote recognition of the patient's autonomy, letting the individual exercise a certain measure of control over life-sustaining care and treatment in the eventuality of becoming incompetent. DESIGN: Attitudes to advance directives were evaluated using a 44-item self-reported questionnaire. It yields an overall score as well as five factor scores: autonomy, beneficence, justice, external norms, and the affective dimension. SETTING: (...) Health care institutions in the province of Québec, Canada. Survey sample: The sampling consisted of 921 subjects: 123 patients, 167 physicians, 340 nurses and 291 administrators of health care institutions. RESULTS: Although the general attitude of each population was favourable to the expression of autonomy, multivariate analysis of variance (MANOVA) indicated that physicians attached less importance to this subscale than did other populations (p < .001). Above all, they favoured legal external norms and beneficence. Physicians and administrators also attached less importance to the affective dimension than did patients and nurses. Specifically, physicians' attitudes towards advance directives were shown to be less positive than patients' attitudes. CONCLUSION: More attention should be given to the importance of adequately informing patients about advance directives because they may not represent an adequate means for patients to assert their autonomy. (shrink)

Philosophers constantly discuss Responsibility. Yet in every discussion of which I am aware, a rather obvious point is ignored. The obvious point is that responsibility is ascribed to collectives, as well as to individual persons. Blaming attitudes are held towards collectives as well as towards individuals. Responsibility is often ascribed to nations, towns, clubs, groups, teams, and married couples. ‘Germany was responsible for the Second World War’; ‘The club as a whole is to blame for being relegated’. Such statements are (...) not rare. (shrink)

These books entertain as well as teach philosophical wisdom by looking closely at entertainment icons.

Background: Despite the expansion of ethics consultation services, questions remain about the aims of clinical ethics consultation, its methods and the expertise of those who provide such services.Objective: To describe physicians’ expectations regarding the training and skills necessary for ethics consultants to contribute effectively to the care of patients in intensive care unit .Design: Mailed survey.Participants: Physicians responsible for the care of at least 10 patients in ICU over a 6-month period at a 921-bed private teaching hospital with an established (...) ethics consultation service. 69 of 92 eligible physicians responded.Measurements: Importance of specialised knowledge and skills for ethics consultants contributing to the care of patients in ICU; need for advanced disciplinary training; expectations regarding formal-training programmes for ethics consultants.Results: Expertise in ethics was described most often as important for ethics consultants taking part in the care of patients in ICU, compared with expertise in law , religious traditions , medicine and conflict-mediation techniques . When asked about the formal training consultants should possess, however, physicians involved in the care of patients in ICU most often identified advanced medical training as important.Conclusions: Although many physicians caring for patients in ICU believe ethics consultants must possess non-medical expertise in ethics and law if they are to contribute effectively to patient care, these physicians place a very high value on medical training as well, suggesting a “medicine plus one” view of the training of an ideal ethics consultant. As ethics consultation services expand, clear expectations regarding the training of ethics consultants should be established. (shrink)

Ce volume, qui comporte six études d’Étienne Évrard, a le grand mérite de rendre pour la première fois accessible deux inédits du grand spécialiste de Philopon qui enseigna le latin pendant près de trente ans à l’Université de Liège. Le projet de Marc-Antoine Gavray de consacrer un volume au travail d’É. Évrard résulte, comme il l’indique lui-même avec enjouement dans son introduction, d’une sorte de hasard bienvenu : l’inondation soudaine du fonds du magasin à livres de l’ULg, au milieu des...

Resumen. El presente documento tiene como finalidad plasmar la importancia que tiene el tomar encuenta los deseos y necesidades de los espectadores para el éxito económico de las organizaciones deproducción cinematográfica mexicanas. Se establecen las funciones culturales y económicas quedeben considerar los directores y productores de las organizaciones aquí estudiadas. Por otro lado, seubica los diferentes grados de insatisfacción en los que cae un espectador al que no le agradó lapelícula. Se propone el concepto “Síndrome Lozano-Barragán”* para ubicar a aquellasorganizaciones (...) de producción cinematográfica que culpan a los espectadores que quedaroninsatisfechos, del fracaso en taquilla, además de argumentar que dichos espectadores no supieronentender la película o que no saben de la naturaleza de la misma. Por último, hacemos algunasrecomendaciones que pueden seguir las organizaciones de producción cinematográfica para evitareste síndrome e incrementar la satisfacción de los espectadores.Palabras Claves. Organizaciones de producción cinematográfica, industria cultural, síndrome Lozano-Barragán, espectadores, insatisfacción.. The main purpose of this document is to state the importance of taking into considerationthe desires and needs of the spectators by the Mexican film production organizations has for theireconomical success. It establishes the cultural and economic functions that filmmakers studied onthis document must consider. On the other hand, it locates the different degrees of the dissatisfactionin which a spectator can falls into when he or she doesn´t like the movie. We propose the “Lozano-Barragan syndrome”* concept, to distinguish those film production organizations that blame thedissatisfied spectator, for the box office failure, as well as, they argued that those spectators didn´tunderstand the movies or that they don´t understand the nature of it. Finally, we make somerecommendations that could de followed by the film production organizations to avoid this syndromeand increase the spectator satisfaction.Keywords. Film production organizations, cultural industry, Lozano-Barragan syndrome,spectators, dissatisfaction. (shrink)

A unique description of the phenomena that arise from the interaction between quantum systems and their environment. Because of the novel character of the approach discussed, the book addresses scientists from all fields of physics and related disciplines as well as students of physics.

The ethical implications of the growth of for-profit health care institutions are complex. Two major moral criticisms of for-profit medicine are analyzed. The first claim is that for-profit health care institutions fail to fulfill their obligations to do their fair share in providing health care to the poor and so exacerbate the problem of access to health care. The second claim is that profit seeking in medicine will damage the physician-patient relationship, creating conflicts of interest that will diminish the quality (...) of care and erode patients' trust in their physicians and the public's trust in the medical profession. The authors conclude that while the continued expansion of for-profit health care may exacerbate in some respects problems of access, trust and conflicts of interest, it is a mistake to consider these problems as unique to for-profit health care; they are problems for not for-profit health care as well. Though these issues justify continuing moral concern, they do not at this time provide decisive grounds for substantially curbing or eliminating for-profit enterprise in health care. (shrink)