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.

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.

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)

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...

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)

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 ramifications of including genetic components in the clinical studies conducted in non-academic settings create unique ethical challenges. We used a qualitative research design consisting of semi-structured interviews that took place between October 2010 and September 2012. The sample consisted of 80 participants − 38 physicians and 42 coordinators − who worked across a number of different settings, including clinics, private practices, small hospitals, free standing research centers, and blended hospital-institutes in both rural and urban communities in 13 states across (...) the United States. The respondents primarily conducted industry sponsored trials and recruited their own patients as research participants. A majority of the respondents (65%) reported that most of the studies they conducted included an additional genetics component, and so participants were asked to donate specimens for genomics or biobanking. While genomics association studies were perceived as being of benefit, awareness of ethical implications associated with such studies was limited. The rapid advances in genetic technologies make it hard for clinicians and coordinators to help patients make informed decisions about participating in clinical research, and underscore the need to ensure that the regulations governing research on human subjects keep pace with the social and technological changes. It seems essential to discern legitimate ethical concerns and find ways to convey what is going on, what is possible and what might not be possible in terms of protecting privacy, anonymity, and confidentiality. (shrink)

This book, formed as a series of essays in honour of Professor Carl Baudenbacher, addresses the very art of judicial reasoning, and features contributions from many of the foremost current or former national, supranational, or international judges. This unique volume is intended first and foremost for legal scholars, but its approachable style makes it readily accessible for students and for those with a general interest in the application of the law and justice in today's multi-layered world. The collection of essays (...) is rather more philosophical and reflective as opposed to doctrinal. Each contribution focuses on the nature and operation of justice, the independence of the judiciary, and on judicial style primarily from the perspective of the judges themselves. The book provides perspectives on what it means to be accountable and independent as a judge, the role of language and languages in the quest for justice, while other contributions acquaint readers with the some of the structures of courts themselves, or indeed question for whom judgments are written. Each chapter has been written by a presiding judge, or head of an institution and the book is divided into three parts: - Part I Art and Method - Part II Justice and the Judiciary - Part III Reasoning and Language(s). (shrink)

Each volume of this series of companions to major philosophers contains specially commissioned essays by an international team of scholars and will serve as a reference work for students and nonspecialists. John Rawls is the most significant and influential philosopher and moral philosopher of the twentieth century. His work has profoundly shaped contemporary discussions of social, political and economic justice in philosophy, law, political science, economics and other social disciplines. In this exciting collection of new essays, many of the world's (...) leading political and moral theorists discuss the full range of Rawls's contribution to the concepts of political and economic justice, democracy, liberalism, constitutionalism, and international justice. There are also assessments of Rawls's controversial relationships with feminism, utilitarianism and communitarianism. New readers will find this the most accessible guide to Rawls currently available. Advanced students and specialists will find a conspectus of recent developments in the interpretation of Rawls. (shrink)

An approach to argument macrostructure -- The dialectical nature of argument -- Toulmin's problematic notion of warrant -- The linked-convergent distinction, a first approximation -- Argument structure and disciplinary perspective : the linked-convergent versus multiple-co-ordinatively compound distinctions -- The linked-convergent distinction, refining the criterion -- Argument structure and enthymemes -- From analysis to evaluation.

Previous ed. by : Lord Lloyd of Hampstead and M.D.A. Freeman.

The feminist philosopher and social scientist shows how "gendering" has affected the social and natural sciences as she reconciles the long-standing dichotomy between the quantitative and qualitative methods and demonstrates the tandem use of both experimental and intuitive approaches.

This chapter contains sections titled: Introduction Postmodernism and pragmatism as a response to the Enlightenment The postmodern response in organization studies Postmodern and pragmatist organizational ethics Conclusion.

John Searle began to discuss his recently published book `The Construction of Social Reality' with Anthony Freeman, and they ended up talking about God. The book itself and part of their conversation are introduced and briefly reflected upon by Anthony Freeman. Many familiar social facts -- like money and marriage and monarchy -- are only facts by human agreement. They exist only because we believe them to exist. That is the thesis, at once startling yet obvious, that philosopher (...) John Searle explores in The Construction of Social Reality. (shrink)

Distinguishing “business” concerns from “ethical” values is not only an unfruitful and meaningless task, it is also an impossible endeavor. Nevertheless, fruitless attempts to separate facts from values produce detrimental second-order effects, both for theory and practice, and should therefore be abandoned. We highlight examples of exemplary research that integrate economic and moral considerations, and point the way to a business ethics discipline that breaks new ground by putting ideas and narratives about businesstogetherwith ideas and narratives about ethics.

The standard view of ignorance is that it consists in the mere lack of knowledge or true belief. Duncan Pritchard has recently argued, against the standard view, that ignorance is the lack of knowledge/true belief that is due to an improper inquiry. I shall call, Pritchard’s alternative account the Normative Account. The purpose of this article is to strengthen the Normative Account by providing an independent vargument supporting it.

In Sarsi I seem to discern the firm belief that in philosophising one must support oneself on the opinion of some celebrated author, as if our minds ought to remain completely sterile and barren unless wedded to the reasoning of someone else…that is not how things are. Philosophy is written in this grand book, the universe, which stands continually open to our gaze.

This article explores the themes of trust and ethical conduct in social research, with particular attention to the trust that can develop between the members of a research team as well as between researchers and the researched. The authors draw upon a three-year empirical study of destinations and outcomes for young people excluded from alternative educational provision. They also make reference to a contemporary exposition of Aristotle's writing on friendship in order to explore two sets of relevant distinctions that have (...) a bearing upon our understanding of relationships that emerge in the context of social research projects. These distinctions are between impartiality and selectivity on the one hand, and between universality and particularity on the other. The authors attempt to demonstrate that these distinctions influence the development of trust and the conduct of ethical research, arguing that the latter is not synonymous with compliance to ethical guidelines. (shrink)

"Deleuze plonge la critique kantienne transcendantale dans le bain dissolvant d'un empirisme renouvelé. Ce livre se propose de restituer cette entreprise, et d'analyser l'étonnante création de ce concept, que Deleuze mène depuis ses premières monographies jusqu'à Différence et Répétition dans un dialogue fécond avec l'histoire de la philosophie. Par quelles opérations de distorsion et de collage, Deleuze compose-t-il l'empirisme de Hume, la théorie du signe comme force de Nietzsche, le virtuel et les multiplicités de Bergson, les modes de Spinoza, les (...) individualisations impersonnelles de Simondon pour renouveler la théorie kantienne du transcendantal? C'est tout l'objet de cette enquête, qui permet d'entrer dans le laboratoire du penseur, pour saisir la philosophie se faisant, mais qui permet également d'expliquer l'insistance du transcendantal dans toute son oeuvre"--P. [4] of cover. (shrink)

This chapter provides a high-level introduction to the topic of propaganda. We survey a number of the most influential accounts of propaganda, from the earliest institutional studies in the 1920s to contemporary academic work. We propose that these accounts, as well as the various examples of propaganda which we discuss, all converge around a key feature: persuasion which bypasses audiences’ rational faculties. In practice, propaganda can take different forms, serve various interests, and produce a variety of effects. Propaganda can aim (...) to affect not only audiences’ beliefs and attitudes, but also their emotions and moods, and in turn how audiences subsequently reason or act. While propaganda is often thought of as false or misinformation, it can instead involve framing effects (“The war on drugs”), covert messaging (“There are Muslims among us”), emotionally charged slogans (“Make America Great Again”), or myths (“The American dream”). These forms of propaganda mislead audiences, not by introducing false information, but by making some beliefs and values, rather than others, salient. In fact, propaganda can even employ straightforwardly true claims (again, as in “There are Muslims among us”) and seemingly objective bureaucratic reports (“Crime has risen 4.2%”). To understand how these and other mechanisms enable propaganda to persuade by arational means, further study is needed. To that end, throughout the chapter we identify a number of places where the study of meaning and communication can help elucidate propaganda, as well as the places where propaganda issues challenges for the study of meaning. (shrink)

In Sarsi I seem to discern the firm belief that in philosophising one must support oneself on the opinion of some celebrated author, as if our minds ought to remain completely sterile and barren unless wedded to the reasoning of someone else…that is not how things are. Philosophy is written in this grand book, the universe, which stands continually open to our gaze.

It has become part of the accepted wisdom to say that the twentieth century was the century of physics and the twenty-first century will be the century of biology. Two facts about the coming century are agreed on by almost everyone. Biology is now bigger than physics, as measured by the size of budgets, by the size of the workforce, or by the output of major discoveries; and biology is likely to remain the biggest part of science through the twenty-first (...) century. Biology is also more important than physics, as measured by its economic consequences, by its ethical implications, or by its effects on human welfare. (shrink)

Pragmatists believe that philosophical inquiry must engage closely with practice to be useful and that practice serves as a source of social norms. As a growing alternative to the analytic and continental philosophical traditions, pragmatism is well suited for research in business ethics, but its role remains underappreciated. This article focuses on Richard Rorty, a key figure in the pragmatist tradition. We read Rorty as a source of insight about the ethical and political nature of business practice in contemporary global (...) markets, focusing specifically on his views about moral sentiments, agency, and democratic deliberation. Importantly for business ethicists, Rorty’s approach sets in stark relief our moral responsibility as useful, practical thinkers in addressing the societal challenges of our time. We use “modern slavery” as an empirical context to highlight the relevance of Rorty’s approach to business ethics. (shrink)

Die vorliegende Schrift unternimmt eine Revision des vorherrschenden Bildes der Rolle und der Konzeptionen von Moral und Ethik im Wiener Kreis. Dieses Bild wird als zu einseitig und undifferenziert zurückgewiesen. Die Ansicht, die Mitglieder des Wiener Kreises hätten kein Interesse an Moral und Ethik gezeigt, wird widerlegt. Viele Mitglieder waren nicht nur moralisch und politisch interessiert, sondern auch engagiert. Des Weiteren vertraten nicht alle die Standardauffassung logisch-empiristischer Ethik, die neben der Anerkennung deskriptiv-empirischer Untersuchungen durch die Ablehnung jeglicher normativer und inhaltlicher (...) Ethik und der Verfechtung eines extremen Nonkognitivismus geprägt ist. Am meisten entspricht die Standardauffassung den Ansichten Rudolf Carnaps, weniger bereits jenen Karl Mengers, Otto Neuraths oder Philipp Franks. Am weitesten weichen Moritz Schlick, Victor Kraft sowie Herbert Feigl von der Standardauffassung ab. Entgegen dem herkömmlichen Bild weltabgewandter Logiker und Metaethiker wurde im Wiener Kreis sogar Angewandte Ethik betrieben, und dies bereits unter diesem Namen. Neben den ethischen Hauptthemen und Ansichten der jeweiligen Philosophen in ihrer Entwicklung im Rahmen ihres persönlichen und kulturellen Kontextes zeigt die Untersuchung, dass allen Ansätzen eine aufgeklärte und humanistische Version von Moral und Ethik gemeinsam ist. Dieser wissenschaftliche Humanismus, der sich schon in der Programmschrift Wissenschaftliche Weltauffassung. Der Wiener Kreis findet, liegt jedoch in verschiedenen Ausprägungen vor. Was die Abweichungen von der Standardauffassung wesentlich betrifft, ist ihre unterschiedliche Auffassung von Moral als gemeinsames oder individuelles Unternehmen. Carnap führt ein extremer Individualismus zu einem extremen Nonkognitivismus, in dem ihm Menger folgt. Bei Schlick ist die Lage zweideutig, was sich in unterschiedlichen Moralbegriffen widerspiegelt. Bei Kraft und Feigl tritt das Verständnis von Moral als gemeinschaftlich geteilte Praxisform klar hervor. Auf der Basis eines gemeinsamen Begriffs des moralisch Guten, der auch eine Sachkomponente enthält, ist eine Verständigung über moralische Fragen möglich. Von einem extremen Nonkognitivismus kann dort nicht mehr die Rede sein. Mit diesen Ergebnissen verbietet es sich, dem Wiener Kreis allgemein eine Ablehnung normativer Ethik und einen extremen Nonkognitivismus zuzuschreiben. Eine systematische Ethik, die Moral als Gemeinschaftspraxis begreift, steht einigen im Wiener Kreis näher, als das vorherrschende Bild suggerieren möge. Wer meint, mit engem Bezug zur Tradition des Wiener Kreises nur Carnap folgen zu können und Ethik als suspektes Unternehmen betrachten zu müssen, irrt. Ethik war in der Tradition Analytischer Philosophie nicht immer so marginalisiert, wie sie es in manchen ihrer Teilrichtungen heute noch ist und Gegner(innen) der Analytischen Philosophie vorwerfen. Die vorliegende Untersuchung liefert die nötige Revision einer verfänglichen Fehlentwicklung. (shrink)

This study investigates the hypothesis that the advantage corporate social performance (CSP) yields in attracting human resources depends on the degree of job choice possessed by the job seeking population. Results indicate that organizational CSP is positively related to employer attractiveness for job seekers with high levels of job choice but not related for populations with low levels suggesting advantages to firms with high levels of CSP in the ability to attract the most qualified employees.

Many philosophers have defended the view that we are subject to the following evidential ought: “One ought to believe in accordance with one's evidence.” Although they agree on this, a more fundamental question keeps dividing them: from where does the evidential ought derive its normative force? The instrinsicalist answer to this question is sometimes described as the claim that "there is a brute epistemic value in believing in accordance with one's evidence" (Cowie, 2014, 4005). But what does this really mean? (...) Intrinsicalists' negative claim is that the normative source of the evidential ought has nothing to do with the fulfilment of our epistemic purposes. But what is their positive claim exactly? This paper aims at improving our understanding of intrinsicalism. Its conclusion is that there is only one possible way of being an intrinsicalist. Intrinsicalists need to be constitutivists. (shrink)

This long-awaited two-volume set constitutes the definitive presentation of the system of classifying moral judgment built up by Lawrence Kohlberg and his associates over a period of twenty years. Researchers in child development and education around the world, many of whom have worked with interim versions of the system, indeed, all those seriously interested in understanding the problem of moral judgment, will find it an indispensable resource. Volume I reviews Kohlberg's stage theory, and the by-now large body of research on (...) the significance and utility of his moral stages. Issues of reliability and validity are addressed. The volume ends with detailed instructions for using the forms in Volume 2. Volume 2, in a specially-designed, user-friendly format, includes three alternative functionally-equivalent forms of the scoring system. (shrink)

Ethical physicians need to share their biases and prejudices and articulate alternatives and also be tolerant of the decisions of their patients and families.I believe that I am a moral, caring, dedicated doctor working with children and parents who are often faced with ethical problems of large and small dimensions. There is no question that these decisions should be ethical, but, in general, I find ethical theory of little day-to-day use. Indeed, even when an ethicist joins me in a discussion (...) of “What should I do?”, or more appropriately, “What should I advocate be done?”, I usually find their additions to the discussion wanting. Ethical theory gives guidance but does not seem to provide sufficient help in decisions for the individual case: What will be best for the infant with spina bifida while still in utero? Termination of the pregnancy? Birth and long-term care? What is best were that same child already born with a high paraplegia and hydrocephalus? What is best for the infant with a major malformation of the brain and uncontrollable seizures whose only hope for controlling the seizures is removal of half of the brain? What is best for the family in each of these situations and the many others I have encountered? What is best for society?I have been called a Hegelian pragmatist, although my knowledge of Hegel is minimal. I think that the term pragmatist is a badge of honour, because, on the front lines of clinical decision-making, I do not have the philosopher’s luxury of days or weeks for managing words. As a pragmatic doctor, I am forced to be a person of action or inaction. I must make a decision and advocate for the position I take.I am clearly a utilitarian, as I strive to produce the greatest good …. (shrink)