Severe staffing shortages have emerged as a prominent threat to maintaining usual standards of care during the COVID-2019 pandemic. In dire settings of crisis capacity, healthcare systems assume the ethical duty to maximise aggregate population-level benefit of existing resources. To this end, existing plans for rationing mechanical ventilators and intensive care unit beds in crisis capacity focus on selecting individual patients who are most likely to survive and prioritising these patients to receive scarce resources. However, staffing capacity is conceptually different (...) from availability of these types of discrete resources, and the existing strategy of identifying and prioritising patients with the best prognosis cannot be readily adapted to fit this real-world scenario. We propose that two alternative approaches to staffing resource allocation offer a better conceptual fit: prioritise the worst off: restrict access to acute care services and hospital admission for patients at relatively low clinical risk and prioritise staff interventions with high near-term value: universally restrict selected interventions and treatments that require substantial staff time and/or energy but offer minimal near-term patient benefit. These strategies—while potentially resulting in care that deviates from usual standards–support the goal of maximising the aggregate benefit of scarce resources in crisis capacity settings triggered by staffing shortages. This ethical framework offers a foundation to support institutional leaders in developing operationalisable crisis capacity policies that promote fairness and support healthcare workers. (shrink)

The reality of resource limitation during the Coronavirus Disease 2019 pandemic has deeply challenged established approaches to healthcare system emergency response. Early preparation du...

In the mid-twentieth century American architectural journals, including Architectural Forum, Architectural Record, and Progressive Architecture, routinely ran features on the state of contemporary church architecture in the United States. Rapid suburban expansion and the revival of religious life in the post-Depression, postwar era generated tremendous amounts of construction, with a great deal of work available for architects. This article examines the concerns and hopes of modernist editors in the 1940s–1960s, as they sought to stabilize a “direction” for church architecture. Specifically, (...) it examines the role of the architectural press as the self-established gatekeepers for acceptable church design, and their relationship with theologians, liturgists, and building commissions within the Catholic Church. Questions of authority and expertise lay behind the stark assertions commonplace in these discussions. Editors, generally not themselves Catholic, used their professional positions to weigh in on hot debates within the Catholic Church over the purpose of a church building, the relationship of the Church to modernity, and the appropriateness of new materials and engineering techniques. (shrink)

This essay argues that Catholic (magisterial) social teaching's division of ethics into public and private creates a structural lacuna which makes it almost impossible to envision a truly just situation for migrant domestic careworkers (MDCs) within the current horizon of Catholic social thought. Drawing on a variety of sociological studies, I conclude that it is easy for MDCs to “disappear” between two countries, two families, and, finally, two sets of ethical norms. If the magisterium genuinely wishes Catholic ethicists to address (...) the plight of these migrant women, normative Catholic social teaching must pay more attention to household sociological realities and more fully absorb the feminist critique of the sharp line between the public and the private, between care and paid work. (shrink)

Praise is a common feature of interpersonal interaction. It is used to encourage, socialize, ingratiate, seduce, reward, and influence other people. These assorted usages reflect a widespread belief in the efficacy of praise for altering the behaviour and affective state of the recipient. Despite this assumed power of praise, and despite its salience and frequency in human social interaction, research interest in praise has been sporadic and intermittent, and not united within an all-embracing theoretical model.In this article we will present (...) an analysis of the effects of praise. We will begin by considering how to define praise. Next, we will examine the view of praise as social reinforcement, a conception which roots praise firmly within an empiricist framework; this appears to have been the predominant theoretical view guiding previous research on praise. We will conclude, however, that this view is conceptually inadequate to account for the empirical evidence. Because of that conclusion, our next step will be to provide a novel examination of the likely processes and consequences involved in praise. The remainder of the article will then be devoted to examining, where it is available, empirical evidence relevant to our analysis. (shrink)

Slavoj Zizek is the most popular and discussed philosopher in the world today. His prolific writings - across philosophy, psychoanalysis, political and social theory, film, music and religion - always engage and provoke. The power of his ideas, the breadth of his references, his capacity for playfulness and confrontation, his willingness to change his mind and his refusal fundamentally to alter his argument - all have worked to build an extraordinary international readership as well as to elicit much critical reaction. (...) The Zizek Dictionary brings together leading Zizek commentators from across the world to present a companion and guide to Zizekian thought. Each of the 60 short essays examines a key term and, crucially, explores its development across Zizek's work and how it fits in with other concepts and concerns. The dictionary will prove invaluable both to readers coming to Zizek for the first time and to those already embarked on the Äi§ekian journey. (shrink)

Online participation in research is used increasingly to recruit geographically dispersed populations. Obtaining online consent is convenient, yet we know little about the acceptability of this practice. We carried out a serostudy among personnel returning to the UK/Ireland following deployment to West Africa during the 2014–2016 Ebola epidemic. We used an online procedure for consenting returnees and designed a small descriptive study to understand: how much of the consent material they read, how informed they felt and if they preferred online (...) to traditional face-to-face consent. Of 261 returnees, 111 completed the consent survey. Participants indicated a high level of engagement with the consent materials, with 67 per cent reporting having read all and 20 per cent having read ‘most’ of the materials. All participants indicated feeling completely or mostly informed about the purpose, methods and intended uses of the research, as well as what participation was required and what risks were involved. Only three participants indicated a preference for face-to-face consent. Free-text comments suggested that online consent may be an acceptable modality for uncomplicated and low-risk studies. The study sample was largely composed of health professionals, suggesting acceptability of online consent within this population. (shrink)

Anorexia nervosa and obsessive–compulsive disorder are commonly reported to co-occur and present with overlapping symptomatology. Executive functioning difficulties have been implicated in both mental health conditions. However, studies directly comparing these functions in AN and OCD are extremely limited. This review provides a synthesis of behavioral and neuroimaging research examining executive functioning in AN and OCD to bridge this gap in knowledge. We outline the similarities and differences in behavioral and neuroimaging findings between AN and OCD, focusing on set shifting, (...) working memory, response inhibition, and response monitoring. This review aims to facilitate understanding of transdiagnostic correlates of executive functioning and highlights important considerations for future research. We also discuss the importance of examining both behavioral and neural markers when studying transdiagnostic correlates of executive functions. (shrink)

This chapter contains sections titled: Catherine Malabou : “Unbind Me” Judith Butler : What Kind of Shape Is Hegel's Body in? Catherine Malabou : What Is Shaping the Body? Judith Butler : A Chiasm between Us, but No Chasm.

There is a growing literature which examines the ways in which individualised responsibilisation of ' risky behaviours' also entails moralisation. In UK discourses about climate change, certain individualised behaviours are designated as responsible and/or good and correspondingly as irresponsible and/or bad. In this context, the decision to engage or not engage in these types of behaviour can be seen as becoming increasingly moralised. Drawing on focus group discussions with members of the British lay public, this paper brings together public production (...) of and negotiated responses to the moral undertones of this aspect of climate change discourse with theories of risk, morality and responsibility to develop important insights for conceptualising climate change mitigation. (shrink)

The research described here contributes to the extant empirical research on business ethics education by examining outcomes drawn from the literature on positive organizational scholarship (POS). The general research question explored is whether a course on ethical decision-making in business could positively influence students’ confidence in their abilities to handle ethical problems at work (i.e., moral efficacy), boost the relative importance of ethics in their work lives (i.e., moral meaningfulness), and encourage them to be more courageous in raising ethical problems (...) at work even if it is unpopular (i.e., moral courage). Specifically, the study used a rigorous quasi-experimental pretest–posttest research design with a treatment (N = 30) and control group (N = 30) to investigate whether a graduate-level course in business ethics could influence students’ levels of moral efficacy, meaningfulness, and courage. Findings revealed that participants in the business ethics treatment course experienced significant positive increases in each of the three outcome variables as compared to the control group. The largest increase was in moral efficacy, followed by moral courage, and finally, moral meaningfulness. These findings are discussed in the context of the current research on business ethics education and POS. Implications for future research are discussed. (shrink)

Noninvasive prenatal testing (NIPT) has become widely available in recent years. While initially used to screen for trisomies 21, 18, and 13, the test has expanded to include a range of other conditions and will likely expand further. This paper addresses the ethical issues that arise from one particularly controversial potential use of NIPT: screening for adult‐onset conditions (AOCs). We report data from our quantitative survey of Australian NIPT users' views on the ethical issues raised by NIPT for AOCs. The (...) survey ascertained support for NIPT for several traits and conditions including AOCs. Participants were then asked about their level of concern around implications of screening for AOCs for the future child and parent(s). Descriptive and comparative data analyses were conducted. In total, 109 respondents were included in data analysis. The majority of respondents expressed support for NIPT screening for preventable (70.9%) and nonpreventable AOCs (80.8%). Most respondents indicated concern around potential harmful impacts associated with NIPT for AOCs, including the psychological impact on the future child and on the parent(s). Despite this, the majority of participants thought that continuation of a pregnancy known to be predisposed to an AOC is ethically acceptable. The implications of these data are critically discussed and used to inform the normative claim that prospective parents should be given access to NIPT for AOCs. The study contributes to a body of research debating the ethical acceptability and regulation of various applications of NIPT as screening panels expand. (shrink)

ABSTRACTFacial stimuli are widely used in behavioural and brain science research to investigate emotional facial processing. However, some studies have demonstrated that dynamic expressions elicit stronger emotional responses compared to static images. To address the need for more ecologically valid and powerful facial emotional stimuli, we created Dynamic FACES, a database of morphed videos from younger, middle-aged, and older adults displaying naturalistic emotional facial expressions. To assess adult age differences in emotion identification of dynamic stimuli and to provide normative ratings (...) for this modified set of stimuli, healthy adults categorised for each video the emotional expression displayed, rated the expression distinctiveness, estimated the age of the face model, and rated the naturalness of the expression. We found few age differences in emotion identification when using dynamic stimuli. On... (shrink)

Literary Studies Deconstructed critiques the state of Literary Studies in the modern university and argues for its comprehensive reconstruction. It argues that Literary Studies as currently practised avoids engaging with much of literary experience and prioritises instead the needs of critics as a professional community: to teach and assess students, to demonstrate the creation of knowledge, and to meet the demands of governments, funders and other bodies. The result is that many areas centrally important to lay readers are largely omitted (...) from critical discussion. Moreover, critical writing and its conventions are framed so as to mask and repress the subject's contradictions. This lively and provocative book will be of interest to undergraduate and postgraduate students with an interest in the critical profession or literary theory, as well as to Literary Studies academics. (shrink)

Background: The factors influencing parents’ willingness to enroll their children in biobanks are poorly understood. This study sought to assess parents’ willingness to enroll their children, and their perceived benefits, concerns, and information needs under different consent and data-sharing scenarios, and to identify factors associated with willingness. Methods: This large, experimental survey of patients at the 11 eMERGE Network sites used a disproportionate stratified sampling scheme to enrich the sample with historically underrepresented groups. Participants were randomized to receive one of (...) three consent and data-sharing scenarios. Results: In total, 90,000 surveys were mailed and 13,000 individuals responded (15.8% response rate). 5737 respondents were parents of minor children. Overall, 55% (95% confidence interval 50–59%) of parents were willing to enroll their youngest minor child in a hypothetical biobank; willingness did not differ between consent and data-sharing scenarios. Lower educational attainment, higher religiosity, lower trust, worries about privacy, and attitudes about benefits, concerns, and information needs were independently associated with less willingness to allow their child to participate. Of parents who were willing to participate themselves, 25% were not willing to allow their child to participate. Being willing to participate but not willing to allow one’s child to participate was independently associated with multiple factors, including race, lower educational attainment, lower annual household income, public health care insurance, and higher religiosity. Conclusions: Fifty-five percent of parents were willing to allow their youngest minor child to participate in a hypothetical biobank. Building trust, protecting privacy, and addressing attitudes may increase enrollment and diversity in pediatric biobanks. (shrink)

Considered together, Butler and Whitehead draw from a wide palette of disciplines to develop distinctive theories of becoming, of syntactical violence, and creative opportunities of limitation. The contributors of this volume offer a unique contribution to and for the humanities in the struggles of politics, economy, ecology, and the arts.

Angels are the ultimate stranger. They come from another world and have a special place in the art of the Russian Jewish painter Marc Chagall (1887-1985). In My Life (1923) the young Chagall recalls one memorable night in Saint-Petersburg. Drifting into sleep in the corner of a room (all he could afford) he suddenly saw the ceiling open and a winged being, surrounded by light and blue air, hovered above him before disappearing through the ceiling again.

Ethical reasoning and decision-making may be thought of as 9professional skills9, and in this sense are as relevant to efficient clinical practice as the biomedical and clinical sciences are to the diagnosis of a patient9s problem. Despite this, however, undergraduate medical programmes in ethics tend to focus on the teaching of bioethical theories, concepts and/or prominent ethical issues such as IVF and euthanasia, rather than the use of such ethics knowledge (theories, principles, concepts, rules) to clinical practice. Not surprisingly, many (...) students and clinicians experience considerable difficulty in using what they know about ethics to help them make competent ethical decisions in their day-to-day clinical practice. This paper describes the development of a seminar programme for teaching senior medical students a more systematic approach to ethical reasoning and analysis and clinical decision-making. (shrink)

In a world surrounded by smart objects from sensors to automated medical devices, the ubiquity of ‘smart’ seems matched only by its lack of clarity. In this article, we use our discussions with expert stakeholders working in areas of implantable medical devices such as cochlear implants, implantable cardiac defibrillators, deep brain stimulators and in vivo biosensors to interrogate the difference facets of smart in ‘implantable smart technologies’, considering also whether regulation needs to respond to the autonomy that such artefacts carry (...) within them. We discover that when smart technology is deconstructed it is a slippery and multi-layered concept. A device’s ability to sense and transmit data and automate medicine can be associated with the ‘sting’ of autonomy being disassociated from human control as well as affecting individual, group, and social environments. (shrink)

The problem of how to make the transition to a more environmentally and socially sustainable society poses questions about how such far-reaching social change can be brought about. In recent years, lifecourse transitions have been identified by a range of researchers as opportunities for policy and other actors to intervene to change how individuals use energy, taking advantage of such disruptive transitions to encourage individuals to be reflexive toward their lifestyles and how they use the technological infrastructures on which they (...) rely. Such identifications, however, employ narratives of voluntary change that take an overly optimistic view of how individuals experience lifecourse transitions and ignore effects of experiences of unresolved or unsuccessful transitions. Drawing on interview data from the Energy Biographies project at Cardiff University, we explore three case studies where the effects of such unresolved transitions are significant. Using the concept of liminal transition as developed by Victor Turner, we examine instances where “progressive” narratives of energy use reduction clash with other “narrative genres” used to make sense of change. Such clashes show how narratives that view lifecourse transitions as opportunities ignore the challenges that such transitions may pose to efforts to construct or sustain identities. (shrink)

Evidence that placebo acupuncture is an effective treatment for chronic pain presents a puzzle: how do placebo needles appearing to patients to penetrate the body, but instead sitting on the skin’s surface in the manner of a tactile stimulus, evoke a healing response? Previous accounts of ritual touch healing in which patients often described enhanced touch sensations suggest an embodied healing mechanism. In this qualitative study, we asked a subset of patients in a singleblind randomized trial in irritable bowel syndrome (...) to describe their treatment experiences while undergoing placebo treament. Analysis focused on patients’ unprompted descriptions of any enhanced touch sensations and any significance patients assigned to the sensations. We found in 5/6 cases, patients associated sensations including “warmth” and “tingling” with treatment efficacy. The conclusion offers a “neurophenomenological” account of the placebo effect by considering dynamic effects of attentional filtering on early sensory cortices, possibly underlying the phenomenology of placebo acupuncture. (shrink)

The purpose of this study was to identify the relative contribution of individual and contextual predictors to students’ attitudes toward the acceptability of cheating and plagiarism. A group of 324 students from a tertiary institution in New Zealand completed an online survey. The findings indicate that gender, justice sensitivity, and understanding of university policies regarding academic dishonesty were the key predictors of the students’ attitudes toward the acceptability of cheating and plagiarism, both as agents of dishonest conduct and as witnesses (...) of misconduct among their peers. The implications of these findings for the development of policies and initiatives in tertiary institutions are discussed. (shrink)

R. J. Butler; VIII*—Substance Un-Locked, Proceedings of the Aristotelian Society, Volume 74, Issue 1, 1 June 1974, Pages 131–160, https://doi.org/10.1093/aristo.

R. J. Butler; VIII*—Substance Un-Locked, Proceedings of the Aristotelian Society, Volume 74, Issue 1, 1 June 1974, Pages 131–160, https://doi.org/10.1093/aristo.

The main objective of this essay is to validate some of the principal, currently competing, mammalian consciousness-brain theories by comparing these theories with data on both cognitive abilities and brain organization in birds. Our argument is that, given that multiple complex cognitive functions are correlated with presumed consciousness in mammals, this correlation holds for birds as well. Thus, the neuroanatomical features of the forebrain common to both birds and mammals may be those that are crucial to the generation of both (...) complex cognition and consciousness. The general conclusion is that most of the consciousness-brain theories appear to be valid for the avian brain. Even though some specific homologies are unresolved, most of the critical structures presumed necessary for consciousness in mammalian brains have clear homologues in avian brains. Furthermore, considering the fact that the reptile-bird brain transition shows more structural continuity than the stem amniote-mammalian transition, the line drawn at the origin of mammals for consciousness by several of the theorists seems questionable. An equally important point is that consciousness cannot be ruled out in the absence of complex cognition; it may in fact be the case that consciousness is a necessary prerequisite for complex cognition. (shrink)

Over the past decade, non-invasive prenatal testing (NIPT) has been adopted into routine obstetric care to screen for fetal sex, trisomies 21, 18 and 13, sex chromosome aneuploidies and fetal sex determination. It is predicted that the scope of NIPT will be expanded in the future, including screening for adult-onset conditions (AOCs). Some ethicists have proposed that using NIPT to detect severe autosomal AOCs that cannot be prevented or treated, such as Huntington’s disease, should only be offered to prospective parents (...) who intend to terminate a pregnancy in the case of a positive result. We refer to this as the ‘conditional access model’ (CAM) for NIPT. We argue against CAM for NIPT to screen for Huntington’s disease or any other AOC. Next, we present results from a study we conducted in Australia that explored NIPT users’ attitudes regarding CAM in the context of NIPT for AOCs. We found that, despite overall support for NIPT for AOCs, most participants were not in favour of CAM for both preventable and non-preventable AOCs. Our findings are discussed in relation to our initial theoretical ethical theory and with other comparable empirical studies. We conclude that an ‘unconditional access model’ (UAM), which provides unrestricted access to NIPT for AOCs, is a morally preferable alternative that avoids both CAM’s fundamental practical limitations and the limitations it places on parents’ reproductive autonomy. (shrink)

The progression of research and scholarly inquiry does not occur in isolation and is wholly dependent on accurate reporting of methods and results, and successful replication of prior work. Without mechanisms to correct the literature, much time and money is wasted on research based on a crumbling foundation. These guidelines serve to outline the respective responsibilities of researchers, institutions, agencies, and publishers or editors in maintaining the integrity of the research record. Delineating these complementary roles and proposing solutions for common (...) barriers provide a foundation for best practices. (shrink)

Abstract:While a ubiquitous phenomenon, initial public offerings (IPOs) have received no attention in the ethics literature. We provide an overview of a series of potential conflicts of interest that pervade the IPO process. We also report the results of an empirical assessment of IPOs and those elements that may inform a substantive moral hazard faced by key players in the period prior to and just after an IPO.

The current study examines patterns of attachment/self-protective strategies and rates of unresolved loss/trauma in children and adolescents presenting to a multidisciplinary gender service. Fifty-seven children and adolescents (8.42–15.92 years; 24 birth-assigned males and 33 birth-assigned females) presenting with gender dysphoria participated in structured attachment interviews coded using dynamic-maturational model (DMM) discourse analysis. The children with gender dysphoria were compared to age- and sex-matched children from the community (non-clinical group) and a group of school-age children with mixed psychiatric disorders (mixed psychiatric (...) group). Information about adverse childhood experiences (ACEs), mental health diagnoses, and global level of functioning was also collected. In contrast to children in the non-clinical group, who were classified primarily into the normative attachment patterns (A1-2, B1-5, and C1-2) and who had low rates of unresolved loss/trauma, children with gender dysphoria were mostly classified into the high-risk attachment patterns (A3-4, A5-6, C3-4, C5-6, and A/C) (χ2= 52.66;p< 0.001) and had a high rate of unresolved loss/trauma (χ2= 18.64;p< 0.001). Comorbid psychiatric diagnoses (n= 50; 87.7%) and a history of self-harm, suicidal ideation, or symptoms of distress were also common. Global level of functioning was impaired (range 25–95/100; mean = 54.88;SD= 15.40; median = 55.00). There were no differences between children with gender dysphoria and children with mixed psychiatric disorders on attachment patterns (χ2= 2.43;p= 0.30) and rates of unresolved loss and trauma (χ2= 0.70;p= 0.40).Post hocanalyses showed that lower SES, family constellation (a non-traditional family unit), ACEs—including maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence)—increased the likelihood of the child being classified into a high risk attachment pattern. Akin to children with other forms of psychological distress, children with gender dysphoria present in the context of multiple interacting risk factors that include at-risk attachment, unresolved loss/trauma, family conflict and loss of family cohesion, and exposure to multiple ACEs. (shrink)

Many areas of business ethics research are “sensitive.” We provide an empirical assessment of the randomized response techniquewhich provides absolute anonymity to subjects and “legal immunity” to the researcher. Beyond that, RRT techniques provide complete disclosure to subjects, unconditional privacy is maintained, and there is no deception.