I explore in this essay an ethically grounded method for structuring a program of study. Rather than attempt to delimit a discipline or to reinforce disciplinarity, I suggest a means of creatively narrowing the scope of research, namely by focusing on inner necessity and conscience. The art of rhetoric as self-discipline is an extension of inner necessity and a framework in which scholars may come to integrate the more rational and more artistic, more public and more private elements of their (...) personalities by exploring the influence of symbols on their lives. By conceptualizing the art of rhetoric as a "self-discipline," I affirm the significance of all these elements and suggest that their harmonious blending will enhance the pleasures and utilities of discourse. (shrink)

An early and persistent criticism of Rahner was his use of transcendental philosophy and his emphasis on human subjectivity, with an attendant loss of concrete historicity and human embodiment. By finding connections between Rahner’s concept of the transcendental and philosopher Ludwig Wittgenstein’s treatment of language and its uses, the article highlights Rahner’s own often-overlooked treatment of human embodiment and concrete historicity. The argument here focuses on the priority of being over appearance, and the necessary connection between intentions and actions, important (...) themes in both men’s thought. (shrink)

Robert Lassalle-Klein’s paper has provided an examination of how Ignatio Ellacuría, working with philosopher Xavier Zubiri, both used and criticized some of Karl Rahner’s key ideas for the purpose of finding a philosophical framework for working out Ellacuría’s own theological vision, rooted in his experiences as a Spanish Jesuit serving in Latin America. While the technical work in this adaptation receives some commentary here, most of my remarks are observations about the impact of this work on Rahner scholarship more generally. (...) Ellacuría’s use of Rahner is in marked contrast to Metz’s critique that saw Rahner’s transcendental method incapable of dealing with historical realities. Ellacuría’s work can be understood as supplying a particularity to Rahner’s austere structures that, I argue, is intrinsic to those structures. As such, Ellacuría’s work should be adopted into the canon of mainstream Rahner scholarship. (shrink)

Gerhard Lenski's classical work on stratification, "Power and Privilege", was an effort to reconcile and to synthesize different approaches to inequality incorporated into the grand theories of the day. It anticipated a variety of developments in the theoretical and empirical understanding of inequalities. These include recognition of the multiplicity of inequalities; emphasis on race, class, gender, and other sources and systems of domination and subordination; and the intersection of these factors in complex patterns to create different standpoints and life consequences. (...) The result was ground-breaking work that underscored the multidimensionality of stratification systems, the variability of their influences, and the notion that their intersection in itself has implications beyond the sum of component parts. In these ways his work foreshadowed the possibilities of finding common ground between modern and postmodern perspectives, to make Lenski the last grand theorist of modernity and a forerunner of postmodern theories of inequality. (shrink)

Premier « organe illustré consacré exclusivement à la femme » (p. 23), la revue Femina a longtemps servi de source de renseignements visuels et textuels sur des personnalités et la vie féminines en France pendant une période où les femmes, même connues, n’ont pas laissé tellement de traces dans les archives. La revue reste toutefois méconnue, ignorée comme objet de recherche, selon l’historien américain Leonard Berlanstein, en raison de son apparence luxueuse et des protestations de non-fémin...

The possibilities for collecting, storing, and processing of data have increased significantly over the last decades. It has been argued that an increasing demand for health data will de...

Anthony Giddens’ theory of structuration is a theory of social action, which claims that society should be understood in terms of action and structure; a duality rather than two separate entities. This paper introduces some of the central characteristics of structuration theory, presenting a conceptual framework that helps to explore how people produce the systems and structures that shape their practice. By understanding how people produce and reproduce structures, then there is the potential for changing them. Criticisms that have been (...) raised about the theory are introduced, followed by examples of how the theory might be useful to nursing research. Structuration theory can be employed to explore how nurses produce, reproduce, and transform nursing practice through social interaction across time and space. (shrink)

This empirical study concerns the authorship credit decision-making processes and outcomes that occur among coauthors in cases of multiauthored publications. The 2002 American Psychological Association (APA) Ethics Code offers standards for determining authorship order; however, little is known about how these decisions are made in actual practice. Results from a survey of 109 randomly selected authors indicated that most authors were satisfied with the decision-making process and outcome with few disagreements. Participants reported cases of both undeserved authorship being given and (...) omission of deserving contributors' names as coauthors. Some factors associated with authorship decisions included "sense of loyalty or obligation," "publish or perish pressures," and "power differentials." Authors who used APA standards were significantly more satisfied with both the process and outcome of authorship credit decisions. (shrink)

In the current study we compared academic locus of control (ALoC) and perceived quality of academic life (PQAL) across three groups of university students: those without disabilities, those with attention deficit disorder or learning disabilities (ADD-LD), and those with other disabilities. Results showed no significant differences in ALoC scores, with each group reporting an internal ALoC. However, students with other disabilities (e.g., sensory, motor, chronic health, and/or mental health) reported significantly lower satisfaction with their overall quality of academic life than (...) students without disabilities. Applied implications are discussed along with recommendations for further research. (shrink)

BackgroundConsent for data research in acute and critical care is complex as patients become at least temporarily incapacitated or die. Existing guidelines and regulations in the European Union are of limited help and there is a lack of literature about the use of data from this vulnerable group. To aid the creation of a patient-centred framework for responsible data research in the acute setting, we explored views of patients and next-of-kin about the collection, storage, sharing and use of genetic and (...) health-related data for observational research.MethodsWe conducted qualitative interviews (n = 19) with Dutch sudden cardiac arrest survivors who donated clinical and socio-economic data and genetic samples to research. We also interviewed their next-of-kin. Topics were informed by ethics literature and we used scenario-sketches to aid discussion of complex issues.ResultsSudden cardiac arrest survivors displayed limited awareness of their involvement in health data research and of the content of their given consent. We found that preferences regarding disclosure of clinically actionable genetic findings could change over time. When data collection and use were limited to the medical realm, patients trusted researchers to handle data responsibly without concern for privacy or other risks. There was no consensus as to whether deferred consent should be explicitly asked from survivors. If consent is asked, this would ideally be done a few months after the event when cognitive capacities have been regained. Views were divided about the need to obtain proxy consent for research with deceased patients’ data. However, there was general support for the disclosure of potentially relevant post-mortem genetic findings to relatives.ConclusionsSudden cardiac arrest patients’ donation of data for research was grounded in trust in medicine overall, blurring the boundary between research and care. Our findings also highlight questions about the acceptability of a one-time consent and about responsibilities of patients, researchers and ethics committees. Finally, further normative investigation is needed regarding the (continued) use of participants’ data after death, which is of particular importance in this setting. Our findings are thought to be of relevance for other acute and life-threatening illnesses as well. (shrink)

This paper offers a conceptualmodel for participatory research projects thataim to improve the sustainability ofagriculture and natural resource management.The purpose of the model is to provide asystematic framework that can guide the designof participatory research projects, theiranalysis, and the documentation of results. Inthe model, conceptual boundaries are drawnbetween research and development, developmentand extension and between extension andimplementation. Objectives, activities, andactors associated with each of these realmsneed to be carefully selected, monitored, andevaluated throughout the course of a projectusing well-designed indicators. The (...) depth ofdisciplinary and methodological integration,and quality of participation needed to reachthe desired impact effectively and efficiently,however, needs to be determined on acase-by-case basis depending on the context andissues surrounding each particular project. (shrink)

Perceived behavioral integrity involves the employee’s perception of the alignment of the manager’s words and deeds. This meta-analysis examined the relationship between perceived behavioral integrity of managers and the employee attitudes of job satisfaction, organizational commitment, satisfaction with the leader and affect toward the organization. Results indicate a strong positive relationship overall (average r = 0.48, p<0.01). With only 12 studies included, exploration of moderators was limited, but preliminary analysis suggested that the gender of the employees and the number of (...) levels between the employee and the manager are potential moderators of the relationship. In the current sample of studies, country where the research was conducted did not seem to have any moderating effects. In addition to suggesting further investigation of potential moderators, we call for research that examines the relationship between behavioral integrity and outcomes that include individual behavior and organizational performance. (shrink)

Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopment advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice.In a letter sent out to 2600 hospitals across the country they [Public Citizen] demand that healthcare facilities “immediately discontinue the distribution of commercial infant formula manufacturer discharge bags,” claiming it undermines women’s success at breastfeeding. What they failed to explain is (...) why a woman’s decision regarding her own tits is anyone’s fucking business but her own.Clearly, policies to promote breast-feeding.. (shrink)

Bishop is a professor of nursing; Scudder is a professor of philosophy.

Developments in medical big data analytics may bring societal benefits but are also challenging privacy and other ethical values. At the same time, an overly restrictive data protection regime can form a serious threat to valuable observational studies. Discussions about whether data privacy or data solidarity should be the foundational value of research policies, have remained unresolved. We add to this debate with an empirically informed ethical analysis. First, experiences with the implementation of the General Data Protection Regulation (GDPR) within (...) a European research consortium demonstrate a gap between the aims of the regulation and its effects in practice. Namely, strictly formalised data protection requirements may cause routinisation among researchers instead of substantive ethical reflection, and may crowd out trust between actors in the health data research ecosystem; while harmonisation across Europe and data sharing between countries is hampered by different interpretations of the law, which partly stem from different views about ethical values. Then, building on these observations, we use theory to argue that the concept of trust provides an escape from the privacy-solidarity debate. Lastly, the paper details three aspects of trust that can help to create a responsible research environment and to mitigate the encountered challenges: trust as multi-agent concept; trust as a rational and democratic value; and trust as method for priority setting. Mutual cooperation in research—among researchers and with data subjects—is grounded in trust, which should be more explicitly recognised in the governance of health data research. (shrink)

In this article, we use the theory of Information Ethics to argue that deceased people have a prima facie moral right to privacy in the context of health data research, and that this should be reflected in regulation and guidelines. After death, people are no longer biological subjects but continue to exist as informational entities which can still be harmed/damaged. We find that while the instrumental value of recognising post-mortem privacy lies in the preservation of the social contract for health (...) research, its intrinsic value is grounded in respect for the dignity of the post-mortem informational entity. However, existing guidance on post-mortem data protection is available only in the context of genetic studies. In comparing the characteristics of genetic data and other health-related data, we identify two features of DNA often given as arguments for this genetic exceptionalism: relationality and embodiment. We use these concepts to show that at the appropriate Level of Abstraction, there is no morally relevant distinction between posthumous genetic and other health data. Thus, genetic data should not automatically receive special moral status after death. Instead we make a plea for ‘contextual exceptionalism’. Our analysis concludes by reflecting on a real-world case and providing suggestions for contextual factors that researchers and oversight bodies should take into account when designing and evaluating research projects with health data from deceased subjects. (shrink)

BackgroundThe emergence of artificial intelligence (AI) in medicine has prompted the development of numerous ethical guidelines, while the involvement of patients in the creation of these documents lags behind. As part of the European PROFID project we explore patient perspectives on the ethical implications of AI in care for patients at increased risk of sudden cardiac death (SCD).AimExplore perspectives of patients on the ethical use of AI, particularly in clinical decision-making regarding the implantation of an implantable cardioverter-defibrillator (ICD).MethodsSemi-structured, future scenario-based (...) interviews were conducted among patients who had either an ICD and/or a heart condition with increased risk of SCD in Germany (n = 9) and the Netherlands (n = 15). We used the principles of the European Commission’s Ethics Guidelines for Trustworthy AI to structure the interviews.ResultsSix themes arose from the interviews: the ability of AI to rectify human doctors’ limitations; the objectivity of data; whether AI can serve as second opinion; AI explainability and patient trust; the importance of the ‘human touch’; and the personalization of care. Overall, our results reveal a strong desire among patients for more personalized and patient-centered care in the context of ICD implantation. Participants in our study express significant concerns about the further loss of the ‘human touch’ in healthcare when AI is introduced in clinical settings. They believe that this aspect of care is currently inadequately recognized in clinical practice. Participants attribute to doctors the responsibility of evaluating AI recommendations for clinical relevance and aligning them with patients’ individual contexts and values, in consultation with the patient.ConclusionThe ‘human touch’ patients exclusively ascribe to human medical practitioners extends beyond sympathy and kindness, and has clinical relevance in medical decision-making. Because this cannot be replaced by AI, we suggest that normative research into the ‘right to a human doctor’ is needed. Furthermore, policies on patient-centered AI integration in clinical practice should encompass the ethics of everyday practice rather than only principle-based ethics. We suggest that an empirical ethics approach grounded in ethnographic research is exceptionally well-suited to pave the way forward. (shrink)

Strengthening the abilities of smallholder farmers in developing countries, particularly women farmers, to produce for both home and the market is currently a development priority. In many contexts, ownership of assets is strongly gendered, reflecting existing gender norms and limiting women’s ability to invest in more profitable livelihood strategies such as market-oriented agriculture. Yet the intersection between women’s asset endowments and their ability to participate in and benefit from agricultural interventions receives minimal attention. This paper explores changes in gender relations (...) and women’s assets in four agricultural interventions that promoted high value agriculture with different degrees of market-orientation. Findings suggest that these dairy and horticulture projects can successfully involve women and increase production, income and the stock of household assets. In some cases, women were able to increase their control over production, income and assets; however in most cases men’s incomes increased more than women’s and the gender-asset gap did not decrease. Gender- and asset-based barriers to participation in projects as well as gender norms that limit women’s ability to accumulate and retain control over assets both contributed to the results. Comparing experiences across the four projects, especially where projects implemented adaptive measures to encourage gender-equitable outcomes, provides lessons for gender-responsive projects targeting existing and emerging value chains for high value products. Other targeted support to women farmers may also be needed to promote their acquisition of the physical assets required to expand production or enter other nodes of the value chain. (shrink)

Sally Gadow influenced our work when we first began exploring the meaning of nursing philosophically. In this article, we discuss two major themes of Gadow's work that have influenced us: existential advocacy and treating the body objectively without reducing the patient to the moral status of an object. Our treatment of these issues is appreciative but not uncritical. We argue that existential advocacy makes an important contribution to the meaning of nursing but that it cannot be its essential meaning. We (...) contend that Gadow, by making self‐direction the essence of care, tends to diminish the intersubjective nature of care. Then we show how Gadow recovers the intersubjective nature of care by disclosing how nurses and patients both become subjects in personal relationships, even when tending to the body objectively. We show how hermeneutic phenomenology, which we favour, can contribute to Gadow's existential phenomenology by using examples from nursing practice to disclose the meaning of nursing. Gadow's major contribution to our work has been in the ways her work has evoked creative thought from us concerning the meaning of nursing. (shrink)

The Greeks attributed to Thales a great many discoveries and achievements. Few, if any, of these can be said to rest on thoroughly reliable testimony, most of them being the ascriptions of commentators and compilers who lived anything from 700 to 1,000 years after his death—a period of time equivalent to that between William the Conqueror and the present day. Inevitably there ilso accumulated round the name of Thales, as round that of Pythagoras , a number of anecdotes of varying (...) degrees of plausibility and of no historical worth whatsoever. These and the achievements credited to Thales have, of course, been painstakingly brought together by Hermann Diels in Der Fragmente der Vorsokratiker. Useful and necessary as this work undoubtedly is, it nevertheless has probably contributed as much as any other book to the exaggerated and false Aew of Thales which we meet in so many modern histories of science or philosophy, and which it is the purpose of this article to combat. (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)

Paul Grobstein, Eleanor A. Bliss Professor of Biology at Bryn Mawr College, Pennsylvania, USA passed away Tuesday, June 28, 2011. Since Paul came to Bryn Mawr in 1986, he taught courses ranging from "Introductory Biology" and "Philosophy of Science" to "Evolution of Stories" and "The Brain and Education." Paul founded the Summer Institutes for K-12 Teachers, which brought hundreds of local educators to campus to consider new ways of teaching science and math. He served as chair of the Biology Department (...) and was instrumental in the establishment and success of the Center for Science in Society at Bryn Mawr College. (shrink)