In this article, we examine the effects of time spent in household labor on the gender gap in earnings. We identify that part of the gender gap in earnings directly attributable to women's greater household labor time. After controlling for years of work experience, hours worked per week, occupation, industry, union membership, and education, we find that household labor time can directly account for 8.2 percent of the gender gap in earnings. In addition to the direct effect of women's household (...) responsibilities on earnings, they also may affect occupational location, work experience, and number of hours worked per week, and through these variables, their earnings. These findings indicate that we cannot truly understand women's earnings relative to those of men without considering the impact of their unpaid labor on their paid work. (shrink)

Voraussetzungen -- Carla Henius, Cathy Berberian und Roy Hart : drei vokale Fallbeispiele -- Interpretationen : Konklusionen -- Verzeichnis der Archive -- Abbildungsverzeichnis -- Literaturverzeichnis.

In 2004, the agricultural economies of many rural communities in the United States were impacted by the cessation of a price-support and supply-control program for tobacco production. Tobacco was not only an important livelihood, but also was central to social and cultural life. Using a social–ecological systems lens and the adaptive cycle metaphor, we examine the reorganization of agriculture in communities that previously produced tobacco under the program. Specifically, we seek to understand how transitional policy that provided financial support to (...) tobacco farmers interacted with other social, cultural, physical and human capitals to condition system reorganization. We conducted semi-structured interviews with farmers, extension agents, and policy makers in Kentucky as well as examined trends in income and number of farmers before and after the transition as indicators of reorganization. We determined that the financial support was perceived as helpful in supporting the transition and that tobacco farmers reorganized their livelihoods primarily around existing, remnant assets and endogenous capacities. In addition, we determined that though the agricultural system may be reorganizing economically, it is not necessarily supportive of the same social bonds and values that co-existed with tobacco economy. Understanding agricultural economies as part of complex social–ecological systems that consist of interconnected values, identities, ecology and social ties is important for developing policies to support systems and communities through economic transitions. (shrink)

We describe a virtue ethics approach and its application in a four-year, integrated, longitudinal, and required undergraduate medical education course that attempts to address some of the challenges of the hidden curriculum and minimize some of its adverse effects on learners. We discuss how a curriculum grounded in virtue ethics strives to have the practical effect of allowing students to focus on their professional identity as physicians in training rather than merely on knowledge and skills acquisition. This orientation, combined with (...) a student-generated curriculum, is designed to prepare students to identify and face challenges during their clinical years, further nurturing their professional growth. In short, a four-year integrated ethics and professionalism curriculum intentionally centered on cultivating virtuous physicians may alleviate, and even counteract, the effects of the hidden curriculum in the clinical years of medical training. (shrink)

Medical students’ concerns during clinical clerkships may not always be addressed with mentors who work under significant time constraints. This study examined 3rd year students’ survey responses regarding patient encounters to elucidate what may be hidden aspects of their learning environment. We analyzed results to an 18-item survey completed during a required ethics and professionalism course in third-year medicine clerkships over a period of 18 months. The survey covered types of concerns elicited by patient encounters, interactions with mentors about concerns, (...) perceptions of mentors, and level of moral distress. We also examined results of a 7-item evaluation of small group discussions during the study period. 1210 surveys and 195 evaluations constituted the study samples. Students’ concerns related primarily to ethics (36.4%, n = 441) and quality of care (34.5%, n = 418). Concerns had not been raised with a mentor in 535 (44.2%) instances. Students experienced moral distress in connection with 35.4% (n = 324) of cases; this was particularly common when a concern applied to a mentor. Higher levels of moral distress were associated with a lower likelihood of wishing to emulate the mentor (r = -0.27, p <.001). Two thirds of students, 66.9% (n = 107), stated that small group discussions where concerns were discussed lowered their stress levels. We suggest that clinical mentors be made aware of students’ learning needs and that structured discussions be available for students to articulate concerns with peers and facilitators in efforts to uncover elements of the hidden curriculum with the goal of optimizing students’ well-being, learning and professional development. (shrink)

The possible future use of lethal autonomous weapons systems (LAWS) and the challenges associated with assigning moral responsibility leads to several debates. Some authors argue that the highly autonomous capability of such systems may lead to a so-called responsibility gap in situations where LAWS cause serious violations of international humanitarian law. One proposed solution is the doctrine of command responsibility. Despite the doctrine’s original development to govern human interactions on the battlefield, it is worth considering whether the doctrine of command (...) responsibility could provide a solution by applying the notion analogously to LAWS. A fundamental condition underpinning the doctrine’s application is the control requirement, stipulating that a superior must exert some degree of control over subordinates. The aim of this article is to provide an in-depth analysis of this control condition and assess whether it leads to the impossibility of applying the doctrine of command responsibility to LAWS. To this end, the first section briefly introduces the topic of LAWS and responsibility gaps. The subsequent section provides a concise overview of the doctrine itself and the conditions typically necessitated for its application. In the third section, a comprehensive scrutiny of the control requirement is undertaken through examination of key case law, examining how the concept has been interpreted. Finally, the fourth section delves into the evaluation of commanders’ potential to exert effective control over their (non-human) subordinates. Based on this, the feasibility of considering command responsibility as a viable solution is assessed, aiming to determine whether its application should be prima facie excluded or warrants further exploration. (shrink)

In the present article, we argue that the constant pressure that leaders face may limit the willpower required to behave according to ethical norms and standards and may therefore lead to unethical behavior. Drawing upon the ego depletion and moral self-regulation literatures, we examined whether self-regulatory depletion that is contingent upon the moral identity of leaders may promote unethical leadership behavior. A laboratory experiment and a multisource field study revealed that regulatory resource depletion promotes unethical leader behaviors among leaders who (...) are low in moral identity. No such effect was found among leaders with a high moral identity. This study extends our knowledge on why organizational leaders do not always conform to organizational goals. Specifically, we argue that the hectic and fragmented workdays of leaders may increase the likelihood that they violate ethical norms. This highlights the necessity to carefully schedule tasks that may have ethical implications. Similarly, organizations should be aware that overloading their managers with work may increase the likelihood of their leaders transgressing ethical norms. (shrink)

Michel Foucault’s _History of Sexuality_ has been one of the most influential books of the last two decades. It has had an enormous impact on cultural studies and work across many disciplines on gender, sexuality, and the body. Bringing a new set of questions to this key work, Ann Laura Stoler examines volume one of _History of Sexuality_ in an unexplored light. She asks why there has been such a muted engagement with this work among students of colonialism for whom (...) issues of sexuality and power are so essential. Why is the colonial context absent from Foucault’s history of a European sexual discourse that for him defined the bourgeois self? In _Race and the Education of Desire, _Stoler challenges Foucault’s tunnel vision of the West and his marginalization of empire. She also argues that this first volume of _History of Sexuality_ contains a suggestive if not studied treatment of race. Drawing on Foucault’s little-known 1976 College de France lectures, Stoler addresses his treatment of the relationship between biopower, bourgeois sexuality, and what he identified as “racisms of the state.” In this critical and historically grounded analysis based on cultural theory and her own extensive research in Dutch and French colonial archives, Stoler suggests how Foucault’s insights have in the past constrained—and in the future may help shape—the ways we trace the genealogies of race. _Race and the Education of Desire_ will revise current notions of the connections between European and colonial historiography and between the European bourgeois order and the colonial treatment of sexuality. Arguing that a history of European nineteenth-century sexuality must also be a history of race, it will change the way we think about Foucault. (shrink)

Reading and writing are increasingly performed with digital, screen-based technologies rather than with analogue technologies such as paper and pen. The current digitization is an occasion to “unpack,” theoretically and conceptually, what is entailed in reading and writing as embodied, multisensory processes involving audiovisual and ergonomic interaction with devices having particular affordances. Highlighting the sensorimotor contingencies of substrates and technologies — how movement and object manipulation affect perception, experience, and sensory “feel” — this article presents an embodied approach to reading, (...) writing, and literacy, using three cases of digitization as illustrations of some educational implications: beginning writing by hand or by keyboard; dialogic reading with iPads and print picture books in kindergarten; and deep reading of long, linear texts on paper and on screens. (shrink)

Is there a link between how a firm manages its internal and external stakeholders? More specifically, are firms that give employees stock ownership and more say in running the enterprise more likely to engage with external stakeholders? This study seeks to answer these questions by elaborating on mechanisms that link employees to external stakeholders, such as the community, suppliers, and the environment. It tests these relationships using a sample of 347 private, mostly small-to-medium size firms, which completed a stakeholder impact (...) assessment organized by the non-profit B Lab. The results support the hypotheses that both employee ownership and employee involvement are positively associated with external stakeholder engagement. Further, we found that certification plays a role, as employee ownership contributes to external stakeholder engagement only in certified B Corporations, and not in firms that merely completed the B Lab Impact assessment. Our findings have import for stakeholder engagement frameworks, as we show that there is interplay between internal employee stakeholders and external stakeholders that may be important to overall firm–stakeholder management. (shrink)

This experimental writing piece by the Earth Unbound Collective explores the ethical, political and pedagogical challenges in addressing climate change, activism and justice. The provocation Earth Unbound: the struggle to breathe and the creative thoughts that follow are inspired by the contagious energy of what Donna Haraway calls response-ability or the ability to respond. This energy ripples through monthly reading groups and workshops organised by this interdisciplinary collective that emerged organically in January 2020.

Although moral distress is now a well-recognized phenomenon among all of the healthcare professions, few evidence-based strategies have been published to address it. In morally distressing situations, the “presenting problem” may be a particular patient situation, but most often signals a deeper unit- or system-centered issue. This article describes one institution’s ongoing effort to address moral distress in its providers. We discuss the development and evaluation of the Moral Distress Consultation Service, an interprofessional, unit/system-oriented approach to addressing and ameliorating moral (...) distress. (shrink)

Public opinion in recent years has soured on multiculturalism, due in large part to fears of radical Islam. In Multiculturalism without Culture, Anne Phillips contends that critics misrepresent culture as the explanation of everything individuals from minority and non-Western groups do. She puts forward a defense of multiculturalism that dispenses with notions of culture, instead placing individuals themselves at its core. Multiculturalism has been blamed for encouraging the oppression of women--forced marriages, female genital cutting, school girls wearing the hijab. Many (...) critics opportunistically deploy gender equality to justify the retreat from multiculturalism, hijacking the equality agenda to perpetuate cultural stereotypes. Phillips informs her argument with the feminist insistence on recognizing women as agents, and defends her position using an unusually broad range of literature, including political theory, philosophy, feminist theory, law, and anthropology. She argues that critics and proponents alike exaggerate the unity, distinctness, and intractability of cultures, thereby encouraging a perception of men and women as dupes constrained by cultural dictates. Opponents of multiculturalism may think the argument against accommodating cultural difference is over and won, but they are wrong. Phillips believes multiculturalism still has an important role to play in achieving greater social equality. In this book, she offers a new way of addressing dilemmas of justice and equality in multiethnic, multicultural societies, intervening at this critical moment when so many Western countries are poised to abandon multiculturalism. (shrink)

Rather than focusing on political and legal debates surrounding attempts to determine if and when genocidal rape has taken place in a particular setting, this essay turns instead to a crucial, yet neglected area of inquiry: the moral significance of genocidal rape, and more specifically, the nature of the harms that constitute the culpable wrongdoing that genocidal rape represents. In contrast to standard philosophical accounts, which tend to employ an individualistic framework, this essay offers a situated understanding of harm that (...) features the importance of interdependence and relationality and that conceptualizes harms as embodied and contextual. The paper ultimately reveals what is distinctive about this particular crime of sexual violence by exploring the logic of genocidal rape: genocidal rape involves the harm of forced self-betrayal unleashed relationally, causing victims as representatives of their group to participate inadvertently in the destruction of that group. (shrink)

Over one-third of older adults in many countries have a companion animal, and pets may harbor health-promoting potential. Few studies have considered pet-ownership in relation to economic vulnerability, and pet-ownership has not been often considered within policy efforts to promote ageing-in-place. We conducted a mixed methods case study to understand perspectives of both community agencies that support ageing-in-place and older adults themselves. A shortage of affordable, appropriate pet-friendly housing emerged as a challenge, even when framed as a legitimate choice and (...) preference for many older adults. In this manuscript, we share the trajectories of three economically vulnerable older adults whose affordable housing needs became entangled with commitments to pets. Guided by dialogical narrative methodology, we offer each narrative as a short vignette to illustrate the extent to which older adults will practice ‘more-than-human solidarity’ for a pet, even when their own well-being is compromised as a result; and highlight incongruence between the underlying moral values that shape solidaristic practices of individuals versus solidaristic arrangements that shape affordable housing opportunities. We suggest that housing rules and legislation that disrupt, rather than confirm, more-than-human solidarity may render older adults susceptible to, rather than protected from, deteriorating physical, mental and social well-being. We propose that collective solidaristic practices must reflect and subsume the moral complexity of solidarity practiced by individuals, to enable fair and equitable ageing-in-place. (shrink)

Stress in health care is affected by moral factors. When people are prevented from doing ‘good’ they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations (...) and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach’s alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: ‘internal demands’ and ‘external demands and restrictions’. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts. (shrink)

Moral duties concerning climate change mitigation are – for good reasons – conventionally construed as duties of institutional agents, usually states. Yet, in both scholarly debate and political discourse, it has occasionally been argued that the moral duties lie not only with states and institutional agents, but also with individual citizens. This argument has been made with regard to mitigation efforts, especially those reducing greenhouse gases. This paper focuses on the question of whether individuals in industrialized countries have duties to (...) reduce their individual carbon footprint. To this end it will examine three kinds of arguments that have been brought forward against individuals having such duties: the view that individual emissions cause no harm; the view that individual mitigation efforts would have no morally significant effect; and the view that lifestyle changes would be overly-demanding. The paper shows how all three arguments fail to convince. While collective endeavours may be most efficient and effective in bringing about significant changes, there are still good reasons to contribute individually to reducing emission. After all, for most people the choice is between reducing one’s individual emissions and not doing anything. The author hopes this paper shows that one should not opt for the latter. (shrink)

In recent decades, concepts of group agency and the morality of groups have increasingly been discussed by philosophers. Notions of collective or joint duties have been invoked especially in the debates on global justice, world poverty and climate change. This paper enquires into the possibility and potential nature of moral duties individuals in unstructured groups may hold together. It distinguishes between group agents and groups of people which – while not constituting a collective agent – are nonetheless capable of performing (...) a joint action. It attempts to defend a notion of joint duties which are neither duties of a group agent nor duties of individual agents, but duties held jointly by individuals in unstructured groups. Furthermore, it seeks to illuminate the relation between such joint duties on the one hand and individual duties on the other hand. Rebutting an argument brought forward by Wringe, the paper concludes that it is not plausible to assume that all humans on earth can together hold a duty to mitigate climate change or to combat global poverty given that the members of that group are not capable of joint action. (shrink)

WINNER BEST SOCIAL PHILOSOPHY BOOK IN 2021 / NASSP BOOK AWARD 2022 -/- Together we can often achieve things that are impossible to do on our own. We can prevent something bad from happening or we can produce something good, even if none of us could do it by herself. But when are we morally required to do something of moral importance together with others? This book develops an original theory of collective moral obligations. These are obligations that individual moral (...) agents hold jointly, but not as unified collective agents. To think of some of our obligations as joint or collective is the best way of making sense of our intuitions regarding collective moral action problems. Where we have reason to believe that our efforts are most efficient as part of a collective endeavor we may incur collective obligations together with others who are similarly placed as long as we are able to establish compossible individual contributory strategies towards that goal. The book concludes with a discussion of “massively shared obligations” to large-scale moral problems such as global poverty. (shrink)

Decades ago, several authors have proposed that disorders in automatic processing lead to intrusive symptoms or abnormal contents in the consciousness of people with schizophrenia. However, since then, studies have mainly highlighted difficulties in patients’ conscious experiencing and processing but rarely explored how unconscious and conscious mechanisms may interact in producing this experience. We report three lines of research, focusing on the processing of spatial frequencies, unpleasant information, and time-event structure that suggest that impairments occur at both the unconscious and (...) conscious level.We argue that focusing on unconscious, physiological and automatic processing of information in patients, while contrasting that processing with conscious processing, is a first required step before understanding how distortions or other impairments emerge at the conscious level. We then indicate that the phenomenological tradition of psychiatry supports a similar claim and provides a theoretical framework helping to understand the relationship between the impairments and clinical symptoms. We base our argument on the presence of disorders in the minimal self in patients with schizophrenia. The minimal self is tacit and non-verbal and refers to the sense of bodily presence. We argue this sense is shaped by unconscious processes, whose alteration may thus affect the feeling of being a unique individual. This justifies a focus on unconscious mechanisms and a distinction from those associated with consciousness. (shrink)

The fundamental determinant of death in donation after circulatory determination of death is the cessation of brain circulation and function. We therefore propose the term donation after brain circulation determination of death [DBCDD]. In DBCDD, death is determined when the cessation of circulatory function is permanent but before it is irreversible, consistent with medical standards of death determination outside the context of organ donation. Safeguards to prevent error include that: 1] the possibility of auto-resuscitation has elapsed; 2] no brain circulation (...) may resume after the determination of death; 3] complete circulatory cessation is verified; and 4] the cessation of brain function is permanent and complete. Death should be determined by the confirmation of the cessation of systemic circulation; the use of brain death tests is invalid and unnecessary. Because this concept differs from current standards, consensus should be sought among stakeholders. The patient or surrogate should provide informed consent for organ donation by understanding the basis of the declaration of death. In cases of circulatory cessation, such as occurs in DBCDD, death can be defined as the permanent cessation of brain functions, determined by the permanent cessation of brain circulation. (shrink)

Disorders of consciousness and the self are at the forefront of schizophrenia symptomatology. Patients are impaired in feeling themselves as the authors of their thoughts and actions. In addition, their flow of consciousness is disrupted, and thought fragmentation has been suggested to be involved in the patients’ difficulties in feeling as being one unique, unchanging self across time. Both impairments are related to self disorders, and both have been investigated at the experimental level. Here we review evidence that both mechanisms (...) of motor control and the temporal structure of signal processing are impaired in schizophrenia patients. Based on this review, we propose that the sequencing of action and perception plays a key role in the patients’ impairments. Furthermore, the millisecond time scale of the disorders, as well as the impaired sequencing, highlights the cooperation between brain networks including the cerebellum, as proposed by Andreasen (1999). We examine this possibility in the light of recent knowledge on the anatomical and physiological properties of the cerebellum, its role in timing, and its involvement in known physiological impairments in patients with schizophrenia, e.g., resting states and brain dynamics. A disruption in communication between networks involving the cerebellum, related to known impairments in dopamine, glutamate and GABA transmission, may help to better explain why patients experience reduced attunement with the external world and possibly with themselves. (shrink)

The Doctrine of Signatures (DoS) figures prominently in both contemporary and historic herbal traditions across a diversity of cultures. DoS—conceptualized beyond its conventional interpretation as “like cures like”, which relies solely on plant morphology—can be viewed as a type of ecosemiotic communication system. This nuanced form of interspecies communication relies on the presence of “signatures”, or signs, corresponding to the therapeutic quality of different plants based on their morphology but also their aroma, taste, texture, and even their context in the (...) landscape. Despite its widespread contemporary dismissal by mainstream science as overly simplistic, childlike, primitive, and generally of limited value, we suggest that the recognition of “signatures” in plants may be considered as a form of communication between humans and plants. Drawing upon Indigenous thought, ecosemiotic theory, and lyric philosophy, we posit that understanding “signatures” metaphorically, as a reflection of the “shape of the world”, offers insights into the interconnectedness of all life forms—a profound affirmation of relational coherence between humans and the more-than-human. We advocate for another perspective on DoS: one which holds potential towards reorienting and restoring our relationships in the vibrant world of the Anthropocene. (shrink)

The question of whether psychopaths are criminally and morally responsible has generated significant controversy in the literature. In this paper, we discuss what relevance a psychopathy diagnosis has for criminal responsibility. It has been argued that figuring out whether psychopathy is a mental illness is of fundamental importance, because it is a precondition for psychopaths’ eligibility to be excused via the legal insanity defense. But even if psychopathy counts as a mental illness, this alone is not sufficient to show the (...) insanity defense is applicable; it must also be shown that, as a result of the illness, specific deficits in moral understanding or control are present. In this paper, we show that a diagnosis of psychopathy will generally not indicate that a defendant is eligible for an insanity defense. This is because the group of individuals subsumed under the diagnosis is so heterogeneous that while some psychopaths do show significant impairments in affect and control which may impact on their responsibility, many psychopaths are not incapacitated in a way relevant to responsibility. (shrink)

I defend an instrumentalist account of moral responsibility and adopt Manuel Vargas’ idea that our responsibility practices are justified by their effects. However, whereas Vargas gives an independent account of morally responsible agency, on my account, responsible agency is defined as the susceptibility to developing and maintaining moral agency through being held responsible. I show that the instrumentalism I propose can avoid some problems more crude forms of instrumentalism encounter by adopting aspects of Strawsonian accounts. I then show the implications (...) for our understanding of responsibility: my account requires us to adopt a graded notion of responsibility and accept the claim that certain individuals may not be responsible because they are not susceptible to being influenced by our moral responsibility practices. Finally, I discuss whether the account is committed to allowing the instrumentalization of non-responsible individuals in cases where blaming them may benefit others’ moral agency. (shrink)

As the COVID-19 pandemic continues to evolve, taking its toll on people’s lives around the world, vaccine passports remain a contentious topic of debate in most liberal democracies. While a small literature on vaccine passports has sprung up over the past few years that considers their ethical pros and cons, in this paper we focus on the question of when vaccine passports are politically legitimate. Specifically, we put forward a ‘public reason ethics framework’ for resolving ethical disputes and use the (...) case of vaccine passports to demonstrate how it works. The framework walks users through a structured analysis of a vaccine passport proposal to determine whether the proposal can be publicly justified and is therefore legitimate. Use of this framework may also help policymakers to design more effective vaccine passports, by incorporating structured input from the public, and thereby better taking the public’s interests and values into account. In short, a public reason ethics framework is meant to encourage better, more legitimate decision-making, resulting in policies that are ethically justifiable, legitimate and effective. (shrink)

We can often achieve together what we could not have achieved on our own. Many times these outcomes and actions will be morally valuable; sometimes they may be of substantial moral value. However, when can we be under an obligation to perform some morally valuable action together with others, or to jointly produce a morally significant outcome? Can there be collective moral obligations, and if so, under what circumstances do we acquire them? These are questions to which philosophers are increasingly (...) turning their attention. It is fair to say that traditional ethical theories cannot give a satisfying answer to the questions, focusing as they do on the actions and attitudes of discreet individual agents. It should also be noted that the debate surrounding collective moral obligations is ongoing and by no means settled. This chapter discusses and compares the different attempts to date to answer the above questions. It proposes a set of meta-criteria—or desiderata— for arbitrating between the various proposals. (shrink)

There has been a focus on policies relating to early years education and care across the developed world and particularly in Europe. In the UK, there has been a raft of policy changes alongside increased investment. However, this paper argues that these changes may not be sufficient to meet EU objectives in terms of quality or the government's policy goals of high quality, affordable and accessible early years education and care. There are major issues that appear to militate against achieving (...) these goals; these relate to the levels of government funding and to the regulatory context. There are also divergences between the providers in terms of their own objectives and underlying values which mean that quality may be variable and access to certain types of providers restricted. These factors appear to militate against the delivery of universal provision of high quality early years education and care. (shrink)

BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...) objective of this review was to identify and map the outcomes reported in primary studies of CEC. The secondary objective was to provide a comprehensive overview of CEC structures, processes, and roles to enhance understanding and to inform standardization.MethodsWe searched electronic databases to identify primary studies of CEC involving patients, substitute decision-makers and/or family members, clinicians, healthcare staff and leaders. Outcomes were mapped across five conceptual domains as identified a priori based on our clinical ethics experience and preliminary literature searches and revised based on our emerging interpretation of the data. These domains included personal factors, process factors, clinical factors, quality, and resource factors. ResultsForty-eight studies were included in the review. Studies were highly heterogeneous and varied considerably regarding format and process of ethical intervention, credentials of interventionist, population of study, outcomes reported, and measures employed. In addition, few studies used validated measurement tools. The top three outcome domains that studies reported on were quality, process factors, and clinical factors. The majority of studies examined multiple outcome domains. All five outcome domains were multidimensional and included a variety of subthemes.ConclusionsThis scoping review represents the initial phase of mapping the outcomes reported in primary studies of CEC and identifying gaps in the evidence. The confirmed lack of standardization represents a hindrance to the provision of high quality intervention and CEC scientific progress. Insights gained can inform the development of a core outcome set to standardize outcome measures in CEC evaluation research and enable scientifically rigorous efficacy trials of CEC. (shrink)

ABSTRACTOrganization and management researchers praise the value of care in the workplace. However, they overlook the conflict between caring for work and for coworkers, which resonates with the dilemma of care allocation highlighted by ethicists of care. Through an in-depth qualitative study of two organizations, we examine how this dilemma is confronted in everyday organizational life. We draw on the concept of boundary work to explain how employees negotiate the boundary of their caring responsibilities in ways that grants or denies (...) care to coworkers. We argue that the possibility of an ethics of care for coworkers requires boundary work that suspends the separation of personal and professional selves and constitutes the worker as a whole person. We contribute to research on care in organizations by showing how care for coworkers may be enabled or undermined by maintaining or suppressing the care allocation dilemma. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Far-Future Paleontology: The Baffling Case of Brunaspis enigmaticaAnne-Sophie Milon (bio) and Jan Zalasiewicz (bio)Paleontologists, for more than two centuries, have studied and debated the petrified remains of plants and animals that have evolved over the past three billion years on Earth. They have argued over the grand concepts that they reveal, such as biological evolution and climate change, and also the many specific questions thrown up by these (...) relics: was such-and-such a shell, a mollusk, or an arthropod? Did this fossil fish live high up in the water, among the plankton, or grub in the mud on the sea floor?These studies have for many paleontologists been a blessedly human-free zone, detached from the busy realities of our everyday lives. The science of paleontology, though, is simply one obscure part of a burgeoning and rapidly evolving technosphere that underpins our lives, and that is now evolving millions of new kinds of fossils—technofossils—far more rapidly than ever happened in biological evolution. Many of these objects will, quite certainly, become part of Earth’s future fossil record.If such an endeavor as paleontology were ever to arise again, in a distant post-human future, how would its practitioners deal with these bizarre relics?We provide a preview, on the following pages, of just one such enigma, and how it may be resolved (or not) by our puzzled disciplinary descendants. [End Page 31] Click for larger view View full resolution[End Page 32] Click for larger view View full resolution[End Page 33] Click for larger view View full resolution[End Page 34] Click for larger view View full resolution[End Page 35] Click for larger view View full resolution[End Page 36] Click for larger view View full resolution[End Page 37] Click for larger view View full resolution[End Page 38] Click for larger view View full resolution[End Page 39] Click for larger view View full resolution[End Page 40] Click for larger view View full resolution[End Page 41] Click for larger view View full resolution[End Page 42] Click for larger view View full resolution[End Page 43] Click for larger view View full resolution[End Page 44]Anne-Sophie Milon Anne-Sophie Milon is an artist-researcher who applies her illustration skills (HEAR, Strasbourg, France, 2010) and 2D traditional animation (UWE, Bristol, UK, 2012) to political arts (SPEAP, Sciences Po, 2015) and science and technology studies (HSTS, EHESS, 2022). For the past ten years, she has translated geological narratives–and ordinary ones for Earth sciences–into extraordinary plots for the uninitiated, including the humanities. She is currently working with Jan Zalasiewicz on a play, The Petrified Museum (2024), based on the British Geological Survey (Keyworth, UK), and on a PhD project in science and technology studies looking at limestones’ agencies in extractive industry practices (2025). She regularly collaborates with researchers from the Anthropocene Working Group: The Cosmic Oasis (Oxford University Press, 2022), “The Victims of Carbon Dioxide are Starting to Appear” in Feral Atlas (2021), and The Epochs of Nature (University of Chicago Press, 2016).Jan Zalasiewicz Jan Zalasiewicz is Emeritus Professor of Paleobiology at the University of Leicester. He was formerly a field geologist and paleontologist with the British Geological Survey, involved in the geological mapping of eastern England and central Wales. His interests include Early Paleozoic fossils, notably the graptolites (a kind of extinct zooplankton), mud and mudrocks, the Quaternary Ice Ages, the nature of geological time, and the geology made by humans. In recent years, he has helped develop the concept of an Anthropocene epoch. He enjoys writing popular science articles and books, and being involved in art/science projects.Copyright © 2023 Johns Hopkins University Press and SubStance, Inc... (shrink)

This paper assesses great apes’ abilities for pantomime and action imitation, two communicative abilities proposed as key contributors to language evolution. Modern great apes, the only surviving nonhuman hominids, are important living models of the communicative platform upon which language evolved. This assessment is based on 62 great ape pantomimes identified via data mining plus published reports of great ape action imitation. Most pantomimes were simple, imperative, and scaffolded by partners’ relationship and scripts; some resemble declaratives, some were sequences of (...) several inter-related elements. Imitation research consistently shows great apes perform action imitation at low fidelity, but also that action imitation may not represent a distinct process or function. Discussion focuses on how findings may advance reconstruction of the evolution of language, including what great apes may contribute to understanding ‘primitive’ forms of pantomime and imitation and how to improve their study. (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 death of a research participant raises numerous ethical and legal issues regarding the return of research results to related family members. This question is particularly acute in the context of genetic research since the research results from an individual may be relevant to each of the biological relatives. This paper first investigates the ethical and legal frameworks governing the return of a deceased participant's individual research results to his or her related family members. Then, it weighs the rights and (...) interests of both the deceased individual and related family members in an attempt to identify key ethical considerations underlying the return of such results. This analysis of international guidelines and national laws and regulations reveals that though the legal framework regarding privacy and confidentiality of clinical and research information is well established (albeit not homogenous), guidelines are generally absent in the post-mortem context. Nevertheless, a brief analysis of this issue through two ethical perspectives (principlism and consequentialism) allows us to identify six key elements to be taken into consideration when returning a deceased participant's research results. (shrink)

Because of the transfer of responsibility from hospitals to community-based settings, providers in home-based care have more responsibilities and a wider range of tasks and responsibilities than before, often with limited resources. The increased responsibilities and the complexity of tasks and patient groups may lead to several ethical challenges. A systematic search in the databases MEDLINE, CINAHL, and SveMed+ was carried out in February 2019 and August 2020. The research question was translated into a modified PICO worksheet. A total of (...) 40 articles were included. The review is conducted according to the Vancouver Protocol. The main findings from the systematic literature review show that ethical challenges experienced by healthcare and social care providers in home-based care are related to autonomy and balancing ethical principles, decisions regarding intensity of care, challenges related to priority settings, truth-telling, and balancing the professional role. Findings regarding ethical challenges within home-based care are in line with findings from institutional healthcare and social care settings. However, some significant differences from the institutional context are also highlighted. (shrink)

Ecological accounts of responsible agency claim that moral feedback is essential to the reasons-responsiveness of agents. In this paper, we discuss McGeer’s scaffolded reasons-responsiveness account in the light of two concerns. The first is that some agents may be less attuned to feedback from their social environment but are nevertheless morally responsible agents – for example, autistic people. The second is that moral audiences can actually work to undermine reasons-responsiveness if they espouse the wrong values. We argue that McGeer’s account (...) can be modified to handle both problems. Once we understand the specific roles that moral feedback plays for recognizing and acting on moral reasons, we can see that autistics frequently do rely on such feedback, although it often needs to be more explicit. Furthermore, although McGeer is correct to highlight the importance of moral feedback, audience sensitivity is not all that matters to reasons-responsiveness; it needs to be tempered by a consistent application of moral rules. Agents also need to make sure that they choose their moral audiences carefully, paying special attention to receiving feedback from audiences which may be adversely affected by their actions. (shrink)

As clinical ethics consultants move toward professionalization, the process of certifying individual consultants or accrediting programs will be discussed and debated. With certification, some entity must be established or ordained to oversee the standards and procedures. If the process evolves like other professions, it seems plausible that it will eventually include a written examination to evaluate the core knowledge competencies that individual practitioners should possess to meet peer practice standards. The American Society for Bioethics and Humanities has published core knowledge (...) competencies for many years that are accepted by experts as the prevailing standard. Probably any written examination will be based upon the ASBH core knowledge competencies. However, much remains to be done before any examination may be offered. In particular, it seems likely that a recognized examining board must create and validate examination questions and structure the examination so as to establish meaningful, defensible parameters after dealing with such challenging questions as: Should the certifying examination be multiple choice or short-answer essay? How should the test be graded? What should the pass rate be? How may the examination be best administered? To advance the field of health care ethics consultation, thought leaders should start to focus on the written examination possibilities, to date unaddressed carefully in the literature. Examination models—both objective and written—must be explored as a viable strategy about how the field of health care ethics consultations can grow toward professionalization. (shrink)

This paper attempts to provide a descriptive theoretical overview of the medical futility debate. I will first argue that quantitative data cannot alone resolve the medical futility debate. I will then examine two aspects of medical futility, which I call the prospective and immediate, respectively. The first involves making prospective factual and value judgments about the efficacy of proposed medical interventions, while the latter involves making value judgments about ongoing medical conditions where the clinical data are clear. At stake is (...) the nature and scope of individual rights. Thus, I maintain there is an undeveloped aspect to the medical futility debate and, briefly, analyze two political perspectives which give rise to different understandings of medical futility. The view that I will defend is that only a system with defined collective goals can accommodate a normative concept of medical futility. These larger questions are the value options which, if unaddressed, may be settled by default of economic grounds. (shrink)

I argue that though a satisfactory semantics for the logic of inexact reference may assign no truth value to some statements, it should not assign truth (or falsity) of various degrees. Well-formed assertions are simply true or not. Inexactness does not “ramify.” I distinguish inexactness from other sorts of vagueness, including nonspecificity. I show that arguments from (i) use of quantifiers, (ii) the existence of properties which can be construed as a series of properties (as, e. g., red can be (...) construed as a set of shades of red), (iii) the constructability of apparently paradoxical sorites arguments, and (iv) the presence of prototypes in the extension of a predicate do not show that there are degrees of truth.Much of the alleged evidence that inexactness ramifies is, in fact, a misreading of the undeniable evidence that there may be uncertainty about the truth value of a claim. In support of my claims, I discuss how cases of deeming that a predicate applies relate to its actually applying. A distinction between predicates of “pure” and “impure” function is essential to this. (shrink)

I argue that though a satisfactory semantics for the logic of inexact reference may assign no truth value to some statements, it should not assign truth (or falsity) of various degrees. Well-formed assertions are simply true or not. Inexactness does not “ramify.” I distinguish inexactness from other sorts of vagueness, including nonspecificity. I show that arguments from (i) use of quantifiers, (ii) the existence of properties which can be construed as a series of properties (as, e. g., red can be (...) construed as a set of shades of red), (iii) the constructability of apparently paradoxical sorites arguments, and (iv) the presence of prototypes in the extension of a predicate do not show that there are degrees of truth.Much of the alleged evidence that inexactness ramifies is, in fact, a misreading of the undeniable evidence that there may be uncertainty about the truth value of a claim. In support of my claims, I discuss how cases of deeming that a predicate applies relate to its actually applying. A distinction between predicates of “pure” and “impure” function is essential to this. (shrink)