Background: Little is known about what factors may contribute to the growth of a consultation service or how a practice may change or evolve across time. Methods: This study examines data collected from a busy ethics consultation service over a period of more than two decades. Results: We report a number of longitudinal findings that represent significant growth in the volume of ethics consultation requests from 19 in 1990 to 551 in 2013, as well as important changes in the patient (...) population for which ethics help is requested. The findings include (1) a steady growth in requests from primary care providers (e.g., physicians and nurses), as well as increases in ancillary services (e.g., social workers); (2) a decrease in length of stay (days) before ethics help is requested; (3) an increase in the reasons that individuals ask for help from ethics; (4) an upsurge in consults requests from areas outside the intensive care unit (ICU); (5) a decrease in patients that died during hospitalization (e.g., live discharges); and (6) growth in the numbers of patients lacking decision-making capacity. Conclusions: We believe the increases in consult requests reflect appropriate and necessary growth because recent consultations have also been associated with consultations requiring (7) additional interventions and (8) reasonably high time intensity scores. (shrink)

Altruism is a deep and complex phenomenon that is analysed by scholars of various disciplines, including psychology, philosophy, biology, evolutionary anthropology and experimental economics. Much confusion arises in current literature because the term altruism covers variable concepts and processes across disciplines. Here we investigate the sense given to altruism when used in different fields and argumentative contexts. We argue that four distinct but related concepts need to be distinguished: (a) psychological altruism , the genuine motivation to improve others’ interests and (...) welfare; (b) reproductive altruism , which involves increasing others’ chances of survival and reproduction at the actor’s expense; (c) behavioural altruism , which involves bearing some cost in the interest of others; and (d) preference altruism , which is a preference for others’ interests. We show how this conceptual clarification permits the identification of overstated claims that stem from an imprecise use of terminology. Distinguishing these four types of altruism will help to solve rhetorical conflicts that currently undermine the interdisciplinary debate about human altruism. (shrink)

Organizations have long struggled to find ways to reduce the occurrence of unethical behaviors by employees. Unfortunately, time theft, a common and costly form of ethical misconduct at work, has been understudied by ethics researchers. In order to remedy this gap in the literature, we used the theory of planned behavior (TPB) to investigate the antecedents of time theft, which includes behaviors such as arriving later to or leaving earlier from work than scheduled, taking additional or longer breaks than is (...) acceptable, and on-the-job daydreaming. We surveyed 135 employed undergraduate business students regarding the TPB variables at Time 1. Two months later, participants reported the frequency they engaged in time theft since Time 1. Results indicate that behavioral, normative, and control beliefs significantly predicted attitudes, subjective norms, and perceived behavioral control, respectively. Attitudes, subjective norms, and perceived behavioral control, in turn, were significantly related to time theft intentions, which predicted later enactment of time theft. Thus, employers can decrease time theft by primarily focusing on altering employees’ attitudes toward time theft, followed by reducing social pressures to engage in it, and lastly, by implementing organizational practices that make it difficult to commit time theft. (shrink)

... View (i) The Thesis of Essential Contestedness The view that freedom and other ideals such as justice are essentially contested is important, ...

In this paper, I set an aspect of what it is to live a flourishing life against the backdrop of neo liberal trends that continue to influence educational policy across the globe. The view I set out is in sharp contrast to any narrow assumption that education’s main task is the measurement of high performing individuals who will thus contribute to an economically viable society. Instead, I explore and argue for a conception of what constitutes a flourishing life that is (...) embedded in a more pragmatist analysis of what education may be. The argument begins with developing the centrality of embodiment to aesthetic sensibility and goes on to suggest how collective understanding of this within a community could constitute a sense of performance and thus contribute to the educational aim of developing a full and flourishing life. The argument is that this way of seeing life could have implications for educational practice, the role of the teacher and could help to reconfigure how education is experienced by the young. (shrink)

The way in which one understands information and concepts, and the way a student works to develop this, is an individual aspect of learning that cannot be universally defined as (at least manifested) the same for everyone. ‘Understanding’ is a broad term, and the way one achieves understanding is dependent on the way that material is presented. In this article, we argue that the philosophy of science can be important to nursing education—in particular, by showing that the way we imbue (...) understanding might depend on the meaning of ‘understanding’. Diagrams and concept maps are meant to guide newly formed knowledge and connections to develop proper thinking (e.g., the order in which nursing students must prioritize data) that a student requires in the field. We argue that whether or not an image/diagram/concept map confers understanding will depend on both what the object is and what we mean by ‘understanding’. (shrink)

In this commentary, we discuss Tom Cochrane’s theory of emotions. Cochrane offers an appealingly unified account of valent representations, ranging from simple responses to complex representations within a mechanistic framework. This offers some guidance as to how we might conceive of emotions as simple action-guiding responses in infants and animals, as well as context-sensitive evaluative states. While Cochrane argues for the centrality of bodily feelings, he does not consider his approach to be embodied in the narrower sense. We question his (...) reasons and suggest to think of emotions as embodied action-oriented representations. We, furthermore, suggest developing the approach with regard to the multiple roles that social norms play, and delve further into the nuanced relationship between bodily self-regulation and the formative influence of social norms on emotions. (shrink)

There has been considerable debate around the ethical issues raised by data-driven technologies such as artificial intelligence. Ethical principles for the field have focused on the need to ensure...

Feedback such as backchannels and clarification requests often occurs subsententially, demonstrating the incremental nature of grounding in dialogue. However, although such feedback can occur at any point within an utterance, it typically does not do so, tending to occur at Feedback Relevance Spaces. We present a corpus study of acknowledgements and clarification requests in British English, and describe how our low-level, semantic processing model in Dynamic Syntax accounts for this feedback. The model trivially accounts for the 85% of cases where (...) feedback occurs at FRSs, but we also describe how it can be integrated or interpreted at non-FRSs using the predictive, incremental and interactive nature of the formalism. This model shows how feedback serves to continually realign processing contexts and thus manage the characteristic divergence and convergence that is key to moving dialogue forward. (shrink)

Background The allocation of any scarce health care resource, especially a lifesaving resource, can create profound ethical and legal challenges. Liver transplant allocation currently is based upon urgency, a sickest-first approach, and does not utilize capacity to benefit. While urgency can be described reasonably well with the MELD system, benefit encompasses multiple dimensions of patients’ well-being. Currently, the balance between both principles is ill-defined. Methods This survey with 502 participants examines how urgency and benefit are weighted by different stakeholders. Results (...) Liver transplant patients favored the sickest-first allocation, although all other groups tended to favor benefit. Criteria of a successful transplantation were a minimum survival of at least 1 year and recovery of functional status to being ambulatory and capable of all self-care. An individual delisting decision was accepted when the 1-year survival probability would fall below 50%. Benefit was found to be a critical variable that may also trigger the willingness to donate organs. Conclusions The strong interest of stakeholder for successful liver transplants is inadequately translated into current allocation rules. (shrink)

On admet en général qu’il y a deux sortes de concepts normatifs : les concepts évaluatifs, comme bon, et les concepts déontiques, comme devoir. La question que soulève cette distinction est celle de savoir comment il est possible d’affirmer que les concepts évaluatifs sont normatifs. En effet, comme les concepts déontiques semblent constituer le coeur du domaine normatif, plus le fossé entre les deux sortes de concepts est grand, moins il paraîtra plausible d’affirmer que les concepts évaluatifs sont normatifs. Après (...) avoir présenté les différences principales entre les concepts évaluatifs et les concepts déontiques, et montré qu’il y a plus qu’une différence superficielle entre les deux sortes de concepts, j’examinerai la question de la normativité des concepts évaluatifs. Il deviendra apparent que même s’il s’agit de concepts ayant des fonctions différentes, il existe un grand nombre de relations entre les concepts évaluatifs, d’une part, et les concepts de devoir et de raison, d’autre part.It is generally accepted that there are two sorts of normative concepts : evaluative concepts, such as good, and deontic concepts, such as ought. The question that is raised by this distinction is how it is possible to claim that evaluative concepts are normative. As deontic concepts appear to be at the heart of normativity, the more there is a gap between evaluative and deontic concepts, the less it appears plausible to say that evaluative concepts are normative. After having presented the main differences between evaluative and deontic concepts, and shown that there is more than a superficial difference between the two sorts of concepts, the paper turns to the question of the normativitity of evaluative concepts. It will become clear that even if these concepts have different functions, there are a great many ties between evaluative concepts, on the one hand, and the concepts of ought and of reason, on the other hand. (shrink)

Cet article, adossé à un cas clinique, propose une réflexion sur la dimension traumatique à l’adolescence en analysant la problématique de l’intrus persécuteur et la problématique transgénérationnelle. L’adolescent manifeste une dynamique de survie psychique par des symptômes somatiques, des conduites phobosociales et une hypersensibilité narcissique. La différenciation et la séparation-individuation d’avec l’objet interne intruseur sont également apparues dans le travail psychique engagé dans les entretiens familiaux.

This chapter argues that the standard epistemological requirements of impartiality on the part of the knower, and passivity on the part of the thing under investigation, exclude from the purview of epistemology a very important kind of knowledge, namely: knowledge of persons. Feminist philosophers have focused on problems in explaining knowledge of other persons, but the same considerations require a reorientation in the way we think of knowledge of oneself. Because of the subjectivity of the knower and reflexive nature of (...) the investigation involving self-knowledge, one's inquiry is affected in a way that challenges the accuracy of what is learned. The chapter's response is to treat the procedural methods used to obtain knowledge of oneself as continuous with the methods of acquiring knowledge of other persons via knowing their moral and cognitive characters. It highlights the intersection between virtue ethics and virtue epistemology. (shrink)

Concerns about the influence of financial interests on research have increased, along with research dollars from pharmaceutical and other for-profit companies. Researchers’ financial ties to industry sponsors of research have also increased. Financial interests in biomedical research could influence research design, conduct, or reporting, and could compromise data integrity, participant safety, or both. Investigators’ financial ties with for-profit companies may influence reported scientific results, and may have compromised research participant safety.Disclosure is one commonly accepted method of managing financial relationships in (...) order to minimize possible threats to scientific objectivity, the safety of research participants, or public trust in the integrity of clinical research. Disclosure is presumed useful to the extent that “it gives those who would be affected, or who are otherwise in a good position to assess the risks, information they need to make their own decision.”. (shrink)

Le Laboratoire d’ANalyse Cognitive de l’Information (LANCI) effectue des recherches sur le traitement cognitif de l’information. La recherche fondamentale porte sur les multiples conceptions de l’information. Elle s’intéresse plus particulièrement aux modèles cognitifs de la classification et de la catégorisation, tant dans une perspective symbolique que connexionniste. La recherche appliquée explore les technologies informatiques qui manipulent l’information. Le territoire privilégié est celui du texte. La recherche est de nature interdisciplinaire. Elle en appelle à la philosophie, à l’informatique, à la linguistique (...) et à la psychologie. Volume 6, Numéro 2007-02 – Août 2007 Publication du Laboratoire d’ANalyse Cognitive de l’Information Directeurs : Luc Faucher, Jean-Guy Meunier, Serge Robert et Pierre Poirier Université du Québec à Montréal Document disponible en ligne à l’adresse suivante : www.lanci.uqam.ca Tirage : 5 exemplaires Aucune partie de cette publication ne peut être conservée dans un système de recherche documentaire, traduite ou reproduite sous quelque forme que ce soit - imprimé, procédé photomécanique, microfilm, microfiche ou tout autre moyen - sans la permission écrite de l’éditeur. Tous droits réservés pour tous pays. / All rights reserved. No part of this publication covered by the copyrights hereon may be reproduced or used in any form or by any means - graphic, electronic or mechanical - without the prior written permission of the publisher. Dépôt légal – Bibliothèque Nationale du Canada Dépôt légal – Bibliothèque Nationale du Québec.. (shrink)

The recent increased prevalence of diseases related to unhealthy lifestyles raises difficulties for healthcare insurance systems traditionally based on the principles of risk-management, solidarity, and selective altruism: since these diseases are, to some extent, predictable and avoidable, patients seem to bear some responsibility for their condition and may not deserve full access to social medical services. Here, we investigate with objective criteria to what extent it is warranted to hold patients responsible for their illness and to sanction them accordingly. We (...) ground our analysis on a series of minimal conditions for ‘practical’ and for ‘moral’ responsibility attribution. By applying these criteria consistently, we highlight that individual responsibility applies to risk-taking life choices rather than stigmatized sickness. We explain that responsibility is a matter of degree, that it varies across life-history, and can be affected by factors beyond the patients’ grasp. We point out that scientific knowledge about the effect of these factors generates responsibilities for other parties such as public health agencies and private industry. The upshot of our analysis is that health policies targeting the ‘liable’ undeserving sick are mostly unwarranted, and tend to increase unequal treatment of already vulnerable groups: the unlucky sick. (shrink)

In organizational psychology the positive effects of democratically structured enterprises on their employees are well documented. However, the longstanding viability as well as economic success of democratic enterprises in a capitalistic market environment has long been contested. For instance, this has given rise to widespread endorsement of the “degeneration thesis” and the so-called “iron law of oligarchy”. By reviewing 77 qualitative studies that examined 83 democratic enterprises within the last 50 years, the present systematic review provides evidence that such enterprises (...) are able to economically survive and prosper. The majority of studied enterprises either resisted pressures toward degeneration or subsequently regenerated after undergoing degenerative processes. Only 9.5% fully degenerated in accordance with the degeneration thesis and the “iron law of oligarchy”, while 27.0% of the democratic enterprises showed diverse and mixed forms of degeneration tendencies, indicating that the notion of an “iron law” needs to be revised. Within the nine investigated cases of Mondragon not one single enterprise or group fully degenerated. Three cases showed degenerative tendencies, another three one degeneration tendencies and simultaneously regeneration, one case fully resisted degeneration tendencies and two cases regenerated. Further, this systematic review provides an overview of organizational and external conditions, non-/democratic or non-/participative practices and psychological phenomena that contribute to the degeneration, regeneration, or resistance to degeneration. The described examples of such practices may help practitioners to implement and maintain democratic structures and processes in contemporary organizations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Experiences of an Obese PatientChristine R. BrassIn the middle of an annual pelvic exam, the gynecologist said to me, “You should apply to be on ‘The Biggest Loser.’” I was too stunned and embarrassed to mutter anything more than a [End Page 88] comment that I didn’t think that, being quite introverted, I was a good candidate for a reality TV show. She argued with me about that. I (...) felt blindsided, intensely vulnerable, and dumbstruck—completely unable to respond—and later, when the shock wore off, incandescent with impotent rage.Four years later, I still don’t have words to adequately describe my outrage at this comment. It was only the second time I’d see this medical professional. The first time was the previous year, when she had been filling in for my regular doctor who was on maternity leave. At neither appointment did this physician ask me any questions about my lifestyle, whether or not I saw a primary care physician, or even if I had any concerns that day. She was very brisk, efficient and did not engage in conversation. Such a statement coming from a health care provider, who did not seek to understand or gather more information, surprised and dismayed me.Other incidents where physicians’ statements were not helpful:• Pediatrician: “Well, my wife has had great success with Weight Watchers.”—I was age 12, about 5’5 and weighted about 145 lbs. at that time. If you look at photos of me at the time, you would see I was not overweight.• Orthopedic Surgeon: “If you want her to look better, make her lose weight.”—This was directed to my mother. I was 19, weighed about 200 lbs., and in his office as per his directions to come back in seven years to see if the surgery he had done on my neck needed more attention.• Internist: “How did you get all those stretch marks?”—I was age 24, weighed approximately 220 lbs., and had lost and gained 50 or so pounds several times as a teenager and in college.• Gynecologist: “Lose weight and your periods will be regular.”—I was age 27, weighed 227 lbs. and my periods, which started at age 15, had never been regular.• Another Orthopedic Surgeon: “You don’t have to worry about osteoporosis; everything you do is a weight–bearing exercise.”—I was age 42 and weighed 300 lbs. This was after follow up surgery to remove pins from a broken ankle that had healed and I had asked about whether or not I should have a bone density test.Coming from a genetic heritage of predominately tall, large–boned people, I was tall and proportionally large compared to other girls my age until high school, when the others caught up. I was told I had to “watch my weight” by family members from my pre–teen years. Enforced dieting ensued, with little result because I wasn’t fat. I did not begin to be overweight until my junior and senior years of high school. I was 5’7” when I graduated from high school and weighed 187. By the time I graduated from college, I was no taller but 50 lbs. heavier. Now, nearing my 40th high school reunion, I am 120 lbs heavier than that. During the intervening years, I have done Weight Watchers®, TOPS®, medically–supervised programs (group and individual), and other popular diets, with periodic but temporary success, and hypnosis and aversion therapy, with no success at all.Over the years, I have been insulted, verbally abused, even bullied, because of my weight. I have been treated as though I am invisible, worthless, and stupid—a pariah. As a result, I have felt invisible, worthless, and stupid, even though I know I am none of those things. I have experienced and been treated for clinical depression. The descent into depression began in my late teen years, which was the time when I started gaining excess weight.In 2004, under medical supervision, I lost 70 lbs. over four–month period. I was delighted to finally lose a substantial amount of weight and feel physical lighter. My diabetes medications were significantly reduced, and... (shrink)

The aim of this study was to elucidate municipal night registered nurses’ (RNs) experiences of the meaning of caring in nursing. The research context involved all night duty RNs working in municipal care of older people in a medium-sized municipality located in central Sweden. The meaning of caring in nursing was experienced as: caring for by advocacy, superior responsibility in caring, and consultative nursing service. The municipal night RNs’ experience of caring is interpreted as meanings in paradoxes: ‘being close at (...) distance’, the condition of ‘being responsible with insignificant control’, and ‘being interdependently independent’. The RNs’ experience of the meaning of caring involves focusing on the care recipient by advocating their perspectives. The meaning of caring in this context is an endeavour to grasp an overall caring responsibility by responding to vocational and personal demands regarding the issue of being a RN, in guaranteeing ethical, qualitative and competent care for older people. (shrink)

Christine Jean Thomas - Plato's Introduction of Forms - Journal of the History of Philosophy 45:3 Journal of the History of Philosophy 45.3 485-486 Muse Search Journals This Journal Contents Reviewed by Christine J. Thomas Dartmouth College R. M. Dancy. Plato's Introduction of Forms. Cambridge-New York: Cambridge University Press, 2004. Pp. xii + 348. Cloth, $75.00. Russell Dancy's recent book could easily bear the title, 'A Socratic Theory of Definition'. The first two-thirds of the text extract and examine (...) various tenets of a "theory of definition" operative in a variety of Socratic dialogues. The bulk of the theory is captured in three conditions on adequacy for a definition : the definiens must be substitutable salve veritate for the definiendum; the.. (shrink)

In this paper I examine Peirce's epistemological and ontological theories and indicate their relevance to educational practice. I argue that Peirces conception of Firsts, Seconds and Thirds entails a fundamental ontological realism. I further argue that Peirce does have a theory of truth, that it is a particular non‐traditional ‘correspondence’ theory, consistent with, and implicit in, an over‐arching position of pragmatic realism. Peirce's epistemological position is subject to misinterpretation when the ontological realism on which it rests is overlooked. Finally I (...) suggest that such a re‐consideration of Peirce's pragmatic ontology and epistemology in an educational context is needed. (shrink)

La bioéthique est à la mode. Il faut " être pour "! La prochaine étude par le législateur français des lois " bioéthiques " en témoigne. Avortement, fabrication d'enfants " prêts-à-porter ", recherche biomédicale, clonage, génétique, rien n'échappe à la bioéthique. Et si, cheval de Troie pénétrant le droit, la morale, les déontologies, elle ne constituait qu'une habile machine de subversion des sciences médicales, d'appropriation globale de l'être humain. Des médecins, des philosophes, parlementaires, juristes engagés dans l'examen des doctrines et (...) mécanismes bioéthiques se sont posés la question. Leur réponse n'est vraiment pas celle du " consensus ". Elle impose au public savant et aux gens prétendus ordinaires et à leurs représentants dans la Cité, une réflexion, un retour vers une nouvelle liberté de penser. (shrink)

This chapter argues that Hume's views on the nature and sources of virtue are pluralistic. He has a pluralistic account of the sources of the moral sentiment, the taxonomy of virtue, and most importantly, the criteria of virtue. The chapter also argues that his views are neither utilitarian in particular nor consequentialist in general, but comprise overlooked but significant non‐consequentialist features, gleaned particularly from Book II of the Treatise (Of the Passions), and which are characteristic of virtue ethics in general. (...) It is devoted to investigating the status of (C2) as an independent criterion of virtue. The chapter discusses three broad categories of “species” or “appearance” which make a trait “naturally fitted” to be regarded as a virtue. Discussions also include indirect passion of pride. The connection between love of truth and hope for success brings us to the virtue cluster associated with the direct passion of hope. (shrink)

This paper is concerned with events that were the subject of an inquest into the deaths of 12 children who died while undergoing or shortly after having undergone cardiac surgery at the Winnipeg Health Sciences Centre, Manitoba, Canada, during 1994. A notable finding of the Sinclair Inquest was that nurses involved with the pediatric cardiac surgery program were concerned about the competence of the surgeon and made sustained efforts throughout 1994 to have these concerns addressed. That the nurses’ concerns were (...) not taken seriously is the central problem of this paper. Essentially, the position articulated is that gendered and gendering discourses constituted a form of power that structured the field of nurses’ possible actions. These discourses constituted a resource to make nurses knowable, to produce them as certain forms of the person, and were therefore part of what governed nurses everyday conduct. Though neither simply good nor bad in themselves, in this case, these discourses had constraining effects on how nurses were able to conduct themselves. (shrink)

This paper starts off from what seems to be a difficulty of ethics in African Business today. For several years now Transparency International has placed some African countries high on its list of most corrupt countries of the world. The conclusion one draws from this assessment is that either African culture has no regard or concern for ethics, or that there has been a gradual loss of the concept of the ethical and the moral in contemporary African society. Equally problematic (...) is the teaching and promotion of Business ethics in organizations. Western philosophical theories and systems alone have not succeeded in providing access to ethical life of people in modern Africa. This paper is an attempt to inject an orientation that takes into account African manners and customs, their religious convictions and their understanding of the world as a whole, in the teaching of Business Ethics. East and Central Africa have been selected due to their common lingua franca, Kiswahili, and the fact that the author has more teaching experience within that region. (shrink)

Cette étude prolonge des considérations sur la musique nées sous l'impulsion des mutations touchant le fait musical et les sciences sociales.

This work is a thought experiment in re-interpreting the virtue of li or ritual/propriety for the contemporary, multi-cultural, world. Using Zhuangzi, the Lunyu, and Zhongyong as my primary points of departure, I re-interpret the Confucian ideas of hierarchy in terms of the Daoist conception of harmony. Many scholars today argue that Confucianism has a relational ontology, yet at the same time, we find that Confucian values can and do lead to rigid and harmful traditions that have historically oppressed marginalized groups (...) like women. As such, I re-imagine what li might look like if we take relational ontology seriously, Drawing from Zhuangzi, I argue that Confucian harmony and order do not necessarily arise out of hierarchy, and that harmony, the most primary goal of li and of the Confucian project, can be best attained through propriety that is influenced by Daoism and feminist values such as equality. (shrink)

This article aims to show how the traditions of ethical reasoning and policy-making shape stem cell research in Britain. To do so I give a detailed account of the earlier developments of regulations on embryo research and the specific scientific advances made in Britain. The subsequent regulation of stem cell research was largely predetermined by those structures and the different and partly opposing orientations of a utilitarian approach to policies on biomedicine. The setting up of the first stem cell bank (...) and the directing of public funding into not only bioethical but also sociological guidance of the development of the new science field are aspects of the particular British way of supporting stem cell research. However, there is also an ongoing philosophical and juridical debate on the possible erosion of fundamental values caused by incremental regulatory weakening. Although I am highly sympathetic to the critical position that there is a need for a metaphysical anchor to secure individual human rights, one has to admit that the British mode of handling the inevitable ethical problems we face with biomedical progress is rather successful in terms of securing some of the basic needs and values of a modern democratic society. (shrink)