The recent production of major treatises devoted to elaborating normative ethical theories and the eruption of lively debates concerning the merits of opposed normative systems have been greeted with applause. This reaction is an historical about-face, since for forty or fifty years “ethical” treatises had been attacking the pretensions of traditional moral philosophy, calling for its demise or at the least severely limiting its claims. These skeptical attacks had succeeded in seriously undermining the academic status of moral philosophy and consequently (...) moral philosophy was transformed into “metaethics,” a highly abstract and technical discipline considered much less necessary to the general education of students than what it replaced and with a diminished role in the curriculum. The recent resurgence of interest in normative ethics has generally been lauded as a sign that philosophy has rededicated itself to its proper and time-honored tasks. There is a widespread feeling that the overblown claims of twentieth century skepticism have been whittled down to innocuous proportions and thus that nothing stands in the way of proceeding to construct ethical theories. The study of normative ethical theory now enjoys such respectability and popularity that it is difficult to raise once more the uncomfortable ideas that the ideal of normative ethical theory is a false one, that vanquishing the spectre of noncognitivism is not sufficient for legitimizing it, and that the popular new justifications for the enterprise fail in mischievous ways. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

Those who urge “realism” in foreign policy making tend to see the American habit of looking at foreign policy in moral terms as a sign of national immaturity or youthful idealism: a good insofar as this trait gives the United States its peculiar vigor, but dangerous and irresponsible insofar as it distorts perception and in the end amounts to “wishful thinking.” This is not to say, of course, that realists believe that the United States has always acted in accordance with (...) what it judged to be morally correct or even that most policy makers have shown such moral concern, but that, by and large, questions of morals and “ideals” arise frequently and are taken seriously in American foreign policy. Henry Kissinger finds men such as Castlereagh and Metternich admirable and imitable just because of their “realism,” their refusal to operate on the basis of “faith” in universal values, and their “coldblooded,” unsentimental submission to the facts. Statesmen and national leaders must attempt to “harmonize the just with the possible,” which in practice turns out not to mean “be as just as possible” ; rather, it means that nations are to choose their ends, or determine what is in their interest, according to their own ideals of justice, and then pursue them by whatever means are possible. This is the point of view Kissinger and other realists recommend. It is the attitude which they believe has prevailed in the diplomacy of other nations at certain times in history and which they judge to be necessary for a mature American foreign policy. (shrink)

Health promotion involves social and environmental interventions designed to benefit and protect health. It often harmfully impacts the environment through air and water pollution, medical waste, g...

An unlinked seroprevalence study of HIV and other viruses was conducted on pregnant women on the Caribbean island of Grenada in 1994. Investigators were from both the developed world and the Grenadian Ministry of Health . There was then no board on Grenada to protect research subjects or review ethical aspects of studies. Nurses from the MOH were asked to verbally inform their patients about the study, and request that patients become subjects of the study and give blood for screening. (...) If consent was given nurses took blood and administered a survey about each subjects' knowledge of HIV transmission routes. Nurses shared a spoken dialect and cultural heritage with prospective subjects and were probably more effective than foreign researchers at informing subjects. Informed consent was obtained with a simplified consent form supplemented by conversation with each prospective research subject. Facilitating discussion between people with common cultural backgrounds helps apply the Western approach to informed consent to communities in the developing world. Researchers must disclose all information to nurses or other mediators, and ensure that nurses disclose as much information as possible to prospective subjects. So modified, informed consent maintains respect for persons and becomes applicable and relevant to various cultures. (shrink)

An unlinked seroprevalence study of HIV and other viruses was conducted on pregnant women on the Caribbean island of Grenada in 1994. Investigators were from both the developed world and the Grenadian Ministry of Health . There was then no board on Grenada to protect research subjects or review ethical aspects of studies. Nurses from the MOH were asked to verbally inform their patients about the study, and request that patients become subjects of the study and give blood for screening. (...) If consent was given nurses took blood and administered a survey about each subjects' knowledge of HIV transmission routes. Nurses shared a spoken dialect and cultural heritage with prospective subjects and were probably more effective than foreign researchers at informing subjects. Informed consent was obtained with a simplified consent form supplemented by conversation with each prospective research subject. Facilitating discussion between people with common cultural backgrounds helps apply the Western approach to informed consent to communities in the developing world. Researchers must disclose all information to nurses or other mediators, and ensure that nurses disclose as much information as possible to prospective subjects. So modified, informed consent maintains respect for persons and becomes applicable and relevant to various cultures. (shrink)

Globally, one of every eight nurses is a migrant, but few studies have focused on the healthcare experiences of migrant nurses (MNs) as consumers or recipients of healthcare. We address this gap by examining MNs and their acculturation, barriers to healthcare access, and perceptions of healthcare encounters as consumers. For this mixed‐methods study, a convenience sample of MNs working in Europe and Israel was recruited. The quantitative component's methods included testing the reliability of scales contained within the questionnaire and using (...) Hayes Process Model #4 to test for mediation. The qualitative component's methods included analyzing interviews with iterative inductive thematic analysis. Quantitative findings on MNs (n = 73) indicated that the association between acculturation and perception of the healthcare encounter, which MNs experienced as healthcare consumers, was mediated by barriers to healthcare access, even after adjusting for age and gender (p = 0.03). Qualitative interviews with MNs (n = 13) provided possible explanations for the quantitative findings. Even after working in the host country's healthcare system for several years, MNs reported difficulties with their healthcare encounters as healthcare consumers, not only due to their limited knowledge about the culture and healthcare resources but also due to the biased responses they received. (shrink)

For those with advanced life-limiting illness, the optimization of quality of life and avoidance of nonbeneficial treatments at the end of life are key ethical concerns. This article evaluates the efficacy of an Interdisciplinary Ethics Panel (IEP) approach to decision making at the end of life for unbefriended nursing home residents who lack decisional capacity and have advanced life-limiting illness, through the use of a ninestep algorithm developed for this purpose. We reviewed the outcomes of three quality-of-care phased initiatives conducted (...) in our facility, a large public nursing home in New York City, between June 2016 and February 2020, which indicated that this IEP approach promoted advance-care planning, as palliative measures were endorsed to optimize quality of life for this vulnerable population at the end of life. We also examined another quality-of-care initiative when this IEP approach was applied to end-of-life decision making for nursing home residents who had a surrogate during the COVID-19 pandemic. This application appeared to be beneficial in adding more residents to our Palliative Care Program while it improved rates of advance-care planning. When all of the above findings are considered, we believe this novel IEP approach and algorithm have the potential to be applied elsewhere after appropriate assessment. (shrink)

Human service managers are called on to make a variety of difficult decisions that often involve fundamental conflicts in values. Such conflicts constitute ethical dilemmas. This qualitative exploratory study examines how human service managers (N = 40), from the United States, identify and resolve ethical dilemmas. The dilemmas identified by the managers tended to result in the restriction of missions, programs, services and practice methods. The resolution of these ethical problems often rested on following the very rules that created the (...) dilemmas. Additional strategies included consultations and reliance on abstract principles, specifically those of one's spiritual faith. Missing, however, were systematic or evidence-based procedures for resolving challenges that often threatened the very goals of the human service agencies. The need for more careful training in the area of ethical problem solving that maintains the vision of human services is presented. (shrink)

In this article, we examine how the U.N. Convention on the Rights of the Child can be useful in pediatric bioethics. Adopted in 1989, the CRC reflects norms that have been deliberated upon for a long period of time and endorsed by most nations. The United States is now the only country that has not ratified the CRC.1 International human rights law shares many key moral concepts with clinical pediatric bioethics, and the CRC provides a considered language common to many (...) jurisdictions that can assist bioethicists in their daily practice and help health-care organizations in their policy development and international interactions. There may, however, be practical challenges with using the CRC in the practice of.. (shrink)

The explicit objective for the 2014 Symposium hosted by the University of North Florida, which serves as the basis for this collection of papers, was to explore the relationship and potential for mutual support between the disciplines of child rights and pediatric bioethics in advancing the health and well-being of children in the United States and around the world. The U.N. Convention on the Rights of the Child served as the locus for this discussion. A significant question emerged in the (...) Symposium about whether the CRC could serve any beneficial purpose in the United States, where it has not yet been ratified. Further, there was.. (shrink)

The purpose of this study was to describe the extent to which nurses perceive the ethical dimensions of clinical practice situations involving patients, families and health care professionals. Using the composite theory of basic moral principles and the professional standard of care established by legal custom as a framework, situations involving ethical dilemmas were gleaned from the nursing literature. They were reviewed for content validity, clarity and representativeness in a two-stage process by expert panels. The situations were presented in a (...) written format to a convenience sample of nurses (n = 125), who were primarily staff nurses (65.6%). Respondents' judgements about whether the main issue of each situation concerned ethics ranged from a low of 0.8% to a high of 40%. From analyses of the categories into which the majority of subjects placed each situation, it was concluded that these nurses generally perceived ethics as the main issue in situations that directly involve patients' autonomy. Analysis yielded unanticipated findings about the themes in ethical situations to which nurses in practice may respond. (shrink)

Mr. G. B. KERFERD, in C.Q. xlviii , 84 ff. writes of ‘Plato's Noble Art of Sophistry’. He suggests that Plato thought there was a ‘Noble Art’ of sophistry, other than philosophy itself; and he seeks to find this Art in the better and worse arguments of Protagoras. This suggestion is, unfortunately, based on a mistranslation of Plato, Sophist 231 a:.

Potraits of teacher relationship through a systematic view of the history of the development of Vietnamese education and to prove the noble traditions.

An objective, honest, impartial history of our country's philosophy in the Soviet period—in a word, a history meeting the requirements of the times—is yet to be written. But it is much needed. Its creation is one of the most important, but perhaps also one of the most difficult of our tasks. There are still many superimposed layers that must be peeled away: for example, the bitter truth must be told about those who inscribed in this history—of course honorifically—their own names (...) and those of dogmatists who shared their ideas. But fortunately, it is not only naked emperors and their stooges, not only their subjects with their mutilated destinies, who will figure in a historical narration oriented toward the truth and facts. This grim context makes even brighter the noble role played by those figures—personalities in the highest sense of the word—whose names, works, and very lives were simply "expunged" from history. And by those who remained alive and in philosophy in the direst times, those who despite all the persecution, all the tribulations they endured, abandoned neither their honor nor philosophical truth. The unofficial authority of talented, creatively thinking scholars has always been extremely high. One of those highly authoritative philosophers of our country, one who today has an international name, was Valentin Ferdinandovich Asmus. (shrink)

Deep and universal spirituality is evident in the life and teachings of all the founders of great world faiths. Over time, however, it gets clouded under the institutional and doctrinal structure of the religion that surrounds it. This book, Interfaith Spirituality: Toward Universal Faith beyond Dogmas, by Ramesh N. Patel, stands out by emphasizing and articulating the noble and inspirational spirituality of world faiths, Eastern and Western. The faiths chosen for narration are Judaism, Christianity, Islam, Taoism, Confucianism, Buddhism and (...) Hinduism. -/- The book goes farther than bringing out the spirituality of Eastern and Western faiths. For, it offers intellectually sound thinking toward relieving the age-old tensions between faiths, such as the numinous and the mystical, monotheism and non-dualism, privileging of believers against open-ended tolerance of differences and so on. -/- A further standout feature of the book is its diving deep to pick out pearls of spiritual wisdom from the world faiths and weaving them into thoughtful necklaces which it calls thought experiments in world spirituality. To top it all is offered an optimal universal spirituality that is comprehensive in scope and universal in application. It manifests a flower with spiritual outlines in four petals of work, faith, concept and contemplation. Spiritual seekers from diverse dimensions of life will find this useful and supportive. -/- The book, Interfaith Spirituality, thus is not just innovative. It offers a message of healing and calming moderation for a world that is torn by polarizing conflicts of various sorts. (shrink)

This commentary explores biological models of analogical and associative learning in support of Illusion 1 and Illusion 4 in D. Noble’s target article. The intent is to support Noble’s theses of emergent higher level functionality from lower level stochastic dynamics and his etiological claim that “there is no privileged level of causation” through a biosemiotic lens. Upon these arguments, a case for creative agency via higher-dimensional constraints will also be made in support of Noble’s claim that organismic (...) behavior is actively directed by an agent. (shrink)

The relationship between religion and education in the Minahasa community still receives inadequate attention. One local wisdom that has experienced degradation of its noble values over the years is the mapalus culture. Therefore, it is imperative to construct and manage Christian Religious Education (CRE) in Minahasa due to its ability to properly accommodate religious values and issues or local culture. This study tries to determine the right management values in mapalus culture that can contribute to CRE development in Minahasa. (...) Data were descriptively collected from articles, books, and interview information from community leaders. The result showed that solidarity and discipline management are elements of mapalus that have the potential to be synergized with CRE management. Contribution: The research's main contribution is to offer mapalus values to the CRE management development. This finding could be a formula for other context and future agenda that could bring together education, religion and culture. (shrink)

What were Shakespeare's final thoughts on history, tragedy, and comedy? Shakespeare's Last Plays focuses much needed scholarly attention on Shakespeare's "Late Romances." The work--a collection of newly commissioned essays by leading scholars of classical political philosophy and literature--offers careful textual analysis of Pericles, Prince of Tyre, Cymbeline, The Winter's Tale, The Tempest, All is True, and The Two Noble Kinsmen. The essays reveal how Shakespeare's thought in these final works compliments, challenges, fulfills, or transforms previously held conceptions of the (...) playwright and his political-philosophical views. (shrink)

Resumen El artículo revisa los discursos de viaje dentro de dos relatos escritos por mujeres durante el período imperialista del fin de siècle, quienes viajaron por espacios marginales a la modernidad. La primera autora es Florence Dixie, noble inglesa que escribe su relato de viaje a la Patagonia durante 1879, mientras que Iris, mujer igualmente aristócrata y chilena, escribe su periplo realizado por el lago Ranco en 1910. Independiente de la nacionalidad de origen de estas mujeres y sus diferencias (...) personales, en tanto el rol jugado por ellas en el grupo de expedición, ambas escritoras viajeras son depositarias de una mirada imperial, que se vuelca en la manera que se internan narrativamente por los espacios explorados.The article reviews the journey discourses in two narratives written by two women during the imperialist period of the fin de siècle, who traveled through marginal spaces to modernity. The first author is Florence Dixie, an English noblewoman who writes her travelogue to Patagonia during 1879, while Iris, an equally aristocratic, and Chilean woman, writes her journey made through Ranco lake in 1910. Independent of nationality of origin of these women and their personal differences, as long as the role played by them in the expedition group, both traveling writers are repositories of an imperial gaze, that shows in the way they go into theirs narrative through the spaces explored. (shrink)

An apparent paradox is obtained in all previous treatments of the Trouton–Noble experiment; there is a three-dimensional (3D) torque T in an inertial frame S in which a thin parallel-plate capacitor is moving, but there is no 3D torque T′ in S′, the rest frame of the capacitor. Different explanations are offered for the existence of another 3D torque, which is equal in magnitude but of opposite direction giving that the total 3D torque is zero. In this paper, it (...) is considered that 4D geometric quantities and not the usual 3D quantities are well-defined both theoretically and experimentally in the 4D spacetime. In analogy with the decomposition of the electromagnetic field F (bivector) into two 1-vectors E and B we introduce decomposition of the 4D torque N (bivector) into 1-vectors N s , N t . It is shown that in the frame of “fiducial” observers, in which the observers who measure N s and N t are at rest, and in the standard basis, only the spatial components $N_{s}^{i}$ and $N_{t}^{i}$ remain, which can be associated with components of two 3D torques T and T t . In such treatment with 4D geometric quantities the mentioned paradox does not appear. The presented explanation is in complete agreement with the principle of relativity and with the Trouton–Noble experiment without the introduction of any additional torque. (shrink)

C.S. Peirce, the founder of pragmatism, argued that truth is what we would agree upon, were inquiry to be pursued as far as it could fruitfully go. In this book, Misak argues for and elucidates the pragmatic account of truth, paying attention both to Peirce's texts and to the requirements of a suitable account of truth. An important argument of the book is that we must be sensitive to the difference between offering a definition of truth and engaging in a (...) distinctively pragmatic project. The pragmatic project spells out the relationship between truth and inquiry; it articulates the consequences of a statement's being true. The existence of a distinct pragmatic enterprise has implications for the status of the pragmatic account of truth and for the way in which philosophy should be conducted. (shrink)

Abstract: Some first person statements, such as ‘I am in pain’, are thought to be immune to error through misidentification (IEM): I cannot be wrong that I am in pain because—while I know that someone is in pain—I have mistaken that person for myself. While IEM is typically associated with the self-ascription of psychological properties, some philosophers attempt to draw anti-Cartesian conclusions from the claim that certain physical self-ascriptions are also IEM. In this paper, I will examine whether some physical (...) self-ascriptions are in fact IEM, and—if they are—what role that fact is supposed to play in arguments for the anti-Cartesian claim that self-consciousness is consciousness of oneself as a material object. I will argue that if we accept the assumptions required to show that physical self-ascriptions are IEM, then IEM cannot play the role it needs to play in these anti-Cartesian arguments. (shrink)